{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T23:07:50Z","timestamp":1788304070011,"version":"build-2803163510"},"reference-count":52,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,8,4]],"date-time":"2020-08-04T00:00:00Z","timestamp":1596499200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Positional obstructive sleep apnea (POSA)\u2014defined as obstructive sleep apnea twice as severe supine than nonsupine\u2014may offer clues to the underlying pattern of upper airway collapse in children. We compared drug\u2010induced sleep endoscopy (DISE) findings in children with and without POSA. We hypothesized that children with POSA would have significantly higher obstruction at the gravity\u2010dependent palate and tongue base but not at the adenoid, lateral wall, or supraglottis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective case series.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary pediatric hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>We included children aged 1 to 12 years with obstructive sleep apnea diagnosed by polysomnography who underwent DISE from July 2014 to February 2019. Scores were dichotomized as \u226550% obstruction (Chan\u2010Parikh 2 or 3) vs &lt;50% obstruction (Chan\u2010Parikh 0 or 1).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 99 children included, 32 (32%) had POSA and 67 (68%) did not. Children with POSA did not differ from children without POSA in age, overall apnea\u2010hypopnea index, sex, race, syndromic diagnoses, obesity, or history of adenotonsillectomy. In logistic regression models, odds of \u226550% obstruction were significantly higher at the tongue base (odds ratio, 2.77; 95% CI, 1.04\u20107.39) after adjustment for age, sex, obesity, previous adenotonsillectomy, and syndrome. No difference was noted at the adenoid, velum, lateral wall, or supraglottis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>POSA was associated with higher odds of obstruction on DISE at the tongue base but not at other levels.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599820941018","type":"journal-article","created":{"date-parts":[[2020,8,4]],"date-time":"2020-08-04T04:11:21Z","timestamp":1596514281000},"page":"191-198","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Drug\u2010Induced Sleep Endoscopy in Children With Positional Obstructive Sleep Apnea"],"prefix":"10.1002","volume":"164","author":[{"given":"Erin M.","family":"Kirkham","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan 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