{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T13:23:47Z","timestamp":1777987427542,"version":"3.51.4"},"reference-count":71,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the effectiveness of drug\u2010induced sleep endoscopy\u2010directed surgery (DISEDS) in improving polysomnographic outcomes in pediatric obstructive sleep apnea (OSA), and to compare its impact in children with Trisomy 21 (T21) pediatric population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>PubMed, Scopus, and CINAHL databases were systematically searched from inception through January 1, 2025, in accordance with PRISMA guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Review Methods<\/jats:title>\n                    <jats:p>Studies were included if they reported pre\u2010 and postoperative apnea\u2010hypopnea index (AHI), obstructive AHI (oAHI), or oxygen nadir in patients \u226421 years undergoing DISEDS. Meta\u2010analyses were performed using random\u2010effects models to calculate mean differences with 95% confidence intervals (CIs). Subgroup analyses were conducted for patients with T21. Risk of bias was assessed using Joanna Briggs Institute (JBI) Critical Appraisal Checklist and the Risk of Bias in Non\u2010Randomized Studies of Interventions (ROBINS\u2010I) tool. Publication bias was evaluated using funnel plots and Egger's test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty\u2010one studies (n\u2009=\u20093404; 320 with T21) met inclusion criteria. DISEDS was associated with significant improvements in AHI (mean difference [MD]: 9.63; 95% CI: 7.54\u201011.73), oAHI (MD: 11.46; 95% CI: 9.13\u201013.80), and oxygen nadir (MD: \u20134.37; 95% CI: \u20135.36 to \u20133.39; all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.00001). Improvements were more pronounced in the T21 subgroup, particularly for AHI (MD: 14.78; 95% CI: 9.99\u201019.56). Publication bias was minimal.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>DISEDS significantly improves OSA severity and oxygenation in pediatric patients, with greater benefits observed in children with T21. These findings support earlier DISE use to guide individualized, anatomy\u2010based surgery in pediatric OSA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.70166","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T21:22:05Z","timestamp":1771276925000},"page":"933-944","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pediatric Drug\u2010Induced Sleep Endoscopy Directed Surgery Outcomes With Trisomy 21 Subgroup Comparison: A Meta\u2010Analysis"],"prefix":"10.1002","volume":"174","author":[{"given":"Alexa F.","family":"Ibrahim","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York Buffalo New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sofia","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York Buffalo New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cindy","family":"Hoang\u2010Tran","sequence":"additional","affiliation":[{"name":"University of California, Riverside School of Medicine Riverside California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas P.","family":"Nanu","sequence":"additional","affiliation":[{"name":"Elson S. 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