Pediatric Drug-Induced Sleep Endoscopy: Technique and Scoring System

Adrian Williamson 4th; Samira R Ibrahim; Steven W Coutras; Michele M Carr

doi:10.7759/cureus.10765

Pediatric Drug-Induced Sleep Endoscopy: Technique and Scoring System

Cureus. 2020 Oct 2;12(10):e10765. doi: 10.7759/cureus.10765.

Authors

Adrian Williamson 4th¹, Samira R Ibrahim², Steven W Coutras¹, Michele M Carr³

Affiliations

¹ Department of Otolaryngology, Head and Neck Surgery, West Virginia University, Morgantown, USA.
² Department of Otolaryngology, Head and Neck Surgery, West Virginia School of Osteopathic Medicine, Lewisburg, USA.
³ Department of Otolaryngology, Head and Neck Surgery, University at Buffalo, Buffalo, USA.

Abstract

Drug-induced sleep endoscopy (DISE) is an invaluable tool for identifying sites of obstruction for patients with obstructive sleep apnea (OSA). During DISE, the patient is in a state of drug-induced sleep, and a flexible laryngoscope is passed through the nose into the upper airway. Sites of obstruction are visualized and scored to guide surgical management. Currently, there is no universally accepted method of DISE analysis and scoring. This limitation in comparability impedes large-scale analysis between clinicians, institutions, and studies. In this report, we propose a standardized method of scoring and performing DISE in children with OSA. Our DISE scoring system is internally developed, consistent through the study, and addresses all levels of potential upper airway obstruction.

Keywords: adenoidectomy; dise; drug induced sleep endoscopy; osa; pediatric obstructive sleep apnea; sleep apnea surgery; tonsillectomy.