ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Pulmonology
Volume 13 - 2025 | doi: 10.3389/fped.2025.1614895
This article is part of the Research TopicAirways and Malocclusion: Etiology and Treatment OutcomesView all 9 articles
Application of drug-induced sleep endoscopy in the infants with dynamic upper airway collapse
Provisionally accepted
- First Affiliated Hospital, Guangxi Medical University, Nanning, China
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Objective The aim of the study was to evaluate the utility and safety of drug-induced sleep endoscopy (DISE) in the infants with suspected dynamic upper airway collapse. Methods The children with suspected dynamic upper airway collapse were enrolled. And, all the subjects included developed clinical signs during the first year of life. For each subject, both awake endoscopy (AE) and DISE were performed. The endoscopic findings and the sedation strategies for DISE were recorded. The diagnostic rate of dynamic upper airway collapse was compared between the DISE and AE. The adverse events during DISE were also recorded. Results 1. A total of 21 cases were included. The median age at performing bronchoscopy was 4.0 months. 2. For the cases beyond neonatal age (n=18), 16 cases (88.9%) used midazolam only and 2 cases (11.1%) used midazolam combined with dexmedetomidine. For the neonates (n=3), 2 cases (66.7%) used 10% chloral hydrate only and 1 case (33.3%) used 10% chloral hydrate combined with phenobarbital. 3. Six cases (28.6%) were diagnosed under both AE and DISE, whereas 15 cases (71.4%) were diagnosed under DISE only. The diagnostic rate was significantly higher under DISE than that under AE (100.0% vs 28.6%, P<0.01) in the cases with dynamic upper airway collapse. Of these cases with laryngomalacia, 3 cases (18.7%) were diagnosed under both AE and DISE, whereas 13 cases (81.3%) were diagnosed under DISE only. The diagnostic rate was significantly higher under DISE than that under AE (100.0% vs 18.7%, P<0.01) in the cases with laryngomalacia. Of these cases with tongue base collapse, all the cases (100.0%) were diagnosed under both AE and DISE. Of these cases with retropalatal and hypopharynx collapse, all the cases (100.0%) were diagnosed under DISE only. 4. One case (4.8%) developed hypoxic episode during DISE and it was resolved by the pressurized facial mask-assisted ventilation. Conclusions DISE was feasible and safe in the infants with suspected dynamic upper airway collapse. Compared to AE, DISE could improve the diagnostic rate of laryngomalacia and seemed to be a more reliable method to diagnose pharyngeal airway collapse, especially retropalatal and hypopharynx collapse.
Keywords: Drug-induced sleep endoscopy, Infant, dynamic upper airway collapse, Laryngomalacia, pharyngeal airway collapse, Midazolam
Received: 20 Apr 2025; Accepted: 02 Sep 2025.
Copyright: © 2025 Wei, Yang, Chen, Yi, Liu and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jing Liu, First Affiliated Hospital, Guangxi Medical University, Nanning, China
Yan Li, First Affiliated Hospital, Guangxi Medical University, Nanning, China
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