PT  - JOURNAL ARTICLE
AU  - An Boudewyns
AU  - Stijn Verhulst
AU  - Mieke Maris
AU  - Vera Saldien
AU  - Paul Van de Heyning
TI  - Drug-induced sleep endoscopy in pediatric obstructive sleep apnoea syndrome
DP  - 2013 Sep 01
TA  - European Respiratory Journal
PG  - P4673
VI  - 42
IP  - Suppl 57
4099  - http://erj.ersjournals.com/content/42/Suppl_57/P4673.short
4100  - http://erj.ersjournals.com/content/42/Suppl_57/P4673.full
SO  - Eur Respir J2013 Sep 01; 42
AB  - Introduction: About 25% of otherwise healthy children have persistent obstructive sleep apnoea (OSA) following adenotonsillectomy.Aim: To investigate whether therapeutic decision making based upon upper airway evaluation by means of drug-induced sleep endoscopy (DISE) may improve treatment outcome.Methods: Non-obese, non-syndromic and surgically naive OSA children underwent an upper airway endoscopy following administration of sevoflurane and/or propofol. The upper airway was examined under spontaneous breathing and the site (s) of upper airway obstruction or hypotonia were documented. Treatment decisions where based upon polysomnographic data and findings during DISE.Results: Nineteen children age 5.2 (±3.6) years, BMI 15.8 (± 2.3) kg/m2, obstructive apnea/hypopnea index (OAHI) 21.6/r (± 27.8)/hr were included. Upper airway obstruction at the level of adenoids and tonsils was found in 15, these children were treated with adenotonsillectomy. Adenotomy was performed in 1 child with obstruction limted to the adenoidregion. Two children were treated with CPAP because of tonguebase collapse (n=1) or global hypotonia (n=1). One child with hypotonia and collapse of the epiglottis received orthodontic treatment. Postoperative polysomnographic data are presently available for 8 of those treated with adenotonsillectomy and all had an OAHI < 2/hr (5.9 months post surgery).Conclusions: This pilot study shows that drug-induced sleependoscopy is feasible in OSA children and DISE-directed treatment may improve therapeutic (surgical) outcomes.