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https://www.readbyqxmd.com/read/28531336/loop-gain-predicts-the-response-to-upper-airway-surgery-in-patients-with-obstructive-sleep-apnoea-ventilatory-control-abnormalities-predict-surgical-responsiveness
#1
Simon A Joosten, Paul Leong, Shane A Landry, Scott A Sands, Philip I Terrill, Dwayne Mann, Anthony Turton, Jhanavi Rangaswamy, Christopher Andara, Glen Burgess, Darren Mansfield, Garun S Hamilton, Bradley A Edwards
Study Objectives: Upper airway surgery is often recommended to treat OSA patients who cannot tolerate continuous positive airways pressure (CPAP). However, the response to surgery is variable, potentially because it does not improve the non-anatomical factors (i.e. loop gain and arousal threshold) causing OSA. Measuring these traits clinically might predict responses to surgery. Our primary objective was to test the value of loop gain and arousal threshold to predict surgical success defined as 50% reduction in apnea-hypopnea index (AHI) and AHI <10 events/hr post-surgery...
May 22, 2017: Sleep
https://www.readbyqxmd.com/read/28528369/effect-of-physical-stress-on-drug-induced-sleep-endoscopy-for-obstructive-sleep-apnea
#2
Sang Min Park, Dong-Kyu Kim
Drug-induced sleep endoscopy (DISE) is a reliable upper airway evaluation tool, widely used to improve surgical results in patients with obstructive sleep apnea (OSA). Several factors, including sleeping position and depth of sedation, affect DISE findings. This study aimed to evaluate the impact of physical stress on DISE findings. Eighty-five patients with OSA underwent two DISE examinations at the same level of sedation. The "first DISE" (control group) was performed after polysomnography, while the "second DISE" (test group) performed immediately after a treadmill stress test...
May 20, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28527878/obstructive-sleep-apnea-and-diabetes-a-state-of-the-art-review
#3
REVIEW
Sirimon Reutrakul, Babak Mokhlesi
Obstructive sleep apnea (OSA) is a chronic treatable sleep disorder and a frequent comorbidity in patients with type 2 diabetes. Cardinal features of OSA, including intermittent hypoxemia and sleep fragmentation, have been linked to abnormal glucose metabolism in laboratory-based experiments. OSA has also been linked to the development of incident type 2 diabetes. The relationship between OSA and type 2 diabetes may be bidirectional in nature given that diabetic neuropathy can affect central control of respiration and upper airway neural reflexes promoting sleep-disordered breathing...
May 17, 2017: Chest
https://www.readbyqxmd.com/read/28526655/digital-morphometrics-a-new-upper-airway-phenotyping-paradigm-in-obstructive-sleep-apnea
#4
Richard J Schwab, Sarah E Leinwand, Cary B Bearn, Greg Maislin, Ramya Bhat Rao, Adithya Nagaraja, Stephen Wang, Brendan T Keenan
BACKGROUND: Obstructive sleep apnea (OSA) is associated with changes in pharyngeal anatomy. The goal of this study was to objectively and reproducibly quantify pharyngeal anatomy using digital morphometrics based on a laser ruler, and to assess differences between apneics and controls and associations with AHI (apnea-hypopnea index). This is the first study to use digital morphometrics to quantify intraoral risk factors for OSA. METHODS: Digital photographs were obtained using an intraoral laser ruler and digital camera in 311 controls (mean AHI=4...
May 16, 2017: Chest
https://www.readbyqxmd.com/read/28513521/otorhinolaryngological-emergencies-in-a-tertiary-hospital-in-port-harcourt
#5
U M Ibekwe
BACKGROUND: Emergencies are not uncommon in a typical otorhinolaryngological (ORL) clinic. The knowledge of the profile and prevalence of these emergencies will go a long way in helping to equip as well as aid proper and prompt management of these conditions so as to reduce their morbidity and mortality. PATIENTS AND METHODS: A descriptive retrospective 8 years review of all patients that presented to the ENT Surgery Department from January 2004 to December 2012...
May 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28511831/obstructive-sleep-apnea-and-dermatologic-disorders
#6
Madhulika A Gupta, Fiona C Simpson, Branka Vujcic, Aditya K Gupta
Obstructive sleep apnea (OSA) is present in at least 2% of women and 4% of men, and its prevalence is increasing, because a major predisposing factor for OSA is a high body mass index. Psoriasis has the most strongly substantiated link with OSA, where the relationship may be bidirectional. Dermatologic disorders may be comorbid with OSA due to several factors: (i) the heightened proinflammatory state in OSA, which can occur independent of body mass index, and may exacerbate inflammatory dermatoses; (ii) intermittent hypoxemia may promote neovascularization and tumor growth in certain cancers, such as melanoma; (iii) obesity, present in majority of OSA patients, can be associated with a heightened proinflammatory state; (iv) upper airway obstruction due to local tumors or soft tissue swelling due to physical urticaria or angioedema; (v) acute nasal congestion in the atopic patient with allergic rhinitis; (vi) dermatologic disorders associated with other OSA risk factors (eg, acanthosis nigricans and metabolic syndrome); and (vii) a high sympathetic tone (eg, in atopic dermatitis) and resultant sleep fragmentation contributing to upper airway instability during sleep...
