%0 Journal Article %A An Boudewyns %A Stijn Verhulst %A Vera Saldien %A Paul Van de Heyning %T Drug-induced sedation endoscopy (DISE) as a tool for upper airway evaluation in obese children with obstructive sleep apnoea %D 2014 %J European Respiratory Journal %P 235 %V 44 %N Suppl 58 %X Aims and objectives: Obese children are at risk for obstructive sleep apnoea (OSAS) with prevalence rates up to 19% (Verhulst S. et al 2008). Adenotonsillar hypertrophy is not correlated to OSAS severity in these children and obesity is a risk factor for persistent OSAS following adenotonsillectomy (ATE) (Bhattacharjee R et al. 2010). We looked at anatomical factors contributing to upper airway (UA) obstruction in obese OSAS children.Methods: All patients underwent a drug induced sedation endoscopy (DISE). The UA was examined and the site (s) of obstruction or hypotonia were documented. Treatment decisions where based upon polysomnographic data and findings during DISE. Weight loss was part of the treatment in all children.Results: Data are available for 13 children, age 11.2 years (8.7-13.6), BMI 28.4 kg/m2 (25.1-33.9), obstructive apnoea/hypopnoea index (oAHI) 8.9/hr (4.8-17.8). Seven had a history of prior UA surgery. In the surgically naïve children, obstruction occured at the level of the adenoids and tonsils and was associated with UA hypotonia in 5/6.Partial or complete tonguebase obstruction was documented 6/7 children with previous UA surgery. Significant tonsillar obstruction occurred in ¾ with previous adenotomy and these children were treated with tonsillectomy.Conclusions: Hypotonia contributed to UA obstruction in the majority of obese children without previous UA surgery along with adenotonsillar hypertrophy. Tongue base obstruction was the most important finding in those with previous UA surgery, a finding that is in line with data obtained in non-obese children with a history of ATE. %U