Impact of Left Lateral Head Turn During DISE on Pediatric Airway Patency

Saturday, October 11, 2025

4:30 PM - 4:36 PM EDT

Location: 136

Disclosure(s):

Alexandra F. Corbin, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Amanda G. Baanante, MS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Deepthi S. Akella, MS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Drug-induced sleep endoscopy (DISE) is a valuable tool for evaluating airway obstruction in pediatric obstructive sleep apnea (OSA). While a full left lateral body position has been shown to improve airway patency compared to supine, the effect of a left lateral head turn alone is unknown. This study evaluated whether a left lateral head turn during DISE improved airway patency and if this improvement was associated with specific obstruction sites.

Methods: This retrospective study included pediatric OSA patients who underwent DISE between Oct 2023–Jan 2025 at a tertiary care center. Patients were assessed in the supine position and after a left lateral head turn. Obstruction at the palate, tonsils, tongue base, and larynx was graded as none, partial, or complete. Improved airway patency was defined as obstruction resolution at one or more sites after the head turn. Statistical analyses evaluated associations between positional improvement and obstruction sites.

Results: 34 patients were included (mean age 4.2 ± 2.8 years; 21 males [61.8%], 13 females [38.2%]), with 13 (38.2%) having a history of tonsillectomy or adenoidectomy.

Overall, 18 patients (52.9%) demonstrated improved airway patency with a left lateral head turn during DISE, while 10 (29.4%) experienced worsened obstruction, and 6 (17.6%) showed no change. Positional improvement was not associated with age, BMI, weight percentile, AHI, or nadir SpO2.

Improvement was observed in 5 of 7 patients (71.4%) with arytenoid obstruction, 15 of 27 (55.6%) with epiglottis obstruction, and 15 of 28 (53.6%) with aryepiglottic fold shortening. Among 17 patients without tonsil or lateral pharyngeal wall obstruction, 10 (58.8%) showed improvement. In contrast, 5 of 7 patients (71.4%) with palatal obstruction showed no improvement. The small sample size limited the ability to detect statistical significance for these findings.

Conclusions: These findings suggest that a left lateral head turn during DISE may identify pediatric OSA patients who could benefit from non-surgical positional airway management, potentially reducing the need for surgical intervention.

Presenting Author(s)

Alexandra F. Corbin, BS

Medical Student
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Buffalo, NY, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

GV

Gaayathri Varavenkataraman, MA

Research Assistant
Department of Otolaryngology, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
East Amherst, New York, United States

Disclosure information not submitted.
Amanda G. Baanante, MS

Medical Student
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Buffalo, New York, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Tony Han, BS

Medical Student
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Buffalo, NY, United States

Disclosure information not submitted.
Deepthi S. Akella, DO, MS

Resident Physician
University of Missouri Department of Otolaryngology
Columbia, MO, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Senior Author(s)

MC

Michele M. Carr, DDS MD PhD

Professor
Department of Otolaryngology, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Williamsville, New York, United States

Disclosure information not submitted.