Drug-induced sleep endoscopy in children

Drug-induced sleep endoscopy (DISE) has become an essential diagnostic tool in children with persistent obstructive sleep apnea (OSA) after adenotonsillectomy or those at high risk of persistent OSA. Utilizing either propofol or dexmedetomidine intravenous sedation to model sleep in the operating room, a flexible laryngoscope is used to look for obstruction at each level of the airway. Several pediatric-specific DISE scoring systems have been published in an effort to provide a thorough and reproducible airway assessment. Although they all assign severity grades, the scoring systems differ depending on which anatomic subsites they include. DISE-directed surgery encompasses a set of procedures which target areas of airway obstruction identified during sleep endoscopy.