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Updated: Apr 26, 2026
Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
[The impact of sleep endoscopy for obstructive sleep-disordered breathing in children and adolescents]
M Quante1, A Merkenschlager1, W Kiess1
1Klinik und Poliklinik für Kinder und Jugendmedizin, Universitätsklinikum Leipzig AöR, Leipzig.
Insights
Drug-induced sleep endoscopy (DISE) helps identify airway obstruction sites in children with obstructive sleep apnea syndrome (OSAS). This method influences treatment decisions for pediatric OSAS.
Area of Science:
- Pediatric Otolaryngology
- Sleep Medicine
- Diagnostic Endoscopy
Context:
- Obstructive sleep apnea syndrome (OSAS) significantly impacts children's health.
- Surgical outcomes in adult OSAS improve with targeted therapy guided by DISE.
- Limited research exists on DISE's application in pediatric populations.
Purpose:
- To evaluate the impact of drug-induced sleep endoscopy (DISE) in children with obstructive sleep-disordered breathing.
- To determine how DISE influences treatment recommendations for pediatric OSAS.
- To identify specific sites of airway obstruction in children undergoing DISE.
Summary:
- A retrospective review of 25 children with OSAS who underwent polysomnography and DISE was conducted.
- The oropharynx was the most frequent site of obstruction, particularly in moderate to severe OSAS cases.
- DISE led to a change in the initial management plan for 20% of the pediatric patients.
Impact:
- DISE is a valuable tool for pinpointing obstruction sites in pediatric OSAS.
- The findings suggest DISE can guide more precise treatment strategies for children with OSAS.
- Further research is warranted to explore DISE's predictive capabilities for persistent pediatric OSAS.
Objective:
Studies on the surgical treatment of OSAS in adults have shown an improved outcome after targeted therapy by drug-induced sleep endoscopy (DISE). So far, only a few studies have focused on this method in children. The aim of this study is to evaluate the impact of DISE for children with obstructive sleep-disordered breathing and to determine the influence of DISE on treatment recommendations.
Subjects And Methods:
The medical records of children (n=25) who underwent polysomnography and DISE between 05/2012 and 12/2013 were retrospectively reviewed. The subjects were divided into an UARS (upper airway resistance syndrome)/mild OSAS group (AHI<5; n=10) and a moderate/severe OSAS group (AHI≥5; n=15).
Results:
The oropharynx was the most common site of obstruction. Prevalence of complete obstruction at the oropharynx was significantly higher in moderate or severe OSAS (p=0.02). The obstruction pattern of the velopharynx was significantly associated with the size of the adenoids (p=0.02), but tonsil and adenoid size were not related to the severity of OSAS. 71% of children with grade IV tonsils showed complete obstruction of the oropharynx. After DISE, the initial management plan changed in 5 patients (20%).
Conclusion:
DISE is a promising technique to identify sites of obstruction in children with OSAS and to guide treatment decisions. Further studies are needed to predict persistent OSAS based on this tool.
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