RT Journal Article
SR Electronic
T1 Drug-induced sleependoscopy in children with persistent obstructive sleep apnoea following adenotonsillectomy
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P4276
VO 42
IS Suppl 57
A1 An Boudewyns
A1 Stijn Verhulst
A1 Mieke Maris
A1 Vera Saldien
A1 Paul Van de Heyning
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P4276.abstract
AB Introduction: Children with persistent symptoms of snoring or obstructive sleep apnoea (OSA) following (adeno) tonsillectomy (A)TE should undergo a comprehensive upper airway (UA) evaluation to guide future treatment.Aim: To investigate the value of drug-induced sleep endoscopy (DISE) in children with residual symptomatic disease following (A)TE.Methods: Children with persistent symptoms of upper airway obstruction (snoring, noisy breathing, apnea) or daytime symptoms following (A)TE and abnormal polysomnographic findings were included. Each child underwent an endoscopic examination of the upper airway during spontaneous breathing following administration of sevoflurane and/or propofol. During DISE, site (s) of UA obstruction or hypotonia were documented.Results: Data are available for 10 children with a previous history of ATE (n=5) or adenotomy (n=5). Age 7.3 ± 2.3 years, BMI 16.5 ± 4.7 kg/m2, obstructive apnea/hypopnea index: 11. 5 ± 18.8/hr. None of them had significant adenoid obstruction requiring adenotomy. Two children had significant obstruction at the level of the tonsils and underwent a tonsillectomy. Five had global airway hypotonia and 3 had laryngomalacia. Collapse at the level of the tonguebase or epiglottis occured in combination with obstruction at other levels. These findings directed further treatment (either medical, orthodontic or CPAP).Conclusions: DISE allows for detection of sites with persistent UA collapse or hypotonia in children with residual symptoms of upper airway obstruction following adeno (tonsillectomy). This information should be taken into account before additional treatment decisions are made.