{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T14:49:16Z","timestamp":1788274156212,"version":"build-2803163510"},"reference-count":19,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T00:00:00Z","timestamp":1737936000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To systematically review the literature for articles evaluating outcomes of drug\u2010induced sleep endoscopy (DISE) directed tongue surgery in children with prior adenotonsillectomy and persistent or recurrent obstructive sleep apnea (OSA), and to perform a meta\u2010analysis on the polysomnographic (PSG) data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Systematic review and metanalysis in accordance with the Preferred Reporting Items for Systematic Review and Meta\u2010Analysis (PRISMA) statement guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome Measures<\/jats:title>\n                    <jats:p>Primary, post\u2010operative apnea\u2010hypopnea index (AHI) and lowest oxygen saturation (LSAT); Secondary, surgical response rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seven studies (283 patients) met criteria and reported PSG outcome data for the systematic review. The mean\u2009\u00b1\u2009standard deviation surgical response rate was 70.0%\u2009\u00b1\u200917.0% [95% CI 67.6, 71.6]. Six of the seven studies (270 patients) reported specific pre\u2010 and post\u2010operative PSG data included in our meta\u2010analysis. The pre\u2010 and post\u2010operative AHI decreased from 9.5\u2009\u00b1\u200912.1 to 4.2\u2009\u00b1\u20096.9 events\/h (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.04) with a mean difference (MD) of \u22125.13 [95% CI \u20107.13, \u22123.13],\n                      <jats:italic>Z<\/jats:italic>\n                      \u2010score 5.02 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.00001). LSAT improved from 87.8\u2009\u00b1\u20095.7 to 90.1%\u2009\u00b1\u20095.1% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.02) with a MD of 2.71 [95% CI 1.53, 3.89],\n                      <jats:italic>Z<\/jats:italic>\n                      \u2010score 4.51 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Existing literature demonstrates DISE\u2010directed tongue surgery in children with persistent OSA can reduce AHI by approximately 50%, improve LSAT by nearly 3%, and have an overall positive response to surgery rate of 70%. There is collective evidence that DISE\u2010directed tongue surgery is effective; limitations include heterogeneity in reported outcomes influenced by confounding factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/coa.14283","type":"journal-article","created":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T01:55:55Z","timestamp":1738029355000},"page":"438-445","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Drug Induced Sleep Endoscopy\u2010Directed Tongue Surgery to Treat Persistent Pediatric Obstructive Sleep Apnea: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-4492-8600","authenticated-orcid":false,"suffix":"IV","given":"R.","family":"Kenneth Sims","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Tripler Army Medical Center  Honolulu Hawaii USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-7191-5232","authenticated-orcid":false,"given":"Alexander","family":"Leeds","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Tripler Army Medical Center  Honolulu Hawaii USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4539-4551","authenticated-orcid":false,"given":"Grace","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Tripler Army Medical Center  Honolulu Hawaii USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9992-8018","authenticated-orcid":false,"given":"Anna","family":"Davide","sequence":"additional","affiliation":[{"name":"University of Hawaii John A. Burns School of Medicine  Honolulu Hawaii USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9200-9085","authenticated-orcid":false,"given":"Macario","family":"Camacho","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Tripler Army Medical Center  Honolulu Hawaii USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,27]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012\u20101671"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ohn.159"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21093"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00385\u20102015"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599818801757"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2006.08.067"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2009.01.043"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2019.02.030"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_14_11_1","unstructured":"Center for Disease Control \u201cHealthy Weight Nutrition and Physical Activity\u201d(2024) https:\/\/www.cdc.gov\/healthyweight\/assessing\/bmi\/childrens_bmi\/about_childrens_bmi.html."},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599817740332"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.10816"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2019.02.004"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405\u2010019\u201005664\u20106"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/2013.jamaoto.197"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40463\u2010022\u201000562\u20100"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/01945998221094211"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100039\u20101685156"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919"}],"container-title":["Clinical Otolaryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/coa.14283","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T17:47:16Z","timestamp":1744048036000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/coa.14283"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,27]]},"references-count":19,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1111\/coa.14283"],"URL":"https:\/\/doi.org\/10.1111\/coa.14283","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1111\/COA.14283\/v2\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/COA.14283\/v1\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/COA.14283\/v2\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/COA.14283\/v2\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/COA.14283\/v1\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/COA.14283\/v2\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/COA.14283\/v1\/review1","asserted-by":"object"}]},"ISSN":["1749-4478","1749-4486"],"issn-type":[{"value":"1749-4478","type":"print"},{"value":"1749-4486","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,27]]},"assertion":[{"value":"2024-07-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}