Pediatric drug-induced sleep endoscopy: An updated review of the literature

Jill M Arganbright1,2, Jason C Lee3, Robert A Weatherly1,2

  • 1Children's Mercy Kansas City, Division of Otolaryngology, Kansas City, MO, USA.

Insights

Drug-induced sleep endoscopy (DISE) is increasingly used in children. This review details its application for pediatric airway obstruction, particularly concerning adenotonsillar enlargement.

Area of Science:

  • Pediatric Otolaryngology
  • Sleep Medicine
  • Airway Management

Background:

  • Drug-induced sleep endoscopy (DISE) has seen significant growth over the past 10-15 years.
  • The application of DISE has expanded to include pediatric populations.
  • Adenotonsillar enlargement is a common cause of airway obstruction in children.

Purpose of the Study:

  • To review the utility of drug-induced sleep endoscopy (DISE) in pediatric patients.
  • To outline a specific approach for using DISE in children with airway obstruction.
  • To focus on the management of pediatric airway obstruction related to adenotonsillar hypertrophy.

Main Methods:

  • This is a review article.
  • The article outlines a practical approach to performing DISE in children.
  • The focus is on diagnostic criteria and interpretation in the pediatric population.

Main Results:

  • DISE is a valuable tool for evaluating pediatric airway obstruction.
  • It aids in identifying the specific sites and patterns of obstruction.
  • The technique is particularly useful when adenotonsillar enlargement is suspected or confirmed.

Conclusions:

  • Drug-induced sleep endoscopy (DISE) is an effective method for diagnosing the causes of airway obstruction in children.
  • The findings from DISE can guide surgical and non-surgical management strategies.
  • This approach is especially beneficial for children with suspected or known adenotonsillar enlargement.

Related Concept Videos

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
37
Sedatives and Hypnotics Drugs: Miscellaneous Agents01:17

Sedatives and Hypnotics Drugs: Miscellaneous Agents

Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
289
Endoscopic Procedures I: Esophagogastroduodenoscopy01:29

Endoscopic Procedures I: Esophagogastroduodenoscopy

An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
During an EGD, the endoscope can be used to:
445
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
43
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
44
Sedatives and Hypnotics: Overview01:23

Sedatives and Hypnotics: Overview

Sedatives are drugs that alleviate anxiety, while hypnotics induce sleep. Both classes of medication suppress neuronal activity, leading to a calming effect for sedatives and facilitating sleep for hypnotics.
Sedative-hypnotics are categorized into barbiturates, benzodiazepines (BZDs), and non-benzodiazepines or Z-drugs. These drugs work by suppressing central nervous system activity, and this suppression is dose-dependent. Older sedative medications, like barbiturates, follow a linear curve in...
854