Drug-Induced Sleep Endoscopy and Its Recent Clinical Applications in Combination with Other Procedures in Children: A Narrative Review.

Drug-induced sleep endoscopy (DISE) is a dynamic diagnostic tool that is increasingly used to evaluate upper airway obstruction, especially in pediatric obstructive sleep apnea. Although initially established in adult populations, its pediatric application is expanding. Since 1990, more than 80 studies have explored various aspects of DISE, with a growing subset focusing specifically on its use in children, supported by advancements in sedation protocols. This narrative review summarizes the clinical indications for pediatric DISE, preparation protocols, and validated scoring systems, including the VOTE and Chan classifications. We also highlight the integration of DISE with adjunctive tools such as positive airway pressure titration, long-range optical coherence tomography, and dynamic magnetic resonance imaging for improved diagnostic accuracy and individualized treatment planning. These developments suggest that DISE, when standardized, holds strong potential to refine the management of complex pediatric airway disorders.