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Updated: Mar 29, 2026
Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Drug-induced sleep-endoscopy in children's sleep related breathing disorders
Eduard Esteller1, Demetrio Mulas2, Raúl Haspert2
1Servicio de Otorrinolaringología, Hospital General de Catalunya y Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, España.
Insights
Drug-induced sedation endoscopy effectively identifies upper airway obstruction in children with sleep apnea. This technique aids in surgical planning for persistent or complex cases, improving treatment outcomes.
Area of Science:
- Otolaryngology
- Pediatric Sleep Medicine
- Anesthesiology
Background:
- Obstructive sleep apnea (OSA) is common in children.
- Drug-induced sedation endoscopy (DISE) is a valuable tool for assessing upper airway obstruction in pediatric OSA.
- ENT departments can integrate DISE into their practice for surgical planning.
Purpose of the Study:
- To evaluate the experience of an ENT department using DISE in children undergoing sleep apnea surgery.
- To identify common sites of airway obstruction in pediatric OSA patients.
Main Methods:
- A retrospective study of 56 children (2-12 years) with OSA.
- Polysomnography (PSG) data and Apnea-Hypopnea Index (AHI) were analyzed.
- DISE was performed in the operating room, with obstruction sites classified using the Chan classification.
Main Results:
- In residual OSA cases, oropharyngeal lateral walls (70%) and turbinates (70%) were most affected, treated with tonsillectomy and turbinate reduction.
- In clinical disproportion cases, oropharyngeal lateral walls (93.3%) and adenoids (66.6%) were primary sites, treated with adenoidectomy and tonsillotomy.
Conclusions:
- DISE is easily incorporated into clinical practice for pediatric OSA.
- DISE is particularly useful for children with residual OSA or suspected causes beyond adenotonsillar hypertrophy.
Introduction:
Drug-induced sedation endoscopy is a valid tool to assess site obstruction of the upper airway responsible for children's obstructive Sleep Apnea The aim is to show the experience of an ENT department with Drug-induced sedation endoscopy in children selected for sleep apnea surgery
Methods:
Includes 56 cases between 2 and 12 years old (mean age: 59,13±27,29 months) presenting at the Otorhinolaryngology consultation clinic with snoring and apnea. Prior polysomnography had been practiced and mean AHI was 6,32±8,71. The distribution of cases was 10 persistent sleep apnea (17.85%), 15 clinical disproportion (26.78%) and 31 conventional (55.35%). All sleep endoscopies were performed in the operating room and Chan classification was used to assess the areas of collapse.
Results:
In cases of residual disease the most affected regions were the side walls of the oropharynx (70%) and turbinate (70%) and the most frequently applied surgery was total tonsillectomy followed by second tongue tonsil reduction and turbinate radiofrequency. In clinical cases of desproportion, the most affected regions were the oropharyngeal side walls (93.3%) and adenoids (66.6%). The most frequently applied surgery in this group was adenoidectomy and radiofrequency tonsillotomy.
Conclusion:
Drug-induced sedation endoscopy is a technique that can be incorporated easily into medical practice, mostly in children with residual sleep apnea syndrome or those suspected to have some cause other than adenotonsillar hypertrophy.
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