Drug-Induced sleep endoscopy in children: NAVOTEL scoring system development.
VOTE classification
drug-induced sleep endoscopy
pediatric obstructive sleep apnea-hypopnea syndrome
pediatric sleep disordered breathing
tonsillectomy
Journal
Pediatric pulmonology
ISSN: 1099-0496
Titre abrégé: Pediatr Pulmonol
Pays: United States
ID NLM: 8510590
Informations de publication
Date de publication:
Jul 2023
Jul 2023
Historique:
revised:
01
03
2023
received:
06
01
2023
accepted:
25
03
2023
medline:
19
6
2023
pubmed:
11
4
2023
entrez:
10
4
2023
Statut:
ppublish
Résumé
Pediatric drug-induced sleep endoscopy (DISE) lacks a universal and easy-to-use scoring system. The velum, oropharynx, tongue, epiglottis (VOTE) scoring system is widely used but needs to be completed in pediatrics. The main objective of this study was to investigate the distribution of obstructive sites in DISE and to propose an appropriate pediatric scoring system. The secondary objective was to evaluate the changes in surgical management induced by the proposed scoring system. A single-center prospective 5-year study was conducted from March 2016 to December 2021, including 99 children with a mean age of 7.2 years (±3.7), with pathological preoperative sleep recordings and undergoing DISE. The distribution of all upper airway obstructive sites was studied. Adenoids (A) were the most frequent obstructive site (63% of patients), and the nasal cavities (N) and the larynx (L) were other frequent obstructive sites. These sites are not explored by the VOTE scoring system, leading to the creation of the nose, adenoids, velum, oropharynx, tongue, epiglottis, larynx (NAVOTEL) scoring system. NAVOTEL was significantly correlated with the severity of obstructive sleep apnea-hypopnea syndrome (OSAS) (ρ = 0.2; p = 0.04) and highlighted obstructive sites in 6/9 patients with VOTE = 0. Of these patients, 4 had a complete obstructive site, and 3 had a multisite obstruction. VOTE indicated 8 additional surgical actions; NAVOTEL indicated 50 other actions compared to clinical examination. The NAVOTEL scoring system was exhaustive regarding surgical indications for OSAS. The NAVOTEL scoring system is exhaustive in pediatric DISE and correlated to OSAS severity. It should be preferred in pediatric DISE.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1889-1895Subventions
Organisme : None
Informations de copyright
© 2023 The Authors. Pediatric Pulmonology published by Wiley Periodicals LLC.
Références
Guilleminault C, Lee JH, Chan A. Pediatric obstructive sleep apnea syndrome. Arch Pediatr Adolesc Med. 2005;159(8):775-785.
Lumeng JC, Chervin RD. Epidemiology of pediatric obstructive sleep apnea. Proc Am Thorac Soc. 2008;5(2):242-252.
Marcus CL, Brooks LJ, Ward SD, et al. Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics. 2012;130(3):e714-e755.
Capdevila OS, Kheirandish-Gozal L, Dayyat E, Gozal D. Pediatric obstructive sleep apnea: complications, management, and long-term outcomes. Proc Am Thorac Soc. 2008;5(2):274-282.
O'Brien LM, Mervis CB, Holbrook CR, et al. Neurobehavioral implications of habitual snoring in children. Pediatrics. 2004;114(1):44-49.
Gozal D. Sleep, sleep disorders and inflammation in children. Sleep Med. 2009;10(suppl 1):S12-S16.
Suratt PM, Barth JT, Diamond R, et al. Reduced time in bed and obstructive sleep-disordered breathing in children are associated with cognitive impairment. Pediatrics. 2007;119(2):320-329.
Mitchell RB, Kelly J. Behavior, neurocognition and quality-of-life in children with sleep-disordered breathing. Int J Pediatr Otorhinolaryngol. 2006;70(3):395-406.
Dutt N, Janmeja A, Mohapatra P, Singh A. Quality of life impairment in patients of obstructive sleep apnea and its relation with the severity of disease. Lung India. 2013;30(4):289-294.
Baugh RF, Archer SM, Mitchell RB, et al. Clinical practice guideline: tonsillectomy in children. Otolaryngol Head Neck Surg. 2011;144(1 suppl):S1-S30.
Baldassari CM, Mitchell RB, Schubert C, Rudnick EF. Pediatric obstructive sleep apnea and quality of life: a meta-analysis. Otolaryngol Head Neck Surg. 2008;138(3):265-273.
Croft CB, Pringle M. Sleep nasendoscopy: a technique of assessment in snoring and obstructive sleep apnoea. Clin Otolaryngol. 1991;16(5):504-509.
Kezirian EJ, Hohenhorst W, de Vries N. Drug-induced sleep endoscopy: the VOTE classification. Eur Arch Otrhinolaryngol. 2011;268(8):1233-1236.
Wilcox LJ, Bergeron M, Reghunathan S, Ishman SL. An updated review of pediatric drug-induced sleep endoscopy. Laryngoscope Investig Otolaryngol. 2017;2(6):423-431.
Baldassari CM, Lam DJ, Ishman SL, et al. Expert consensus statement: pediatric Drug-Induced sleep endoscopy. Otolaryngol Head Neck Surg. 2021;165(4):578-591.
Akkari M, Yildiz S, Marianowski R, et al. Role of the ENT specialist in the diagnosis of pediatric obstructive sleep apnea-hypopnea syndrome (POSAHS). part 3: sleep recordings. Eur Ann Otorhinolaryngol Head Neck Dis. 2020;137(5):405-410.
