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Updated: Jan 31, 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

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Polysomnography outcomes in children with small tonsils undergoing drug-induced sleep endoscopy-directed surgery

Craig Miller1,2,3,4, Erin Kirkham1,2,3,4, Cheng-Cheng Ma3,4

  • 1Department of Otolaryngology-Head and Neck Surgery, Seattle, Washington.

The Laryngoscope
|December 22, 2018
PubMed

Insights

Drug-induced sleep endoscopy (DISE) helps guide surgery for children with small tonsils and sleep apnea. DISE-directed procedures significantly improved the apnea-hypopnea index (AHI), with supraglottoplasty being the most common intervention.

Area of Science:

  • Pediatric Otolaryngology
  • Sleep Medicine
  • Surgical Innovation

Background:

  • Optimal surgical treatment for pediatric sleep apnea with small tonsils remains unclear.
  • Drug-induced sleep endoscopy (DISE) shows promise in tailoring surgical interventions.
  • Small tonsils present unique challenges in diagnosing and treating sleep-disordered breathing.

Purpose of the Study:

  • To evaluate the effectiveness of DISE-directed surgery in improving polysomnography (PSG) measures for children with small tonsils.
  • To identify the most frequent surgical procedure performed under DISE guidance in this population.
  • To test the hypothesis that DISE-directed surgery improves PSG outcomes in pediatric patients with small tonsils.

Main Methods:

  • Retrospective chart review of pediatric patients undergoing DISE over a 6-year period.
  • Inclusion criteria: 1+ tonsils, pre- and post-operative PSG; Exclusion criteria: prior tonsillectomy, tonsil score 2+.
  • Paired t-tests were used to compare pre- and postoperative PSG parameters.

Main Results:

  • The study included children with an average age of 7 years.
  • Supraglottoplasty was the most common DISE-directed intervention (n=23).
  • Significant improvement in mean apnea-hypopnea index (AHI) from 14.4 to 8.0 (P=.02); other parameters showed non-significant trends.

Conclusions:

  • DISE-directed surgery effectively improves AHI in pediatric patients with small tonsils.
  • Supraglottoplasty is the predominant surgery in this cohort, often addressing supraglottic collapse.
  • DISE is valuable for assessing airway collapse, particularly supraglottic, which is difficult to evaluate in awake children.
Abstract

Keywords:
Obstructive sleep apneadrug induced sleep endoscopypediatricspolysomnographysleep disordered breathing

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