ORCID
0000-0002-4439-8108 (Baldassari)
Document Type
Article
Publication Date
2026
DOI
10.1002/ohn.70386
Publication Title
Otolaryngology - Head and Neck Surgery
Volume
Advance online publication
Pages
5 pp.
Abstract
Objective
Data regarding drug-induced 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.
Study Design
Case-control.
Setting
Tertiary care children's hospital.
Methods
A 10-year retrospective review was conducted of obese adolescents 12 to 21 years old with OSA (apnea-hypopnea index [AHI] ≥ 1) that underwent DISE prior to AT. All DISE procedures were scored utilizing a modified VOTE classification.
Results
Forty surgically naïve 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 = 36) of obese adolescents. Complete tongue base obstruction was infrequent, occurring in only 12.8% (n = 5) of obese patients. While the majority (n = 31, 80%) of obese patients had multilevel obstruction, median AHI was not associated with multilevel collapse (diff 19.2, 95% CI [-44.1, 5.7], P = .13).
Conclusion
The most common site of collapse found on DISE in surgically naïve obese adolescents is the oropharynx. Multilevel upper airway obstruction is common among obese adolescents with OSA. Future research is needed to assess if DISE-directed multilevel sleep surgery improves outcomes in this challenging-to-treat population.
Rights
© 2026 The Authors
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) License.
Original Publication Citation
Kearney, T., Vazifedan, T., & Baldassari, C. M. (2026). Drug-induced sleep endoscopy findings in obese adolescents with sleep apnea. Otolaryngology–Head and Neck Surgery. Advance online publication. https://doi.org/10.1002/ohn.70386
Repository Citation
Kearney, T., Vazifedan, T., & Baldassari, C. M. (2026). Drug-induced sleep endoscopy findings in obese adolescents with sleep apnea. Otolaryngology–Head and Neck Surgery. Advance online publication. https://doi.org/10.1002/ohn.70386