{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T22:25:38Z","timestamp":1793399138519,"version":"4.5.0"},"reference-count":21,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Otolaryngol Head Neck Surg"],"published-print":{"date-parts":[[2023,4,1]]},"abstract":"<jats:sec id=\"ab-ooi220103-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Drug-induced sleep endoscopy (DISE) is increasingly used to guide treatment decisions in children with sleep-disordered breathing (SDB). Previous reports of DISE findings in children have typically included a broad age range, but it is unclear how these patterns of obstruction vary with age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ooi220103-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare patterns of airway obstruction observed during DISE in 3 age groups of surgically naive children with SDB.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ooi220103-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This cross-sectional analysis of a prospective cohort of surgically naive nonsyndromic children with SDB or obstructive sleep apnea [OSA] at risk for residual disease after adenotonsillectomy (defined as having at least 1 of these criteria: severe OSA, older than 7 years, obesity, or Black race) who were recruited between May 1, 2015, and February 28, 2020, was conducted at a tertiary children\u2019s hospital. Data analysis was conducted from September 2021 to February 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ooi220103-7\">\n                    <jats:title>Exposures<\/jats:title>\n                    <jats:p>DISE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ooi220103-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>DISE findings were rated at 6 anatomic sites using the Sleep Endoscopy Rating Scale (SERS). The association between age and severity of obstruction at each anatomic site and overall were compared using correlation (Kendall \u03c4) and ordinal logistic regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ooi220103-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Data from 288 children (144 girls [50%]; 20 American Indian\/Alaska Native [7%], 4 Asian [1%], 19 Black [7%], 93 Hispanic [33%], 2 Middle Eastern [1%], 6 Native Hawaiian\/Pacific Islander [2%], and 203 White [70%] individuals; median [IQR] age, 9.2 [7.0-11.7] years) were stratified by participant age into preschool (age 2-5 years; 27 [9%]), younger school-aged (age 5-10 years; 146 [51%]), and older school-aged (age 10-18 years; 115 [40%]). Among these subgroups, the prevalence of multilevel obstruction was 59%, 51%, and 30%, respectively. Increasing age was inversely correlated with obstruction of the nasal airway (\u03c4\n                      <jats:sub>b<\/jats:sub>\n                      , \u22120.19; 95% CI, \u22120.29 to \u22120.09), nasopharynx (\u03c4\n                      <jats:sub>b<\/jats:sub>\n                      , \u22120.20; 95% CI, \u22120.31 to \u22120.10), velopharynx (\u03c4\n                      <jats:sub>b<\/jats:sub>\n                      , \u22120.16; 95% CI, \u22120.26 to \u22120.06), and overall obstruction (SERS total score: \u03c4\n                      <jats:sub>b<\/jats:sub>\n                      , \u22120.24; 95% CI, \u22120.33 to \u22120.14). An adjusted analysis demonstrated an inverse association between age and nasopharyngeal obstruction (odds ratio [OR], 0.84; 95% CI, 0.76 to 0.92), SERS total score (OR, 0.83; 95% CI, 0.76 to 0.90), and the number of sites of complete obstruction (OR, 0.87; 95% CI, 0.87 to 0.95).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ooi220103-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>This cross-sectional analysis of data from a prospective cohort study of surgically naive children with SDB found that preschool-aged children had more frequent multilevel obstruction, more severe overall obstruction, and nasopharyngeal obstruction compared with older children. Understanding the most common sites of obstruction and expected changes with age could inform personalized treatment for children with SDB.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamaoto.2022.5187","type":"journal-article","created":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T11:01:08Z","timestamp":1677150068000},"page":"327","source":"Crossref","is-referenced-by-count":12,"title":["Drug-Induced Sleep Endoscopy Differences by Age in Surgically Naive Children With Sleep-Disordered Breathing"],"prefix":"10.1001","volume":"149","author":[{"given":"Maya X.","family":"Herzig","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Oregon Health and Science University, Portland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea D.","family":"Hildebrand","sequence":"additional","affiliation":[{"name":"Biostatistics and Design Program, Oregon Health and Science University, 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