Department of Otorhinolaryngology, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Canada.
Division of Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A.
Laryngoscope. 2020 Aug;130(8):2076-2080. doi: 10.1002/lary.28397. Epub 2019 Nov 25.
Drug-induced sleep endoscopy (DISE) is used to assess site of obstruction for patients in a pharmacologically induced sleep-like state. It is traditionally performed in the operating room (OR), however, no data exists regarding the feasibility of this intervention outside the OR in children. The objective is to compare the safety of DISE performed in the MRI induction room to those performed in the OR.
Prospective case-series of patients undergoing DISE in the MRI induction room (study group) to those assessed in the OR (controls) in a single-institution pediatric tertiary care center. Consecutive patients undergoing DISE examination for persistent obstructive sleep apnea (OSA) after adenotonsillectomy from September 2016 to September 2017 were included.
Overall, 118 patients (38 study patients, 80 controls) with a mean age of 10.6 years (95% confidence interval [CI], 9.3-11.9) underwent DISE; 39.8% (47/118) were female. The most frequent comorbidity was cardiac disease (22.0%, 26/118). The mean obstructive apnea-hypopnea index was 12.2 events/hour (95% CI, 8.8-15.6) for controls and 13.5 events/hour (95% CI, 8.7-18.3) for study patients (P = .76). No major complication or unplanned admissions occurred in either group. Induction time was similar (12 vs. 13 minutes, P = .7) as was total procedure time (12 vs. 14 minutes, P = .3) for procedures performed in both settings.
There were no significant complications for DISE performed in the OR or the MRI induction room and procedure times were similar. Further assessment of patient outcomes and resource utilization is needed.
4 Laryngoscope, 130: 2076-2080, 2020.
药物诱导睡眠内镜（DISE）用于评估处于药物诱导睡眠状态下的患者阻塞部位。它传统上是在手术室（OR）中进行的，但是，关于在 OR 之外的儿童中进行此干预的可行性尚无数据。目的是比较在 MRI 诱导室中进行 DISE 的安全性与在 OR 中进行 DISE 的安全性。
对单中心儿科三级保健中心中在 MRI 诱导室中进行 DISE 的患者（研究组）与在 OR 中评估的患者（对照组）进行前瞻性病例系列研究。从 2016 年 9 月至 2017 年 9 月，连续入组因腺样体扁桃体切除术后持续阻塞性睡眠呼吸暂停（OSA）而行 DISE 检查的患者。
总体而言，有 118 例患者（38 例研究患者，80 例对照）接受了 DISE 检查，平均年龄为 10.6 岁（95%置信区间[CI]，9.3-11.9）；39.8%（47/118）为女性。最常见的合并症是心脏病（22.0%，26/118）。对照组的平均阻塞性呼吸暂停低通气指数为 12.2 次/小时（95%CI，8.8-15.6），研究患者为 13.5 次/小时（95%CI，8.7-18.3）（P=.76）。两组均未发生重大并发症或计划外住院。在两种情况下进行的手术中，诱导时间相似（12 分钟与 13 分钟，P=.7），总手术时间也相似（12 分钟与 14 分钟，P=.3）。
在 OR 或 MRI 诱导室中进行 DISE 没有明显的并发症，且手术时间相似。需要进一步评估患者结局和资源利用情况。
4 Laryngoscope，130：2076-2080，2020。
