Publication
Title
Drug-induced sedation endoscopy in surgically naive infants and children with obstructive sleep apnea: impact on treatment decision and outcome
Author
Abstract
Purpose Adenotonsillectomy (AT) is the first-line treatment for obstructive sleep apnea (OSA) in children irrespective of clinical upper airway (UA) findings. We aimed to investigate whether drug-induced sedation endoscopy (DISE) changes treatment decision and outcome in otherwise healthy children and infants with OSA. Methods Retrospective analysis of prospectively collected data on polysomnography, DISE, and treatment in surgically naive, otherwise healthy infants (n = 34) and children (n = 75) with OSA. Treatment success is defined as post-treatment obstructive apnea/hypopnea index (oAHI) < 5 h-5(-)1, and cure is defined as oAHI < 2 h(-1). Results Based upon UA findings during DISE, AT was performed in 22 infants and 57 children. oAHI improved from 16.5 h(-1) (8.1-28.3) to 0.8 h(-1) (0.3-4.2) (p = 0.01) in infants and from 28.6 h(-1) (23.4-34.9) to 0.7 h(-1) (0.4-1.8) (p < 0.001) in children. AT was successful in 84.2% of infants and 91.4% of children. A cure was obtained in 68.4% of infants and 78.7% of children. DISE changed the treatment decision in 1/3rd of infants and 1/4th of children, and they did not undergo AT. In the non-AT group, isolated adenoidectomy/tonsillectomy or non-surgical treatment was successful in 86.6% of children and in 100% of infants. Cure was achieved in 66.6% of children and 75% of infants. Conclusions DISE performed in otherwise healthy and surgically na < ve infants and children with OSA altered the therapeutic decision making in up to 1/3rd to 1/4th of the cases and resulted in comparable treatment outcomes as standard treatment by AT. The present data suggest that DISE may provide individually tailored treatment of OSA in otherwise healthy infants and children.
Language
English
Source (journal)
Sleep and breathing. - Berlin
Publication
Berlin : 2018
ISSN
1520-9512
Volume/pages
22:2(2018), p. 503-510
ISI
000430993000030
Pubmed ID
29081031
Full text (Publisher's DOI)
Full text (publisher's version - intranet only)
UAntwerpen
Faculty/Department
Research group
Publication type
Subject
Affiliation
Publications with a UAntwerp address
External links
Web of Science
Record
Identification
Creation 12.06.2018
Last edited 15.07.2021
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