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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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Drug-Induced Sleep Endoscopy Differences by Age in Surgically Naive Children With Sleep-Disordered Breathing
Maya X Herzig1, Andrea D Hildebrand2, Thuan Nguyen2
1Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland.
JAMA Otolaryngology-- Head & Neck Surgery
|February 23, 2023
Summary
Preschoolers with sleep-disordered breathing (SDB) show more airway obstruction during drug-induced sleep endoscopy (DISE) than older children. Age impacts obstruction patterns, guiding personalized SDB treatment for children.
Area of Science:
- Pediatric Otolaryngology
- Sleep Medicine
- Respiratory Physiology
Background:
- Drug-induced sleep endoscopy (DISE) is crucial for guiding treatment in pediatric sleep-disordered breathing (SDB).
- Previous studies on DISE in children covered broad age ranges, limiting understanding of age-specific obstruction patterns.
Purpose of the Study:
- To compare airway obstruction patterns during DISE across three distinct age groups of surgically naive children with SDB.
- To investigate the relationship between age and the severity and location of airway obstruction in pediatric SDB.
Main Methods:
- Cross-sectional analysis of a prospective cohort of 288 surgically naive children with SDB.
- DISE findings were assessed at six anatomical sites using the Sleep Endoscopy Rating Scale (SERS).
- Statistical analyses included Kendall τ correlation and ordinal logistic regression to compare age groups and assess age-related obstruction severity.
Main Results:
- Preschool-aged children (2-5 years) exhibited a higher prevalence of multilevel obstruction (59%) compared to younger (5-10 years, 51%) and older (10-18 years, 30%) school-aged children.
- Increasing age showed an inverse correlation with obstruction in the nasal airway, nasopharynx, velopharynx, and overall obstruction (SERS total score).
- Adjusted analyses confirmed an inverse association between age and nasopharyngeal obstruction, overall obstruction severity, and the number of completely obstructed sites.
Conclusions:
- Preschool-aged children with SDB present with more frequent multilevel and severe overall obstruction, particularly at the nasopharynx, compared to older children.
- Understanding age-dependent variations in airway obstruction sites is vital for tailoring individualized treatment strategies for pediatric SDB.
- These findings highlight the importance of age stratification in interpreting DISE results for children with SDB.
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