Does the degree of lateral pharyngeal wall (LPW) obstruction on pediatric drug-induced sleep endoscopy (DISE) correlate with pre-procedure tonsillar hypertrophy scores on physical examination, and are clinically small tonsils obstructive?
Bottom line
Tonsillectomy alone may not be sufficient at treating obstructive sleep apnea (OSA) in pediatric patients with small tonsils. There was a positive correlation between Brodsky Score and DISE LPW score, and the majority of children with sleep-disordered breathing with a Brodsky score of 1 did not demonstrate LPW obstruction.
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August 2017Background: Adenotonsillectomy is the recommended surgical treatment for pediatric OSA, but children with small tonsils may not experience the same benefit and may have other sources of obstruction contributing to their OSA, which could lead to residual disease. This observation has led to increased interest in the role of DISE to evaluate airway obstruction.
Study design: Retrospective review of 115 patients who underwent DISE at a single pediatric tertiary care center between Jan. 1, 2011, and March 30, 2016.