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https://www.readbyqxmd.com/read/28738391/updated-palate-surgery-for-obstructive-sleep-apnea
#1
Hsueh-Yu Li
Initially described in 1981, uvulopalatopharyngoplasty was the first surgical procedure specially designed at the palatal level for snoring and obstructive sleep apnea (OSA). To date, palatal surgery remains the most commonly used surgery for OSA. The advancement of this surgery over the past 30 years has been a process of evolution in concepts, examination, and technique to increase safety and effectiveness in the treatment of OSA. Concept changes have emerged in the disease etiology, purpose of surgery, treatment priorities, staging of operations, integration therapy, and surgical endpoints...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28738377/updated-nasal-surgery-for-obstructive-sleep-apnea
#2
David M Johnson, Ryan J Soose
Numerous studies report that difficulty breathing through the nose is associated with reduced sleep quality, increased daytime dysfunction, and increased risk of snoring and obstructive sleep apnea (OSA). Additionally, chronic nasal obstruction often complicates and limits successful medical device therapy for OSA, particularly with continuous positive airway pressure (CPAP). When medical evaluation and management of the nose is inadequate, surgical therapy to lower nasal resistance has been shown to substantially improve sleep and breathing outcome measures...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28738374/multilevel-obstructive-sleep-apnea-surgery
#3
Hsin-Ching Lin, Edward M Weaver, Ho-Sheng Lin, Michael Friedman
Continuous positive airway pressure (CPAP) is the primary treatment of obstructive sleep apnea/hypopnea syndrome (OSA). Most sleep physicians are in agreement that a certain number of OSA patients cannot or will not use CPAP. Although other conservative therapies, such as oral appliance, sleep hygiene, and sleep positioning, may help some of these patients, there are many who fail all conservative treatments. As sleep surgeons, we have the responsibility to screen patients for both symptoms and signs of OSA...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28738368/updated-minimally-invasive-surgery-for-sleep-related-breathing-disorders
#4
Bhik Kotecha
Sleep-related breathing disorders (SRBD) consist of a variety of clinical entities, ranging from primary snoring to severe obstructive sleep apnoea at the opposite extreme. Although it has no official definition, minimally invasive surgery infers surgery where the procedure is clinically less aggressive and may involve a much smaller incision or none at all. It also implies that such procedures may result in a quicker recovery and reduced morbidity, and that they are often conducted under local anaesthesia as day cases...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28738365/advances-in-box-surgery-for-obstructive-sleep-apnea-genioglossus-advancement-hyoid-suspension-and-maxillomandibular-advancement
#5
Yau Hong Goh, Winston Tan, Victor James Abdullah, Sung Wan Kim
Box surgery for obstructive sleep apnea (OSA) patients consists of mandibular surgery, including genioglossus advancement, hyoid suspension, and maxillomandibular advancement, as an airway reconstruction. This surgery was developed in the early 1980s. Thereafter, techniques were modified in each surgery for the enhancement of outcome and prevention of complications. However, the indication for surgery remains poorly defined due to the dynamicity of the upper airway, variability of the phenotype in OSA patients, and absence of a representative method for the obstruction site in the upper airway...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28738358/innovative-surgery-for-obstructive-sleep-apnea-nerve-stimulator
#6
J Ulrich Sommer, Karl Hörmann
Obstructive sleep apnea (OSA) as a multifactorial disease is treated with continuous positive airway pressure (CPAP) as the gold standard. Yet, if patients suffer from CPAP incompliance, traditional OSA surgery only targets morphological changes of the upper airway while neglecting functional issues. With the advent of upper airway stimulation, and in particular hypoglossal nerve stimulation as a treatment option, a highly effective, clinically proven and functional therapy with good evidence is available. This article gives a comprehensive overview of current and upcoming hypoglossal nerve stimulation systems (Inspire, ImThera, and Nyxoah), the specific advantages of this approach, the selection criteria and screening process, relevant clinical data, and a description of the different implantation procedures...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28738340/novel-positional-devices-for-the-treatment-of-positional-obstructive-sleep-apnea-and-how-this-relates-to-sleep-surgery
#7
Madeline J L Revesloot, Linda Benoist, Peter van Maanen, Nico de Vries
If untreated, obstructive sleep apnea (OSA) develops as a gradual progressive disease. In the early stage of the disease most patients with OSA are positional. The archetypical patient might progress from simple positional snoring via positional early-stage mild disease to less positional moderate and finally nonpositional severe OSA. At first, the apnea-hypopnea index (AHI) is high only in the supine position, and later is high in all sleeping positions. The phenomenon is reversible. After partial effective treatment, patients with severe OSA can reverse to less severe positional OSA or, in other words, the AHI drops more in the lateral position than in supine position...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28738333/updated-hypopharyngeal-surgery-for-sleep-apnea
#8
B Tucker Woodson
The failure of traditional upper airway surgery such as uvulopalatopharyngoplasty has been attributed to lower airway obstruction related to base of tongue collapse. Multiple procedures, including glossectomy, tongue base radiofrequency, genioglossus advancement, and tongue suspension techniques, have been advocated to improve success rates. No consensus exists on which subsets of patients are best treated by individual approaches and direct comparative data are lacking. The selection of procedures must be based on individual patient needs and the relative potential benefits and risks...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28736115/three-dimensional-volumetric-changes-in-the-upper-airway-after-maxillomandibular-advancement-in-obstructive-sleep-apnoea-patients-and-the-impact-on-quality-of-life
#9
B Veys, L Pottel, W Mollemans, J Abeloos, G Swennen, N Neyt
Obstructive sleep apnoea (OSA) is a sleep-related breathing disorder, characterized by repetitive airway obstructions, causing disruptive snoring and daytime sleepiness. Maxillomandibular advancement (MMA), which enlarges the upper airway, is a therapeutic surgical approach. However, no study has performed an upper airway sub-region analysis using validated three-dimensional (3D) anatomical and technical limits on cone beam computed tomography (CBCT). Hence, this prospective, observational trial was performed to evaluate 3D volumetric changes in the upper airway according to validated 3D cephalometric landmarks, before and after MMA, for all patients with a polysomnography diagnosis of OSA (apnoea-hypopnoea index (AHI) ≥5)...
