Drug-induced sleep endoscopy in the identification of obstruction sites causing obstructive sleep apnea-hypopnea syndrome in children - 19/08/26

Doi : 10.1016/j.anorl.2026.08.001

M. Demoures-Patris de Breuil ^a, F. Chatelet ^b,^c, N. Leboulanger ^a,^c, B. Fauroux ^d,^e, F. Simon ^a,^c, V. Couloigner ^a,^c, B. Thierry ^a,^c, R. Luscan ^a,^c,⁎

^a Service d’Otorhinolaryngologie Pédiatrique, AP–HP, Hôpital Necker-Enfants Malades, 75015 Paris, France

^b Service d’Otorhinolaryngologie, AP–HP, Lariboisière Hospital, 75010 Paris, France

^c Université Paris Cité, Faculté de Médecine, 75006 Paris, France

^d Unité de Sommeil et de Ventilation Non Invasive Pédiatrique, AP–HP, Hôpital Necker-Enfants Malades, 75015 Paris, France

^e Université Paris Cité, UMR 7330 VIFASOM (Vigilance Fatigue Sommeil et Santé Publique), 75006 Paris, France

^⁎ Corresponding author. Service d’Otorhinolaryngologie Pédiatrique, AP–HP, Hôpital Necker-Enfants Malades, 149, Rue de Sèvres, 75015 Paris, France. Service d’Otorhinolaryngologie Pédiatrique, AP–HP, Hôpital Necker-Enfants Malades 149, Rue de Sèvres Paris 75015 France

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Wednesday 19 August 2026

Abstract

Background

Evidence for drug-induced sleep endoscopy (DISE) versus multilevel surgery guided by clinical examination is sparse in pediatrics.

Methods

A retrospective cohort study included all children undergoing DISE for obstructive sleep apnea (OSA) between September 2021 and April 2025 in a tertiary pediatric center. Clinical examination of obstruction sites was performed in consultation, and treatment was proposed. The data were compared against the intraoperative anatomic data collected during DISE and associated procedures.

Objective

To assess the surgical contribution of DISE compared to clinical examination in consultation.

Results

Files were analyzed for 240 patients, with a mean age of 6.4 ± 4.6 years. 137 (57%) had type 3 OSA, 7 (3%) type 2, and 96 (40%) type 1. DISE led to changes in surgical strategy in 75% of cases, with 803 procedures performed, compared to 597 planned in consultation ( P < 0.001). Agreement was satisfactory for partial tonsillectomy, but moderate to weak for surgery in other sites, and especially the tongue base and the laryngeal vestibule. Total anatomic score was significantly higher on DISE than in consultation. Median apnea-hypopnea index (AHI) improved significantly after surgery ( P < 0.001).