Role of drug-induced sleep endoscopy in the treatment of moderate to severe pediatricobstructive sleep apnea
10.16066/j.1672-7002.2024.12.009
- VernacularTitle:药物诱导睡眠喉镜检查在儿童中重度阻塞性睡眠呼吸暂停治疗中的作用
- Author:
Yongchao CHEN
1
;
Xin WANG
;
Hongguang PAN
;
Yishu TENG
Author Information
1. 深圳市儿童医院耳鼻咽喉科,广东 深圳 518038
- Keywords:
Child;
Sleep Apnea,Obstructive;
Treatment Outcome;
drug-induced sleep endoscopy
- From:
Chinese Archives of Otolaryngology-Head and Neck Surgery
2024;31(12):790-795
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To evaluate upper airway obstruction in children with moderate-to-severe obstructive sleep apnea(OSA)using drug-induced sleep endoscopy(DISE)and to guide the development of individualized treatment plans.METHODS Children diagnosed with moderate-to-severe OSA via polysomnography(PSG)at Shenzhen Children's Hospital between October 2020 and June 2022,who had not received prior treatment and met inclusion criteria,were enrolled.DISE was performed after completing routine physical examinations,pediatric sleep questionnaires(PSQ),and PSG monitoring.Participants were divided into two groups based on the presence or absence of a history of upper airway surgery:the conventional OSA group and the postoperative persistent OSA group.The Chan-Parikh scoring system was used to assess the location and severity of upper airway obstruction,guiding the development of individualized treatment plans.Short-term efficacy was analyzed using PSQ and PSG results 3 months post-treatment.RESULTS A total of 51 children with moderate-to-severe OSA were included,comprising 37 in the conventional OSA group and 14 in the postoperative persistent OSA group.DISE altered the conventional surgical approach in 45.1%(23/51)of patients,including 40.5%(15/37)in the conventional OSA group and 57.1%(8/14)in the postoperative persistent OSA group.Postoperative PSQ scores improved significantly in the conventional OSA group(9.65±2.24 vs.4.51±1.10,P<0.05),and PSQ scores in the postoperative persistent OSA group also improved significantly after reintervention(9.79±2.97 vs.4.57±1.22,P<0.05).In six patients who underwent PSG follow-up,postoperative obstructive apnea-hypopnea index(OAHI)decreased significantly compared to preoperative values(8.45±5.26 vs.1.12±0.61,P<0.05),and the lowest oxygen saturation(LSaO?)improved significantly(78.67%±7.71%vs.91.67%±1.70%,P<0.05).CONCLUSION For children with moderate to severe OSA undergoing upper airway surgery,DISE is a safe and reliable adjunctive examination method.It can evaluate upper airway obstruction during sedated sleep,identify areas of obstruction missed during awake examination,and aid in providing targeted and effective treatment plans,resulting in favorable treatment outcomes.