July 20, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28732224/three-dimensional-changes-in-the-upper-airway-of-skeletal-class-iii-patients-after-different-orthognathic-surgical-procedures
#10
Yuxue Yang, Kai Yang, Ying Zhao
PURPOSE: We hypothesized that 3-dimensional changes in the upper airway of patients with skeletal Class III malocclusion are different after mandibular setback and maxillary advancement (MSMA) compared with mandibular setback (MS) and that upper airway changes and the amount of jaw movement are correlated. PATIENTS AND METHODS: Skeletal Class III patients who underwent MS surgery or MSMA surgery were included in this retrospective cohort study. Cone beam computed tomography scans were acquired before and 3 months after surgery...
June 24, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28727896/proseal-versus-classic-laryngeal-mask-airway-lma-for-positive-pressure-ventilation-in-adults-undergoing-elective-surgery
#11
REVIEW
Muhammad Qamarul Hoda, Khalid Samad, Hameed Ullah
BACKGROUND: The development of supraglottic airway devices has revolutionized airway management during general anaesthesia. Two devices are widely used in clinical practice to facilitate positive pressure ventilation: the ProSeal laryngeal mask airway (pLMA) and the Classic laryngeal mask airway (cLMA). It is not clear whether these devices have important clinical differences in terms of efficacy or complications. OBJECTIVES: To compare the effectiveness of the ProSeal laryngeal mask airway (pLMA) and the Classic LMA (cLMA) for positive pressure ventilation in adults undergoing elective surgery...
July 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28727888/association-of-mental-health-status-with-perception-of-nasal-function
#12
Erika Strazdins, Yu Feng Nie, Raziqah Ramli, Tom Palesy, Jenna M Christensen, George Nicholas Marcells, Richard John Harvey
Importance: Mental health issues are thought to be overrepresented among patients undergoing rhinoplasty and may be associated with patient presentation prior to surgery. Objective: To assess the association of poor mental health with perception of nasal function. Design, Setting, and Participants: A cross-sectional study of patients presenting for airway assessment was performed from December 1, 2011, to October 31, 2015, at 2 tertiary rhinoplasty centers in Sydney, Australia...
July 20, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/28718208/quantification-of-nasal-airflow-resistance-in-english-bulldogs-using-computed-tomography-and-computational-fluid-dynamics
#13
Eric T Hostnik, Brian A Scansen, Rachel Zielinski, Samir N Ghadiali
Stenotic nares, edematous intranasal turbinates, mucosal swelling, and an elongated, thickened soft palate are common sources of airflow resistance for dogs with brachycephalic airway syndrome. Surgery has focused on enlarging the nasal apertures and reducing tissue of the soft palate. However, objective measures of surgical efficacy are lacking. Twenty-one English bulldogs without previous surgery were recruited for this prospective, pilot study. Computed tomography was performed using conscious sedation and without endotracheal intubation using a 128 multidetector computed tomography scanner...
July 17, 2017: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/28715092/the-origins-of-oral-medicine-in-the-hippocratic-collected-works
#14
REVIEW
Helen Askitopoulou, Vasileia Nyktari, Alexandra Papaioannou, Georgios Stefanakis, Elina Konsolaki
The collected works of Hippocrates describe for the first time in a systematic way a large number of oral diseases, such as ulcers, inflammations, abscesses and tumours from the epiglottis, mouth, tongue, palate, uvula and the sublingual area. Several of these case reports are remarkable for the accurate observation of clinical symptoms and signs, the aetiology, the pathogenesis and their therapeutic approach in relation to prognosis. The Hippocratic authors report cases of 'aphthae' as part of a polysystemic disease, described many centuries later by Behçet and Adamantiades, while they associate features of splenomegaly from endemic malaria with gingivitis ('ulitis')...