Brodsky L. Modern assessment of tonsils and adenoids. Pediatr Clin North Am. 1989;36(6):1551-1569.
Berry RB, Budhiraja R, Gottlieb DJ, et al. Rules for scoring respiratory events in sleep: update of the 2007 AASM manual for the scoring of sleep and associated events. deliberations of the sleep apnea definitions task force of the American academy of sleep Medicine. J Clin Sleep Med. 2012;08(5):597-619.
Berry RB, Gamaldo CE, Harding SM, et al. AASM scoring manual version 2.2 updates: new chapters for scoring infant sleep staging and home sleep apnea testing. J Clin Sleep Med. 2015;11(11):1253-1254.
Leclere JC, Marianowski R, Monteyrol PJ, et al. Guidelines of the French society of otorhinolaryngology. role of the ENT specialist in the diagnosis of childhood obstructive sleep apnea-hypopnea syndrome (OSAHS). part 1: interview and physical examination. Eur Ann Otorhinolaryngol Head Neck Dis. 2019;136(4):301-305.
Hyzer JM, Milczuk HA, Macarthur CJ, King EF, Quintanilla-Dieck L, Lam DJ. Drug-Induced sleep endoscopy findings in children with obstructive sleep apnea with vs without obesity or down syndrome. JAMA Otolaryngol Head Neck Surg. 2021;147(2):175-181.
Best J, Mutchnick S, Ida J, Billings KR. Trends in management of obstructive sleep apnea in pediatric patients with Down syndrome. Int J Pediatr Otorhinolaryngol. 2018;110:1-5.
Maris M, Verhulst S, Saldien V, Van de Heyning P, Wojciechowski M, Boudewyns A. Drug-induced sedation endoscopy in surgically naive children with Down syndrome and obstructive sleep apnea. Sleep Med. 2016;24:63-70.
Sarah R. A, Cheng C. M, Erin M. K, et al. Does drug induced sleep endoscopy-directed surgery improve polysomnography measures in children with Down syndrome and obstructive sleep apnea? Acta Otolaryngol. 2018;138(11):1009-1013. https://pubmed.ncbi.nlm.nih.gov/30776267/
Mitchell RB, Call E, Kelly J. Diagnosis and therapy for airway obstruction in children with Down syndrome. Arch Otolaryngol Head Neck Surg. 2003;129(6):642-645.
Blanc F, Kennel T, Merklen F, Blanchet C, Mondain M, Akkari M. Contribution of drug-induced sleep endoscopy to the management of pediatric obstructive sleep apnea/hypopnea syndrome. Eur Ann Otorhinolaryngol Head Neck Dis. 2019;136(6):447-454.
Pang KP, Montevecchi F, Vicini C, et al. Does nasal surgery improve multilevel surgical outcome in obstructive sleep apnea: A multicenter study on 735 patients. Laryngoscope Investig Otolaryngol. 2020;5(6):1233-1239.
Sin S, Wootton DM, McDonough JM, Nandalike K, Arens R. Anterior nasal resistance in obese children with obstructive sleep apnea syndrome. Laryngoscope. 2014;124(11):2640-2644.
Fitzpatrick MF, McLean H, Urton AM, Tan A, O'Donnell D, Driver HS. Effect of nasal or oral breathing route on upper airway resistance during sleep. Eur Respir J. 2003;22(5):827-832.
Revell SM, Clark WD. Late-onset laryngomalacia: a cause of pediatric obstructive sleep apnea. Int J Pediatr Otorhinolaryngol. 2011;75(2):231-238.
Thevasagayam M, Rodger K, Cave D, Witmans M, El-Hakim H. Prevalence of laryngomalacia in children presenting with sleep-disordered breathing. Laryngoscope. 2010;120(8):1662-1666.
Chan DK. Supraglottoplasty for occult laryngomalacia to improve obstructive sleep apnea syndrome. Arch Otolaryngol Head Neck Surg. 2012;138(1):50-54.
Chan DK, Liming BJ, Horn DL, Parikh SR. A new scoring system for upper airway pediatric sleep endoscopy. JAMA Otolaryngol Head Neck Surg. 2014;140(7):595-602.
Lam DJ, Weaver EM, Macarthur CJ, et al. Assessment of pediatric obstructive sleep apnea using a drug-induced sleep endoscopy rating scale. Laryngoscope. 2016;126(6):1492-1498.
Boudewyns A, Van de Heyning P, Verhulst S. Drug-induced sedation endoscopy in children <2 years with obstructive sleep apnea syndrome: upper airway findings and treatment outcomes. European Archives of Oto-rhino-Laryngology: Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS): affiliated with the German Society for Oto-Rhino-Laryngology-Head and Neck Surgery. 2017;274(5):2319-2325.
Fishman G, Zemel M, DeRowe A, Sadot E, Sivan Y, Koltai PJ. Fiber-optic sleep endoscopy in children with persistent obstructive sleep apnea: inter-observer correlation and comparison with awake endoscopy. Int J Pediatr Otorhinolaryngol. 2013;77(5):752-755.
Bachar G, Nageris B, Feinmesser R, et al. Novel grading system for quantifying upper-airway obstruction on sleep endoscopy. Lung. 2012;190(3):313-318.
Williamson A, Ibrahim SR, Coutras SW, Carr MM. Pediatric Drug-Induced sleep endoscopy: technique and scoring system. Cureus. 2020;12(10):e10765.