RESUMEN
PURPOSE: Drug-induced sleep endoscopy (DISE) is suitable for evaluating persistent obstructive sleep apnea syndrome (OSAS) after adenotonsillar surgery as a means to guide surgical intervention, yet few studies demonstrate its usefulness in resolving the syndrome. We describe our experience of DISE-directed surgery in children with persistent OSAS by analysing objective and subjective outcomes of this treatment. METHODS: Prospective study of 20 otherwise healthy 2-12 year-old children with OSAS persisting after adenotonsillar surgery. All patients underwent DISE-directed surgery and were followed up clinically and with a polysomnogram at 12⯱â¯3 months. RESULTS: All 20 children had an apnea-hypopnea index (AHI) score ≥1 (mean: 6.1⯱â¯4.9) and 75% had AHI>3 before surgery. We performed a total of 14 total tonsillectomies (70%), 7 with associated pharyngoplasties; 5 radiofrequency turbinate reductions (25%); 7 radiofrequency lingual tonsil reductions (35%); and 10 revision adenoidectomies (50%). No surgery-related complications were observed. AHI scores at follow-up were significantly lower than AHI scores before surgery (1.895⯱â¯1.11 vs 6.143⯱â¯4.88; pâ¯<â¯0.05) and, in 85% (nâ¯=â¯17) of patients, AHI was below 3. There was a significant reduction in the number of children with AHI>3 in follow-up at 12⯱â¯3 months (15%; nâ¯=â¯3) compared to before surgery (75%; nâ¯=â¯15) (pâ¯<â¯0.005). CONCLUSION: DISE-directed surgery for otherwise healthy children with persistent OSAS is a useful and safe technique to decide a therapeutic strategy and to obtain good objective and subjective results regarding resolution of the syndrome.