July 17, 2017: Journal of Oral Pathology & Medicine
https://www.readbyqxmd.com/read/28714612/weaning-from-long-term-continuous-positive-airway-pressure-or-noninvasive-ventilation-in-children
#15
Meriem Mastouri, Alessandro Amaddeo, Lucie Griffon, Annick Frapin, Samira Touil, Adriana Ramirez, Sonia Khirani, Brigitte Fauroux
OBJECTIVES: A significant number of children are able to discontinue long term continuous positive airway pressure (CPAP) or noninvasive ventilation (NIV) but the underlying disorders, weaning criteria, and outcome of these children have not been studied. STUDY DESIGN: Retrospective cohort follow up. SUBJECT SELECTION: Consecutive children who were weaned from long term CPAP/NIV between October 2013 and January 2016. METHODOLOGY: Underlying disorders, weaning criteria, and clinical outcome were analyzed...
July 17, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28714430/laparoscopic-instrument-use-in-laryngeal-surgery-transoral-resection-of-a-supraglottic-haemangioma
#16
R Bannon, R Gohil, J Manickavasagam
BACKGROUND: Adult laryngeal haemangiomas are rare vascular tumours that have been managed by a variety of surgical techniques. METHODS: This paper describes a case of near-fatal acute airway obstruction secondary to such a lesion, followed by our approach to surgical resection using a laparoscopic bipolar tissue-sealing device. RESULTS: This technique resulted in successful excision of the lesion, with no evidence of recurrence at one year of follow up...
July 17, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28713750/comminuted-laryngeal-fracture-following-blunt-trauma-a-need-for-strict-legislation-on-roads
#17
Shraddha Jain, Pragya Singh, Minal Gupta, Bhavna Kamble, Suresh S Phatak
Laryngeal fracture is a rare condition with potential life-long implications related to airway patency, voice quality, and swallowing. Rarity of the condition leads to lack of consensus on the most suitable way to manage this injury. The mode of injury can be prevented by strict legislation on the roads. We report a case of a 28-year-old Indian male who sustained a comminuted displaced fracture of the thyroid cartilage with disruption of anterior commissure due to blunt trauma caused by the metallic side rod of a ladder projecting from the rear of a vehicle in front of the bike on which he was riding...
January 2017: Annals of Maxillofacial Surgery
https://www.readbyqxmd.com/read/28713745/recovering-breathing-and-feeding-of-a-newborn-with-pierre-robin-sequence
#18
Francisnele Maria de Aquino Fraporti Tomáz, Alvaro Henrique Borges, Alexandre Meireles Borba, Luiz Evaristo Ricci Volpato
Pierre Robin sequence (PRS) is characterized by the triad micrognathia, glossoptosis, and airway obstruction, commonly associated with cleft palate. This study reports the case of a patient with characteristics consistent with the diagnosis of PRS in the 1(st) week of life. To stabilize the airway, oro-tracheal intubation was performed without success, followed by tracheostomy and glossopexy and after a small improvement in symptoms, it was decided to perform the mandibular distraction osteogenesis (MDO). At the age of 6, her maxillofacial development was within expectations, with patent airway, the presence of deciduous teeth, and without neurological impairment...
January 2017: Annals of Maxillofacial Surgery
https://www.readbyqxmd.com/read/28712185/effect-of-midazolam-premedication-on-doses-of-propofol-for-laryngeal-mask-airway-insertion-in-children
#19
Muhammad Adnan, Aamir Furqan, Muhammad Kaleem Sattar
BACKGROUND: Propofol is a widely-accepted medication for the successful insertion of laryngeal mask airway (LMA). When propofol is used alone, larger doses are required which can lead to cardiorespiratory distress resulting in hypotension and prolonged apnoea. The objective of this study was to evaluate the effect of premedication of midazolam on different doses of propofol for LMA insertion. METHODS: In this randomized clinical trial, eighty-six (86) patients who were scheduled to undergo elective surgery is supine position not requiring the need for tracheal intubation from September 2015 to 6 March 2016 were included...
January 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28701597/randomized-comparative-study-of-intravenous-infusion-of-three-different-fixed-doses-of-milrinone-in-pediatric-patients-with-pulmonary-hypertension-undergoing-open-heart-surgery
#20
Neeraj Kumar Barnwal, Sanjeeta Rajendra Umbarkar, Manjula Sudeep Sarkar, Raylene J Dias
BACKGROUND: Pulmonary hypertension secondary to congenital heart disease is a common problem in pediatric patients presenting for open heart surgery. Milrinone has been shown to reduce pulmonary vascular resistance and pulmonary artery pressure in pediatric patients and neonates postcardiac surgery. We aimed to evaluate the postoperative outcome in such patients with three different fixed maintenance doses of milrinone. METHODOLOGY: Patients were randomized into three groups...
July 2017: Annals of Cardiac Anaesthesia
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