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

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A case-control study of Drug-Induced Sleep Endoscopy (DISE) in pediatric population: A proposal for indications

Maria Antonietta Collu1, Eduard Esteller2, Fiorella Lipari3

  • 1Otorhinolaryngology Department, Cliniche Universitarie, Sassari, Italy.

International Journal of Pediatric Otorhinolaryngology
|April 2, 2018
PubMed

Insights

Drug-Induced Sleep Endoscopy (DISE) significantly alters treatment plans for pediatric Obstructive Sleep Apnoea Syndrome (OSAS), especially in non-conventional and persistent cases. This diagnostic tool is crucial for tailoring interventions beyond standard procedures.

Area of Science:

  • Pediatric Otolaryngology
  • Sleep Medicine
  • Diagnostic Endoscopy

Background:

  • Obstructive Sleep Apnoea Syndrome (OSAS) is a common condition in children.
  • Standard diagnostic methods for pediatric OSAS include history, questionnaires, physical exams, and polysomnography.
  • The role of Drug-Induced Sleep Endoscopy (DISE) in refining diagnosis and treatment for pediatric OSAS requires further elucidation.

Purpose of the Study:

  • To determine if and when Drug-Induced Sleep Endoscopy (DISE) changes the diagnosis and treatment plan for pediatric Obstructive Sleep Apnoea Syndrome (OSAS).
  • To identify specific pediatric OSAS patient subgroups who would benefit most from undergoing DISE.
  • To evaluate the impact of DISE on surgical planning beyond standard tonsillectomy and adenoidectomy (T&A).

Main Methods:

  • A case-control study involving 150 children diagnosed with OSAS undergoing DISE.
  • Patients were categorized into conventional, disproportional, and persistent OSAS subgroups based on clinical and polysomnography criteria.
  • Surgical plans were modified if DISE findings led to interventions other than T&A, with outcomes compared between cases and controls.

Main Results:

  • DISE altered surgical plans in 4.5% of conventional OSAS, 17.5% of disproportional OSAS, and 72.7% of persistent OSAS cases (p < 0.005).
  • A change in treatment plan due to DISE was significantly associated with a non-conventional OSAS status (OR = 6).
  • The persistent OSAS subgroup showed the highest rate of DISE-guided treatment modification.

Conclusions:

  • Drug-Induced Sleep Endoscopy (DISE) is a safe and valuable procedure for pediatric OSAS patients.
  • DISE is particularly recommended for non-syndromic pediatric OSAS patients with non-conventional or persistent disease patterns.
  • The findings support considering DISE in a broader range of pediatric OSAS cases beyond those previously identified.
Abstract

Keywords:
AdenotonsillectomyChildrenDecision-makingDrug induced sleep endoscopyObstructive sleep apnoea syndromeUpper airway

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