{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T16:30:29Z","timestamp":1794241829642,"version":"4.9.0"},"reference-count":50,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2026,5]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n \n Drug\u2010induced sleep endoscopy (\n DISE<\/jats:styled-content>\n ) has gained popularity for evaluating obstructive sleep apnea (\n OSA<\/jats:styled-content>\n ) and sleep\u2010disordered breathing (\n SDB<\/jats:styled-content>\n ) in children, particularly those with comorbidities or residual disease after adenotonsillectomy (T&A). This study aimed to characterize\n DISE<\/jats:styled-content>\n findings in pediatric\n OSA<\/jats:styled-content>\n \/\n SDB<\/jats:styled-content>\n across surgical status (surgically naive vs. post\u2010T&A) and comorbidities (Down syndrome and overweight\/obese children).\n <\/jats:p>\n <\/jats:sec>\n \n Data Sources<\/jats:title>\n A literature search was conducted in Pubmed\/MEDLINE, Cochrane Library, and EMBASE.<\/jats:p>\n <\/jats:sec>\n \n Review Methods<\/jats:title>\n Terms including \u201cSleep Apnea Syndromes,\u201d \u201cPediatrics,\u201d \u201cSedation,\u201d and \u201cEndoscopy,\u201d were used, covering the databases until September 2024. Strict inclusion criteria were applied. Forest plots were generated using R software.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Three hundred and fifty articles were identified, with 16 meeting inclusion criteria, involving 1415 pediatric patients. Across all subgroups, post\u2010T&A children demonstrated less adenoid and lateral wall\/tonsillar obstruction; however, revision T&A\/adenoidectomy\/tonsillectomy remained the most common surgical intervention (56.4%) for residual\n OSA<\/jats:styled-content>\n \/\n SDB<\/jats:styled-content>\n . Palatal obstruction was less prevalent in children post\u2010T&A compared to surgically na\u00efve counterparts. Tongue base obstruction was more prevalent in children post\u2010T&A, particularly in those with Down syndrome (na\u00efve: 50%, 95%\n CI<\/jats:styled-content>\n : 25%\u201375%; post\u2010T&A: 92%, 95%\n CI<\/jats:styled-content>\n : 32%\u2013100%) and in children with no comorbidities (na\u00efve: 24%, 95%\n CI<\/jats:styled-content>\n : 11%\u201347%; post\u2010T&A: 56%, 95%\n CI<\/jats:styled-content>\n : 15%\u201391%). Among surgically na\u00efve children, multisite obstruction was greatest in those with Down syndrome (71%, 95%\n CI<\/jats:styled-content>\n : 44%\u201389%) but was highest in children without comorbidities post\u2010T&A.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n DISE<\/jats:styled-content>\n demonstrates substantial variability in anatomic obstruction patterns among children with\n OSA<\/jats:styled-content>\n \/\n SDB<\/jats:styled-content>\n , underscoring the complexity of the disease, particularly in children with obesity, Down syndrome, or residual disease following T&A.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/lary.70289","type":"journal-article","created":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T12:25:13Z","timestamp":1764937513000},"page":"1978-1990","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["DISE<\/scp>\n Findings Across Comorbidity Groups and Surgical Status in Pediatric Sleep\u2010Disordered Breathing"],"prefix":"10.1002","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-4540-8891","authenticated-orcid":false,"given":"Elise","family":"Krippaehne","sequence":"first","affiliation":[{"name":"Division of Pediatric Otolaryngology, Department of Otolaryngology\u2010Head and Neck Surgery, School of Medicine Oregon Health & Science University Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Hildebrand","sequence":"additional","affiliation":[{"name":"Biostatistics & Design Program Oregon Health & Science University \u2013 Portland State University School of Public Health Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thuan","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Biostatistics & Design Program Oregon Health & Science University \u2013 Portland State University School of Public Health Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8979-3478","authenticated-orcid":false,"given":"Derek J.","family":"Lam","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology, Department of Otolaryngology\u2010Head and Neck Surgery, School of Medicine Oregon Health & Science University Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,5]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2024.1393272"},{"issue":"10","key":"e_1_2_10_3_1","first-page":"S274","article-title":"Obstructive Sleep Apnea Syndrome (OSAS) in Children: Diagnostic Challenges","volume":"19","author":"Rosen C. 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