Related Experiment Video

Updated: Jan 28, 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

20.6K

Drug-induced sleep endoscopy-directed adenotonsillectomy in pediatric obstructive sleep apnea with small tonsils

Jie Chen1, Shan He1

  • 1Department of Otolaryngology, Shanghai Children's Medical Center Affiliated with Shanghai Jiaotong University School of Medicine, Shanghai, China.

Plos One
|February 23, 2019
PubMed

Insights

Drug-induced sleep endoscopy (DISE) helps identify tonsillar obstruction in pediatric obstructive sleep apnea (OSA) patients with small tonsils. This guided approach improves surgical decisions and long-term outcomes, making tonsillectomy more effective.

Area of Science:

  • Otolaryngology
  • Pediatric Sleep Medicine
  • Respiratory Medicine

Background:

  • Pediatric obstructive sleep apnea (OSA) diagnosis can be challenging, especially in children with small tonsils.
  • Tonsillectomy is a common treatment, but its necessity in cases with seemingly small tonsils requires careful evaluation.
  • Accurate assessment of airway obstruction is crucial for effective OSA management in children.

Purpose of the Study:

  • To evaluate the utility of drug-induced sleep endoscopy (DISE) in guiding tonsillectomy decisions for pediatric OSA patients with small tonsils.
  • To compare surgical outcomes between patients who underwent DISE-directed tonsillectomy and those who did not.
  • To assess the impact of DISE on the respiratory disturbance index (RDI) and oxygen saturation post-surgery.

Main Methods:

  • Retrospective study of 126 pediatric OSA patients (ages 2.8-10.4) undergoing awake endoscopy and adenoidectomy, with or without tonsillectomy.
  • DISE was performed to identify tonsillar obstruction, guiding the decision for tonsillectomy.
  • Cardio-pulmonary coupling (CPC) and oximetry were monitored pre- and post-operatively; RDI was assessed at 6 months and 1 year.

Main Results:

  • DISE revealed tonsillar obstruction in 45.2% of patients, including 18.6% with initially assessed grade 1 tonsils.
  • DISE-directed tonsillectomy was performed in 57 patients.
  • Both groups showed significant improvement in RDI and oxygen saturation post-surgery, with superior RDI improvement in the DISE group at 1 year.

Conclusions:

  • DISE is a valuable tool for determining the necessity of tonsillectomy in pediatric OSA patients with small tonsils.
  • DISE-guided surgery leads to better long-term respiratory outcomes compared to standard care in this population.
  • The findings support the routine use of DISE in the decision-making process for pediatric OSA patients with ambiguous tonsillar size.

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