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Updated: May 14, 2026
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Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Obstructive sleep apnea due to extrathoracic tracheomalacia
Hiren Muzumdar1, K Nandalike, J Bent
1Pediatric Respiratory and Sleep Medicine, Children's Hospital at Montefiore, Bronx, NY 10467, USA. hmuzumda@montefiore.org
Summary
A metallic stent resolved obstructive sleep apnea in a child with tracheomalacia after tracheotomy. Polysomnography aided in managing the tracheostomy decannulation process.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Otolaryngology
Background:
- Obstructive sleep apnea (OSA) is a common condition in children, often linked to upper airway abnormalities.
- Tracheomalacia, a condition characterized by the collapse of the trachea, can be a complication of tracheotomy.
- Tracheotomy is a surgical procedure to create an opening in the neck into the trachea.
Observation:
- A 3-year-old boy presented with obstructive sleep apnea.
- The patient had a history of tracheomalacia secondary to a tracheotomy.
- The airway obstruction was identified in the trachea during sleep.
Findings:
- Placement of a metallic stent in the tracheomalacia region successfully resolved the obstructive sleep apnea.
- The location of the tracheal obstruction during sleep was unusual, differing from typical pharyngeal or laryngeal sites.
- Polysomnography proved valuable in assessing and managing the decannulation of the tracheostomy.
Implications:
- Metallic stents can be an effective treatment for tracheomalacia-induced obstructive sleep apnea in pediatric patients.
- This case highlights the importance of considering tracheal obstruction in sleep apnea evaluations, especially in patients with a history of tracheotomy.
- Polysomnography is a critical tool for guiding tracheostomy management and decannulation decisions in complex pediatric airway cases.
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