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Updated: Dec 1, 2025
Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Outcome of drug induced sleep endoscopy directed surgery in paediatrics obstructive sleep apnoea: A systematic review
Jeyasakthy Saniasiaya1, Jeyanthi Kulasegarah1
1Department of Otorhinolaryngology, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia.
Insights
Drug-Induced Sleep Endoscopy (DISE) effectively guides surgical planning for pediatric obstructive sleep apnea (OSA). DISE-directed surgery demonstrates a safe and effective therapeutic approach for treating children with OSA.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Sleep Medicine
Background:
- Pediatric obstructive sleep apnea (OSA) is a significant clinical challenge.
- Accurate upper airway evaluation is crucial for effective surgical planning in pediatric OSA.
- Drug-Induced Sleep Endoscopy (DISE) aids in identifying the site and degree of upper airway collapse.
Purpose of the Study:
- To review the literature on the outcomes of surgery directed by DISE in children with OSA.
- To evaluate the effectiveness and safety of DISE-guided surgical interventions for pediatric OSA.
Main Methods:
- A systematic literature search was conducted from January 2000 to December 2019 using databases like Scopus, PubMed, and Embase.
- Keywords included 'drug-induced sleep endoscopy,' 'sleep endoscopy directed surgery,' and 'pediatrics sleep apnea.'
- The review adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
Main Results:
- Seven Level III evidence studies (retrospective, case-control, prospective series) involving 996 pediatric patients were analyzed.
- DISE altered surgical decisions in 30% of patients, with 86% undergoing multilevel surgery.
- The mean age was 6 years, and 61% of patients were male; 10% had comorbidities.
Conclusions:
- DISE-directed surgery is an effective and safe therapeutic strategy for pediatric obstructive sleep apnea.
- DISE significantly influences and changes surgical management in the majority of pediatric OSA cases.
Introduction:
Paediatrics obstructive sleep apnoea have been discussed to a great degree over the recent years and remains a conundrum till date. The advent of instrumentation has aided upper airway evaluation in determining the site and degree of upper airway collapse for targeted and effective surgical planning. The literature was reviewed to determine the outcome of Drug Induced Sleep Endoscopy (DISE) directed surgery in children with obstructive sleep apnoea.
Material And Methods:
A literature search was conducted for the period from January 2000 to December 2019 by using a number of medical literature data bases including Scopus, PubMed and Embase. The following search words were used either individually or in combination: drug-induced sleep endoscopy, sleep endoscopy directed surgery, paediatrics sleep apnoea. The search was conducted over a month period (December 2019). Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the Cochrane Handbook for Systematic Reviews of Interventions were followed when possible.
Results:
Seven clinical research articles were selected based on our objective and selection criteria. Seven studies were of level III evidence: retrospective, case-control and prospective series. Altogether, there were 996 patients with male predominance; 61%. Over 10% of patients (133 patients) were found to have comorbidities or were syndromic. The mean age of patient was 6 years and majority (87.6%) of our patients were found to be surgically naïve, that is, no previous surgical procedures were performed for OSA. Surgical decision was changed in 295 patients (30%) following DISE. Post intervention outcomes were objectively revealed in 4 studies. Most of our patients underwent a multilevel surgery based on DISE (86%). Complications were documented in 3 studies.
Conclusions:
Analysis of the results indicated that DISE directed surgery was an effective, safe therapeutic approach to treating paediatrics obstructive sleep apnoea. DISE directed surgery has shown to have changed surgical management in most studies.
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