{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:37:11Z","timestamp":1787315831524,"version":"build-2736575974"},"reference-count":14,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"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."],"abstract":"Abstract<\/jats:title>\n \n Objective<\/jats:title>\n Data regarding drug\u2010induced sleep endoscopy (DISE) findings in obese adolescents with obstructive sleep apnea (OSA) are lacking; such information could be used to direct and improve management as there is controversy whether adenotonsillectomy (AT) or positive airway pressure is standard therapy for this population. Our primary objective is to describe DISE findings in obese adolescents.<\/jats:p>\n <\/jats:sec>\n \n Study Design<\/jats:title>\n Case\u2010control.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Tertiary care children's hospital.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A 10\u2010year retrospective review was conducted of obese adolescents 12 to 21 years old with OSA (apnea\u2010hypopnea index [AHI]\u2009\u2265\u20091) that underwent DISE prior to AT. All DISE procedures were scored utilizing a modified VOTE classification.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Forty surgically na\u00efve obese adolescents underwent DISE. Median age of the adolescents was 16 (interquartile range [IQR] 3.0) years. The majority of patients had severe disease with a median AHI of 44 (IQR 46). The most common site of collapse noted on DISE was the oropharynx\/lateral oropharyngeal walls, occurring in 93.3% (n\u2009=\u200936) of obese adolescents. Complete tongue base obstruction was infrequent, occurring in only 12.8% (n\u2009=\u20095) of obese patients. While the majority (n\u2009=\u200931, 80%) of obese patients had multilevel obstruction, median AHI was not associated with multilevel collapse (diff 19.2, 95% CI [\u221244.1, 5.7],\n P<\/jats:italic>\n \u2009=\u2009.13).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The most common site of collapse found on DISE in surgically na\u00efve obese adolescents is the oropharynx. Multilevel upper airway obstruction is common among obese adolescents with OSA. Future research is needed to assess if DISE\u2010directed multilevel sleep surgery improves outcomes in this challenging\u2010to\u2010treat population.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/ohn.70386","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:13:04Z","timestamp":1787314384000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Drug\u2010Induced Sleep Endoscopy Findings in Obese Adolescents With Sleep Apnea"],"prefix":"10.1002","author":[{"given":"Timothy","family":"Kearney","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology MedStar Health Georgetown University Hospital Washington DC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Turaj","family":"Vazifedan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Children's Hospital of the King's Daughters Norfolk Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina M.","family":"Baldassari","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Eastern Virginia Medical School at Old Dominion University Norfolk Virginia USA"},{"name":"Department of Pediatric Sleep Medicine Children's Hospital of the King's Daughters Norfolk Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"issue":"5","key":"e_1_2_8_2_1","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1164\/rccm.200912-1930OC","article-title":"Adenotonsillectomy outcomes in treatment of obstructive sleep apnea in children: a multicenter retrospective study","volume":"182","author":"Bhattacharjee R","year":"2010","journal-title":"Am J Respir Crit Care Med"},{"issue":"6","key":"e_1_2_8_3_1","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1016\/j.otohns.2006.02.033","article-title":"The effectiveness of tonsillectomy and adenoidectomy in the treatment of pediatric obstructive sleep apnea\/hypopnea syndrome: a meta\u2010analysis","volume":"134","author":"Brietzke SE","year":"2006","journal-title":"Otolaryngol Head Neck Surg"},{"key":"e_1_2_8_4_1","article-title":"The effect of drug\u2010induced sleep endoscopy on surgical outcomes for obstructive sleep apnea: a systematic review","author":"Di Bari M","year":"2023","journal-title":"Sleep Breath"},{"issue":"4","key":"e_1_2_8_5_1","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1177\/0194599820985000","article-title":"Expert consensus statement: pediatric drug\u2010induced sleep endoscopy","volume":"165","author":"Baldassari CM","year":"2021","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"2","key":"e_1_2_8_6_1","first-page":"152","article-title":"Drug\u2010induced sleep endoscopy in pediatric obstructive sleep apnea","volume":"161","author":"Raposo D","year":"2019","journal-title":"Otolaryngol Head Neck Surg"},{"key":"e_1_2_8_7_1","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.sleep.2016.06.018","article-title":"Drug\u2010induced sedation endoscopy in surgically naive children with Down syndrome and obstructive sleep apnea","volume":"24","author":"Maris M","year":"2016","journal-title":"Sleep Med"},{"key":"e_1_2_8_8_1","volume-title":"The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications. 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