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.