Date of download: 7/8/2016 Copyright © 2016 American Medical Association. All rights reserved. From: A New Scoring System for Upper Airway Pediatric Sleep Endoscopy JAMA Otolaryngol Head Neck Surg. 2014;140(7): doi: /jamaoto Scoring Form and GuidelinesThe form (A) and guidelines (B) used for post hoc scoring of drug-induced sleep endoscopy are presented. Some data fields in the scoring form, including turbinate and tonsil size, and use of adjunct airway, were not included in our analysis. LPW indicates lateral pharyngeal wall. Figure Legend:

Date of download: 7/8/2016 Copyright © 2016 American Medical Association. All rights reserved. From: A New Scoring System for Upper Airway Pediatric Sleep Endoscopy JAMA Otolaryngol Head Neck Surg. 2014;140(7): doi: /jamaoto Patient ProfileIndividual patient obstructive, polysomnographic, and demographic profiles are shown. Mean obstructive score at each of the 5 evaluated sites (adenoid, velum, lateral pharyngeal wall [LPW], tongue base, and supraglottis) is graphically represented as either less than 2.0 (white box) or 2.0 or more (black box). Multilevel obstruction group (1, 2, or 3) was defined as follows: Group 1: No or 1 site with obstructive score greater than 2; group 2: 2 or more sites with obstructive score greater than 2 but confined to upper (adenoid, velum, LPW) or lower (tongue base, supraglottis) airway complex; group 3: 2 or more sites with obstructive score greater than 2, encompassing both upper and lower airway complexes. Total indicates total obstructive score (sum of obstructive scores at each of the 5 sites) from sleep endoscopy. AHI indicates apnea-hypopnea index from preoperative polysomnography. Oxygen nadir is low oxygen saturation from preoperative polysomnography. Age in years, body mass index (BMI; calculated as weight in kilograms divided by height in meters squared), prior sleep surgery (N, none; A, adenoidectomy; or TA: adenotonsillectomy), and medical comorbidities (neuromuscular, syndromic, pulmonary, or chromosomal) are shown. Figure Legend:

Date of download: 7/8/2016 Copyright © 2016 American Medical Association. All rights reserved. From: A New Scoring System for Upper Airway Pediatric Sleep Endoscopy JAMA Otolaryngol Head Neck Surg. 2014;140(7): doi: /jamaoto Representative ImagesEach of the 4 ordinal scores at each of the 5 upper-airway sites are shown. Figure Legend:

Date of download: 7/8/2016 Copyright © 2016 American Medical Association. All rights reserved. From: A New Scoring System for Upper Airway Pediatric Sleep Endoscopy JAMA Otolaryngol Head Neck Surg. 2014;140(7): doi: /jamaoto Internal ReliabilityInterrater (A) and intrarater (B) reliability assessed with the intraclass correlation coefficient (ICC) are shown for the 5 sites of upper airway obstruction scored for videos of drug-induced sleep endoscopy. Ratings for minimum (light blue) and maximum (white) obstruction at each site are shown. 1.0 indicates perfect correlation; 0, no correlation. Error bars indicate 95% CIs for each measurement. LPW indicates lateral pharyngeal wall. Figure Legend:

Date of download: 7/8/2016 Copyright © 2016 American Medical Association. All rights reserved. From: A New Scoring System for Upper Airway Pediatric Sleep Endoscopy JAMA Otolaryngol Head Neck Surg. 2014;140(7): doi: /jamaoto Multilevel ObstructionMultilevel obstruction was determined based solely on objective site-specific obstructive scores. Apnea- hypopnea index (AHI) and low oxygen saturation values for patients in the 3 multilevel obstruction groups were compared. Multilevel obstruction group (1, 2, or 3) was defined as follows: group 1, no or 1 site with obstructive score greater than 2; group 2, 2 or more sites with obstructive score greater than 2 but confined to upper (adenoid, velum, lateral pharyngeal wall [LPW]) or lower (tongue base, supraglottis) airway complex; group 3, 2 or more sites with obstructive score greater than 2, encompassing both upper and lower airway complexes. a P =.02. Figure Legend: