Results
Search terms “Pediatric,” “DISE,” “OSA,” “Tongue Surgery,” and
their synonyms individually yielded tens of thousands of articles. There
was significant filtration when combined in PubMed: ultimately a total
of 89 articles were screened for relevance, and 49 were excluded. After
identification of 40 potentially relevant articles, they were downloaded
and reviewed. Eight articles met initial inclusion and exclusion
criteria, but one paper18 was excluded due to
duplicate patient data published by the same author (screening
flowchart, Figure 1).
In total, seven articles were used in the systematic review (284
patients, age 9.5 ± 3.9
years, normal/overweight status) and six of the studies (271 patients,
age 8.5 ± 3.8 years, majority normal weight status) were suitable for
metanalysis.10–16 See Table 1 and S1 for a summary of
the studies. Individual patient data tended to be reported in studies
with lower population sizes (Esteller et al, Kanotra et al, Maksimoski
et al, Ulualp et al); means and standard deviations were
included.10,11,13,16 Demographic data was reported in
most studies but not clearly linked to individual patient PSG outcomes.
The majority of DISE-directed tongue surgery involved multi-level airway
surgery (e.g. lingual tonsillectomy plus revision adenoidectomy).
He et al reported pre- and post- operative PSG data but did not specify
which data corresponds to which type of surgery; however, the study did
include responder and non-responder data directly linked to the type of
surgery, so it was included in the systematic review but not primary
outcome metanalysis.15 Only three of the seven studies
(185 patients, 65% of pooled study population) documented
post-operative PSG timeline with an average of minimum 2.1 months
post-op.10,14,16