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Iannella G, Magliulo G, Greco A, De Virgilio A, Maniaci A, Lechien JR, Calvo-Henriquez C, Bahgat AY, Casale M, Lugo R, Baptista P, Salamanca F, D’Ecclesia A, Perrone T, Leone F, Cannavicci A, Cammaroto G, Vicini C, Pace A. Clinical Application of Pediatric Sleep Endoscopy: An International Survey. CHILDREN (BASEL, SWITZERLAND) 2024; 11:94. [PMID: 38255407 PMCID: PMC10814917 DOI: 10.3390/children11010094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 12/26/2023] [Accepted: 01/05/2024] [Indexed: 01/24/2024]
Abstract
OBJECTIVES To investigate through an international survey the actual clinical application of drug-induced sleep endoscopy (DISE) in pediatric patients with obstructive sleep apnea (OSA) and to clarify the use, application, clinical indications, and protocol of pediatric DISE. METHODS A specific survey about pediatric DISE was initially developed by five international otolaryngologists with expertise in pediatric sleep apnea and drug-induced sleep endoscopy and was later spread to experts in the field of sleep apnea, members of different OSA-related associations. RESULTS A total of 101 participants who answered all the survey questions were considered in the study. Sixty-four sleep apnea experts, equivalent to 63.4% of interviewed experts, declared they would perform DISE in pediatric OSA patients. A total of 81.9% of responders agreed to consider the DISE as the first diagnostic step in children with persistent OSA after adenotonsillectomy surgery, whereas 55.4% disagreed with performing DISE at the same time of scheduled adenotonsillectomy surgery to identify other possible sites of collapse. In the case of young patients with residual OSA and only pharyngeal collapse during DISE, 51.8% of experts agreed with performing a velopharyngeal surgery. In this case, 27.7% disagreed and 21.4% were neutral. CONCLUSION Pediatric DISE is internationally considered to be a safe and effective procedure for identifying sites of obstruction and collapse after adenotonsillectomy in children with residual OSA. This is also useful in cases of patients with craniofacial malformations, small tonsils, laryngomalacia or Down syndrome to identify the actual site(s) of collapse. Despite this evidence, our survey highlighted that pediatric DISE is not used in different sleep centers.
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Affiliation(s)
- Giannicola Iannella
- Department of Organi di Senso, Sapienza University, 00185 Rome, Italy; (G.M.); (A.G.); (A.P.)
| | - Giuseppe Magliulo
- Department of Organi di Senso, Sapienza University, 00185 Rome, Italy; (G.M.); (A.G.); (A.P.)
| | - Antonio Greco
- Department of Organi di Senso, Sapienza University, 00185 Rome, Italy; (G.M.); (A.G.); (A.P.)
| | - Armando De Virgilio
- Department of Biomedical Sciences, Humanitas University, 20072 Milan, Italy;
| | - Antonino Maniaci
- Department of Otolaryngology, Kore University, 94100 Enna, Italy;
| | - Jerome R. Lechien
- Department of Otolaryngology, Elsan Polyclinic of Poitiers, 86000 Poitiers, France;
| | - Christian Calvo-Henriquez
- Service of Otolaryngology, Rhinology Unit, Hospital Complex of Santiago de Compostela Travesía de Choupana, 15706 Santiago de Compostela, Spain;
| | - Ahmed Yassin Bahgat
- Department of Otorhinolaryngology-Head & Neck Surgery, Alexandria University, Alexandria 5424041, Egypt;
| | - Manuele Casale
- Integrated Therapies in Otolaryngology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy;
| | - Rodolfo Lugo
- Department of Otorhinolaryngology, Grupo Medico San Pedro, Monterrey 64660, Mexico;
| | - Peter Baptista
- Department of Otorhinolaryngology, Clínica Universidad de Navarra, 31008 Pamplona, Spain;
| | - Fabrizio Salamanca
- Otorhinolaryngology Unit, San Pio X Hospital, 20159 Milan, Italy; (F.S.); (F.L.)
| | - Aurelio D’Ecclesia
- IRCCS ‘Casa Sollievo della Sofferenza’, 71013 San Giovanni Rotondo, Italy;
| | - Tiziano Perrone
- Otorhinolaryngology Unit, Civil Hospital of Alghero, 07041 Alghero, Italy;
| | - Federico Leone
- Otorhinolaryngology Unit, San Pio X Hospital, 20159 Milan, Italy; (F.S.); (F.L.)
| | - Angelo Cannavicci
- Head-Neck and Oral Surgery Unit, Department of Head-Neck Surgery, Otolaryngology, Morgagni Pierantoni Hospital, 47121 Forlì, Italy; (A.C.); (G.C.)
| | - Giovanni Cammaroto
- Head-Neck and Oral Surgery Unit, Department of Head-Neck Surgery, Otolaryngology, Morgagni Pierantoni Hospital, 47121 Forlì, Italy; (A.C.); (G.C.)
| | - Claudio Vicini
- Department ENT & Audiology, University of Ferrara, 44121 Ferrara, Italy;
| | - Annalisa Pace
- Department of Organi di Senso, Sapienza University, 00185 Rome, Italy; (G.M.); (A.G.); (A.P.)
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