{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:00:16Z","timestamp":1787162416360,"version":"build-2736575974"},"reference-count":47,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2017,1,1]],"date-time":"2017-01-01T00:00:00Z","timestamp":1483228800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006701","name":"Umm Al-Qura University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006701","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002383","name":"King Saud University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002383","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Otolaryngology - Head &amp; Neck Surgery"],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adenotonsillectomy is the most commonly performed operation for pediatric snoring\/sleep disordered breathing (S\/SDB). However, 20\u201340% of patients will fail to improve. Drug-induced sleep endoscopy (DISE) may provide a more individualized surgical plan and limit unsuccessful surgeries. The aim of this study was to assess the impact of DISE on surgical decision-making in surgically na\u00efve children with S\/SDB.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective observational cohort study was undertaken at the Stollery Children's Hospital. Patients 3\u201317 years of age who underwent DISE-directed surgery for S\/SDB between January 2009 and December 2015 were eligible. We excluded other indications for tonsillectomy and syndromic children. The primary outcome was the level of agreement between a DISE-based surgical decision and the reference standard based on the American Academy of Pediatrics (AAP) guidelines via un-weighted Cohen's kappa. Secondary outcomes included the frequency and type of alternate surgical targets identified by DISE. The agreement on tonsil size between in-office physical assessment and DISE was also calculated. The effectiveness of DISE-directed surgery on postoperative S\/SDB was not investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Five hundred fifty-eight patients were included. DISE changed the surgical plan in 35% of patients. Agreement between DISE-based and AAP clinical practice guidelines-based management was low (\u03ba\u2009=\u20090.354 +\/- 0.021 [95% CI 0.312\u20130.395]). An alternate diagnosis or surgical target was identified by DISE in 54% of patients. There was moderate agreement on tonsil size (\u03ba\u2009=\u20090.44 [0.33\u20130.55]) between DISE and in-office clinical assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This is a first phase diagnostic study, which demonstrates that DISE affects decision-making in surgically na\u00efve children with S\/SDB in up to 35% of patients. It has utility in individualizing first stage surgical treatments as well as identifying alternate targets for further surgical or medical therapy, while potentially limiting unsuccessful surgeries. Further studies to examine the effect of DISE on surgical outcomes are required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40463-017-0190-6","type":"journal-article","created":{"date-parts":[[2017,2,13]],"date-time":"2017-02-13T07:52:29Z","timestamp":1486972349000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":58,"title":["Does drug-induced sleep endoscopy change the surgical decision in surgically na\u00efve non-syndromic children with snoring\/sleep disordered breathing from the standard adenotonsillectomy? A retrospective cohort study"],"prefix":"10.1177","volume":"46","author":[{"given":"Malak Jamal","family":"Gazzaz","sequence":"first","affiliation":[{"name":"Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada"},{"name":"Division of Otolaryngology - Head and Neck Surgery, Umm Al-Qura University, Makkah, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Isaac","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Anderson","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noura","family":"Alsufyani","sequence":"additional","affiliation":[{"name":"Department of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada"},{"name":"Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaser","family":"Alrajhi","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada"},{"name":"Division of Pediatric Surgery, Department of Surgery, Stollery Children's Hospital, Edmonton, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamdy","family":"El-Hakim","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada"},{"name":"Division of Pediatric Surgery, Department of Surgery, Stollery Children's Hospital, Edmonton, AB, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,1,1]]},"reference":[{"key":"bibr1-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1513\/pats.200708-135MG"},{"key":"bibr2-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200912-1930OC"},{"key":"bibr3-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2009.01.043"},{"key":"bibr4-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-1671"},{"key":"bibr5-s40463-017-0190-6","volume":"6348","author":"Tan H-L","year":"2016","journal-title":"Expert Rev Respir Med"},{"key":"bibr6-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200604-577OC"},{"key":"bibr7-s40463-017-0190-6","unstructured":"Dehlink E, Tan H. Update on paediatric obstructive sleep apnoea. 