Drug-induced sleep endoscopy in persistent pediatric sleep-disordered breathing after adenotonsillectomy.

OBJECTIVES

To demonstrate the feasibility of drug-induced sleep endoscopy (DISE) in the pediatric population and to examine DISE results in children with persistent sleep-disordered breathing (SDB) after tonsillectomy and adenoidectomy (T&A).

DESIGN

Retrospective case series with medical chart review.

SETTING

Tertiary pediatric medical center.

PATIENTS

Thirteen pediatric subjects with persistent SDB after T&A are included in the study.

INTERVENTION

Drug-induced sleep endoscopy was per-formed on all patients with documentation of all sites of persistent airway obstruction.

RESULTS

Multilevel upper-airway obstruction was identified in the majority of patients, most commonly related to tongue base obstruction, adenoid regrowth, and/or inferior turbinate hypertrophy. There were no differences among the 4 subgroups.

CONCLUSIONS

Findings from DISE suggest that multiple factors contribute to airway obstruction in persistent SDB after T&A. Further research can address the extent to which directed surgical treatment can improve outcomes in these patients.