Drug Induced Sleep Endoscopy in the decision-making process of children with obstructive sleep apnea

Galluzzi, Francesca; Pignataro, L; Gaini, Renato Maria; Garavello, Werner

doi:10.1016/j.sleep.2014.10.017

Cited by 53 publications

(34 citation statements)

References 32 publications

(43 reference statements)

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“…The main objectives of DISE are to reconstitute the upper airway conditions as similarly as possible to those that occur during natural sleep [103]. DISE enables direct visualization of dynamic airway changes and, therefore, permits delineation of the site of obstruction and subsequent treatment planning [104]. As mentioned, DISE has rapidly gained momentum and the indications and guidelines for the use of this technique will likely emerge in the upcoming years [105][106][107][108][109][110].…”

Section: Drug Induced Sleep Endoscopymentioning

confidence: 99%

Treatment of Obstructive Sleep Apnea in Children: Handling the Unknown with Precision

Gozal

Tan

Kheirandish‐Gozal

2020

JCM

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Treatment approaches to pediatric obstructive sleep apnea (OSA) have remarkably evolved over the last two decades. From an a priori assumption that surgical removal of enlarged upper airway lymphadenoid tissues (T&A) was curative in the vast majority of patients as the recommended first-line treatment for pediatric OSA, residual respiratory abnormalities are frequent. Children likely to manifest persistent OSA after T&A include those with severe OSA, obese or older children, those with concurrent asthma or allergic rhinitis, children with predisposing oropharyngeal or maxillomandibular factors, and patients with underlying medical conditions. Furthermore, selection anti-inflammatory therapy or orthodontic interventions may be preferable in milder cases. The treatment options for residual OSA after T&A encompass a large spectrum of approaches, which may be complementary, and clearly require multidisciplinary cooperation. Among these, continuous positive airway pressure (CPAP), combined anti-inflammatory agents, rapid maxillary expansion, and myofunctional therapy are all part of the armamentarium, albeit with currently low-grade evidence supporting their efficacy. In this context, there is urgent need for prospective evidence that will readily identify the correct candidate for a specific intervention, and thus enable some degree of scientifically based precision in the current one approach fits all model of pediatric OSA medical care.

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Section: Drug Induced Sleep Endoscopymentioning

confidence: 99%

Treatment of Obstructive Sleep Apnea in Children: Handling the Unknown with Precision

Gozal

Tan

Kheirandish‐Gozal

2020

JCM

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“…However, in the majority of OSA cases where there are hypertrophied tonsillar and adenoidal tissues, DISE is not needed in the surgical decision-making process. The role of DISE is in cases without hypertrophied tonsils or adenoids, or in the cases where the OSA is refractory to adenotonsillectomy [26].…”

Section: Drug-induced Sleep Endoscopymentioning

confidence: 99%

Adenoidectomy in Children: What Is the Evidence and What Is its Role?

Schüpper

Nation

Pransky

2018

Curr Otorhinolaryngol Rep

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Purpose of Review Review the current state of the adenoidectomy procedure in the pediatric population with up-to-date indications for surgery, operative techniques, adverse events, non-surgical management of adenoid hypertrophy, and future directions. Recent Findings Adenoidectomy is indicated in children for the treatment of sleep-disordered breathing, nasal airway obstruction, recurrent acute otitis media, and chronic rhinosinusitis. A new recommendation was released in 2016, not supporting adenoidectomy for a primary indication of otitis media in children under 4 years old, including those with prior tympanostomy tubes, unless a distinct indication exists such as nasal obstruction or chronic adenoiditis. Although adenotonsillectomy is the mainstay of treatment for obstructive sleep apnea (OSA), recent studies have identified that non-obese patients with moderate OSA and small tonsils have comparable benefits with adenoidectomy alone with less complications. While conventional approaches such as indirect mirror-assisted curette and suction coagulation are still utilized, direct transnasal endoscopeassisted removal of the adenoids has proven to be a safe technique, with good short-and long-term outcomes. Novel nonsurgical therapies including immunotherapy have been evaluated. Summary Adenoidectomy is a safe procedure in the pediatric population and leads to excellent outcomes. Adverse events are rare, and hospitalization is uncommon. Children with sleep disturbance from nasal airway obstruction, ear disease, or chronic rhinosinusitis are the best operative candidates for this procedure.

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“…The pathophysiology of childhood OSA is mainly caused by enlarged adenotonsillar tissues [27,28]; therefore, adenotonsillectomy is the first-line therapy for pediatric OSA worldwide [29e34]. Increasingly, laryngomalacia is recognized as a risk factor for childhood OSA and a potential cause of residual disease after adenotonsillar surgery in children [21,35,36]. Therefore, children with both laryngomalacia and OSA may require supraglottoplasty.…”

Section: Introductionmentioning

confidence: 99%

Treatment outcomes of supraglottoplasty for pediatric obstructive sleep apnea: A meta-analysis

Lee

Hsu

Lee

et al. 2016

International Journal of Pediatric Otorhinolaryngology

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Drug Induced Sleep Endoscopy in the decision-making process of children with obstructive sleep apnea

Cited by 53 publications

References 32 publications

Treatment of Obstructive Sleep Apnea in Children: Handling the Unknown with Precision

Treatment of Obstructive Sleep Apnea in Children: Handling the Unknown with Precision

Adenoidectomy in Children: What Is the Evidence and What Is its Role?

Treatment outcomes of supraglottoplasty for pediatric obstructive sleep apnea: A meta-analysis

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