2016;8(Ii):224\u2013235. doi:10.3978\/j.issn.2072-1439.2015.12.04."},{"key":"bibr8-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1186\/1916-0216-43-13"},{"key":"bibr9-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1016\/S1389-9457(03)00100-X"},{"key":"bibr10-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2006.08.067"},{"key":"bibr11-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1177\/000348949009900305"},{"key":"bibr12-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1001\/2013.jamaoto.197"},{"key":"bibr13-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200401000-00024"},{"key":"bibr14-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2273.1991.tb01050.x"},{"key":"bibr15-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2273.1996.tb01095.x"},{"key":"bibr16-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-011-1798-1"},{"key":"bibr17-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-008-0831-5"},{"key":"bibr18-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-012-0647-9"},{"key":"bibr19-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-013-2795-3"},{"key":"bibr20-s40463-017-0190-6","unstructured":"Fung E, Witmans M, Ghosh M, Cave D, El-Hakim H. Upper airway findings in children with Down syndrome on sleep nasopharyngoscopy: case-control study. J Otolaryngol Head Neck Surg. 2012;41(2):138\u201344."},{"key":"bibr21-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2273.2000.00323.x"},{"key":"bibr22-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2012.02.028"},{"key":"bibr23-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/576719"},{"key":"bibr24-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1016\/j.otorri.2015.09.001"},{"key":"bibr25-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2014.04.041"},{"issue":"12","key":"bibr26-s40463-017-0190-6","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1055\/s-0034-1377007","volume":"93","author":"Quante M","year":"2014","journal-title":"Laryngorhinootologie"},{"key":"bibr27-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2014.06.016"},{"key":"bibr28-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.324.7336.539"},{"key":"bibr29-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1016\/S1389-9457(99)00009-X"},{"key":"bibr30-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1016\/S0031-3955(16)36806-7"},{"issue":"7","key":"bibr31-s40463-017-0190-6","first-page":"CR431","volume":"10","author":"Modrzy\u0144ski M","year":"2004","journal-title":"Med Sci Monit"},{"key":"bibr32-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1542\/peds.113.1.e19"},{"key":"bibr33-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26091"},{"key":"bibr34-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2015.0468"},{"key":"bibr35-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23832"},{"key":"bibr36-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2273.1990.tb00777.x"},{"key":"bibr37-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2014.10.017"},{"key":"bibr38-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2016.06.017"},{"key":"bibr39-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2014.2338"},{"key":"bibr40-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1007\/s40136-012-0006-1"},{"key":"bibr41-s40463-017-0190-6","doi-asserted-by":"crossref","unstructured":"Mahmoud M, Gunter J, Donnelly LF, Wang Y, Nick TG A comparison of dexmedetomidine with propofol for magnetic resonance imaging sleep studies in children 2009 745 753","DOI":"10.1213\/ane.0b013e3181adc506"},{"key":"bibr42-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1177\/0194599815625972"},{"key":"bibr43-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2273.1998.00097.x"},{"key":"bibr44-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1016\/B978-1-4160-3112-3.00006-1"},{"key":"bibr45-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1177\/0194599810389949"},{"key":"bibr46-s40463-017-0190-6","volume-title":"Systematic review of pediatric tonsil size and polysomnogram-measured obstructive sleep apnea severity","author":"Nolan J","year":"2016"},{"key":"bibr47-s40463-017-0190-6","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.324.7335.477"}],"container-title":["Journal of Otolaryngology - Head &amp; Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1186\/s40463-017-0190-6","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1186\/s40463-017-0190-6","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s40463-017-0190-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1186\/s40463-017-0190-6","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T15:30:29Z","timestamp":1741620629000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1186\/s40463-017-0190-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,1]]},"references-count":47,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2017,1]]}},"alternative-id":["10.1186\/s40463-017-0190-6"],"URL":"https:\/\/doi.org\/10.1186\/s40463-017-0190-6","relation":{},"ISSN":["1916-0216","1916-0216"],"issn-type":[{"value":"1916-0216","type":"print"},{"value":"1916-0216","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,1]]},"article-number":"12"}}