Drug-Induced Sleep Endoscopy in Infants With Obstructive Sleep Apnea: Current Evidence and Knowledge Gaps
Abstract
Objective: To map and synthesize the available evidence and evidence gaps on drug-induced sleep endoscopy (DISE) in infants with obstructive sleep apnea (OSA), focusing on reported sites of obstruction, DISE-associated management decisions, postoperative outcomes, safety, and limitations in current reporting.
Data sources: PubMed/MEDLINE/Embase/Google Scholar was searched for studies published in English and French from January 1980 to September 2025.
Review methods: This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Eligible studies included original reports describing infants under 12 months with OSA who underwent DISE. Two reviewers independently screened titles, abstracts, and full texts, extracted data with a standardized form, and synthesized results descriptively. Extracted variables included available polysomnography (PSG) parameters, DISE methodology, comparator airway evaluations when reported, DISE-directed interventions, postoperative outcomes, and complications.
Results: Eight observational studies published between 2013 and 2024 met inclusion criteria, involving 151 infants. DISE often revealed multilevel obstruction, most commonly involving the supraglottis (epiglottis, aryepiglottic folds, arytenoids; including sleep-state laryngomalacia) and retrolingual airway. Contributors from the nasal and adenotonsillar regions were also reported. DISE findings were…
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