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Updated: May 11, 2026

Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
07:54

Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea

Published on: December 6, 2016

[Nasal obstruction and mouth breathing: the ENT's point of view]

Nicolas Leboulanger

    L' Orthodontie Francaise
    |May 31, 2013
    PubMed

    Insights

    Pediatric upper airway obstruction, often from enlarged tonsils and adenoids, requires surgery only when clinically significant. Hypertrophy without obstruction or symptoms, even with snoring, is not an indication for adenotonsillectomy.

    Area of Science:

    • Pediatric Otolaryngology
    • Sleep Medicine

    Background:

    • Obstructive diseases of children's upper airways are common.
    • Enlarged tonsils and adenoids are frequent causes of obstruction.
    • Other contributing factors include nasal septum deviation and turbinate hypertrophy.

    Purpose of the Study:

    • To define the indications for tonsillectomy and adenoidectomy in children.
    • To differentiate between hypertrophy requiring intervention and that which does not.

    Main Methods:

    • Clinical evaluation of airway obstruction.
    • Documentation of obstruction via sleep studies when necessary.

    Main Results:

    • Tonsillectomy and adenoidectomy are indicated for clinically significant airway obstruction.
    • Hypertrophy without significant obstruction or symptoms does not warrant surgery.

    Conclusions:

    • Surgical intervention for tonsil and adenoid hypertrophy in children should be based on documented clinical obstruction.
    • Snoring or planned orthodontic treatment alone are insufficient indications for adenotonsillectomy.

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