Christopher T Wootten1, Sivakumar Chinnadurai2, Steven L Goudy2. 1. Department of Otolaryngology, Division of Pediatric Otolaryngology, Vanderbilt University, Nashville, TN, United States. Electronic address: christopher.t.wootten@vanderbilt.edu. 2. Department of Otolaryngology, Division of Pediatric Otolaryngology, Vanderbilt University, Nashville, TN, United States.
Abstract
OBJECTIVES: In this study we determine the subjective and objective outcomes of pediatric patients with refractory OSA undergoing drug-induced sleep endoscopy (DISE)-directed surgical treatment. METHODS: 31 consecutive children with OSA following TA underwent DISE. 26 completed DISE-directed operative management of the level(s) of ongoing upper airway obstruction. Pre- and postoperative OSA were assessed through a detailed history (of nighttime symptoms (NS) and daytime symptoms (DS)), physical examination, and polysomnography. RESULTS: Age ranged 5-18 years (mean 9.7 ± 3.4). Fourteen of 26 had trisomy 21 (51%). Operations were performed in the following frequencies: lingual tonsillectomy (LT) (22), midline posterior glossectomy (MPG) (16), revision adenoidectomy (11), inferior turbinate submucosal resection (7), uvulopalatoplasty (2), and supraglottoplasty (2). Overall, 92% reported subjective improvement. NS improved from 5.8 ± 2.9 preoperatively to 2.1 ± 2.5 postoperatively (p<0.05), while DS improved from 2.1 ± 1.3 preoperatively to 0.6 ± 1.1 postoperatively (p<0.05). Seventeen patients completed preoperative polysomnography, while only 11 of them also completed postoperative polysomnography. Mean OAHI fell from 7.0 (±5.8) events/hr to 3.6 (±1.8) events/hr (t-test, p=0.09). CONCLUSIONS: Individualized, multilevel, DISE-directed operative therapy was associated with substantial improvement in subjective measures of sleep.
OBJECTIVES: In this study we determine the subjective and objective outcomes of pediatric patients with refractory OSA undergoing drug-induced sleep endoscopy (DISE)-directed surgical treatment. METHODS: 31 consecutive children with OSA following TA underwent DISE. 26 completed DISE-directed operative management of the level(s) of ongoing upper airway obstruction. Pre- and postoperative OSA were assessed through a detailed history (of nighttime symptoms (NS) and daytime symptoms (DS)), physical examination, and polysomnography. RESULTS: Age ranged 5-18 years (mean 9.7 ± 3.4). Fourteen of 26 had trisomy 21 (51%). Operations were performed in the following frequencies: lingual tonsillectomy (LT) (22), midline posterior glossectomy (MPG) (16), revision adenoidectomy (11), inferior turbinate submucosal resection (7), uvulopalatoplasty (2), and supraglottoplasty (2). Overall, 92% reported subjective improvement. NS improved from 5.8 ± 2.9 preoperatively to 2.1 ± 2.5 postoperatively (p<0.05), while DS improved from 2.1 ± 1.3 preoperatively to 0.6 ± 1.1 postoperatively (p<0.05). Seventeen patients completed preoperative polysomnography, while only 11 of them also completed postoperative polysomnography. Mean OAHI fell from 7.0 (±5.8) events/hr to 3.6 (±1.8) events/hr (t-test, p=0.09). CONCLUSIONS: Individualized, multilevel, DISE-directed operative therapy was associated with substantial improvement in subjective measures of sleep.
Authors: David F Smith; Shan He; Nithin S Peddireddy; P Vairavan Manickam; Christine H Heubi; Sally R Shott; Aliza P Cohen; Stacey L Ishman Journal: Sleep Breath Date: 2020-04-10 Impact factor: 2.816
Authors: S Savini; A Ciorba; C Bianchini; F Stomeo; V Corazzi; C Vicini; S Pelucchi Journal: Acta Otorhinolaryngol Ital Date: 2019-10 Impact factor: 2.124
Authors: Erin M Kirkham; Karen Hoi; Jonathan B Melendez; Lauren M Henderson; Aleda M Leis; Michael P Puglia; Ronald D Chervin Journal: Sleep Breath Date: 2020-09-02 Impact factor: 2.816