May 2017: Clinics in Dermatology
https://www.readbyqxmd.com/read/28508288/repetitive-postoperative-extubation-failure-and-cardiac-arrest-due-to-laryngomalacia-after-general-anesthesia-in-an-elderly-patient-a-case-report
#7
Jun Takeshita, Kei Nishiyama, Masashi Fujii, Hiroyuki Tanaka, Satoru Beppu, Nozomu Sasahashi, Nobuaki Shime
The authors report a case involving an elderly patient who experienced repetitive perioperative cardiac arrest caused by laryngomalacia. The patient underwent surgery under general anesthesia; however, 2 h after initial extubation, he experienced cardiopulmonary arrest. Return of spontaneous circulation was achieved by immediate resuscitation. Four hours later, a second extubation was performed without any neurological complications. However, 2 h later, he experienced cardiopulmonary arrest again. Immediately after the third extubation, 12 h after the second cardiopulmonary arrest, fiberoptic laryngoscopy revealed laryngomalacia...
May 15, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28507531/noradrenergic-activation-of-hypoglossal-nucleus-modulates-the-central-regulation-of-genioglossus-in-chronic-intermittent-hypoxic-rats
#8
Xinshi Nie, Ling Zhou, Aidi Wang, Hongyu Jin, Zheng Qin, Jian Pang, Wei Wang, Jian Kang
Neuromuscular compensation of the genioglossus muscle can be induced by chronic intermittent hypoxia (CIH) in obstructive sleep apnea to maintain upper airway stability. Noradrenergic activation of hypoglossal nucleus plays a critical role in the central control of the genioglossus. However, it remains unknown whether norepinephrine takes part in the central regulation of the genioglossus during CIH. Adult male Wistar rats (n = 32) were studied to explore the influence of noradrenergic activation of hypoglossal nucleus on the central control of the genioglossus at different stages of CIH...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28493349/adult-acute-supraglottitis-analysis-of-358-patients-for-predictors-of-airway-intervention
#9
Yael Shapira Galitz, Hagit Shoffel-Havakuk, Oded Cohen, Doron Halperin, Yonatan Lahav
OBJECTIVES/HYPOTHESIS: Acute supraglottitis is a potentially life-threatening condition due to rapid onset upper airway obstruction. The study aimed to characterize adult acute supraglottitis patients and to recognize factors associated with an aggressive disease course. STUDY DESIGN: Retrospective chart review. METHODS: All adult acute supraglottitis patients admitted to a single academic medical center between 2000 and 2014 were included and their medical charts reviewed...
May 11, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28489776/is-c-reactive-protein-a-marker-of-obstructive-sleep-apnea-a-meta-analysis
#10
Kun Li, Peng Wei, Yanwen Qin, Yongxiang Wei
BACKGROUND: Obstructive sleep apnea (OSA) is a common disease, distinguished by recurrent episodes of upper airway obstruction during sleep, with an inflammatory component. C-reactive protein (CRP) and high-sensitivity C-reactive protein (hs-CRP) are markers of systemic inflammation and may serve as biomarkers of OSA. METHODS: Scientific studies published from January 1, 2006, to January 1, 2016 were obtained via searches of PubMed, Embase, SCI, and China National Knowledge Internet (CNKI) using relevant terms...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28485295/hearing-loss-in-mild-osas-and-simple-snoring-patients
#11
Maria Carla Spinosi, Francesca D'Amico, Giulio Passali, Cemal Cingi, Hugo Rodriguez, Desiderio Passali
Introduction Obstructive Sleep Apnea Syndrome (OSAS) is characterized by recurrent episodes of prolonged partial or complete obstruction of the upper airways. Several study groups studied the effect of snoring and OSAS on auditory function, showing an increase in the incidence of hearing loss in apneic patients, an earlier onset and/or a degree of hearing loss deeper than in peers. The aim of our study is to evaluate the audiological performance of a population of simple-snoring patients and patients suffering from mild OSAS, and the impact that such pathological condition can have on the auditory function, considering the significant levels of chronic noise...
April 30, 2017: Otolaryngologia Polska
https://www.readbyqxmd.com/read/28483254/teratoma-of-the-neonatal-head-and-neck-a-41-year-experience
#12
Jacob R Brodsky, Alexandria L Irace, Amanda Didas, Karen Watters, Judy A Estroff, Carol E Barnewolt, Antonio Perez-Atayde, Reza Rahbar
OBJECTIVE: To review our institution's experience with the presentation, evaluation, and management of teratoma of the head and neck in the neonatal population. DESIGN: Retrospective case series (November 1970 through September 2011). SETTING: Tertiary care children's hospital. PATIENTS: 14 patients (12 boys and 2 girls). INTERVENTION: Detailed review of presentation, diagnostic approaches, surgical management, and outcomes...
June 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28483230/changes-in-airway-dimensions-following-functional-appliances-in-growing-patients-with-skeletal-class-ii-malocclusion-a-systematic-review-and-meta-analysis
#13
REVIEW
MingLi Xiang, Bo Hu, Yang Liu, Jicheng Sun, Jinlin Song
OBJECTIVES: The purpose of the study was to evaluate the treatment effects of functional appliances (FAs) on upper airway dimensions in growing Class II patients with mandibular retrognathism. METHODS: Five databases and the references of identified articles were electronically searched for relevant studies that met our eligibility criteria. The quality of the included studies was assessed using the Newcastle-Ottawa Scale. The effects of FAs on airway dimensions were combined by meta-analysis using the RevMan and STATA software...
June 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28483219/laryngotracheal-anomalies-and-airway-fluoroscopy-in-infants
#14
Amal Isaiah, Kevin D Pereira
OBJECTIVES: The role of airway fluoroscopy in the diagnosis of laryngotracheal anomalies in infants is controversial. We aimed to (i) compare airway fluoroscopic characteristics with endoscopic findings in infants presenting for evaluation of upper airway obstruction and (ii) assess the as low as is reasonably achievable (ALARA) status for airway fluoroscopy as an initial diagnostic test in suspected laryngotracheal anomalies. MATERIALS AND METHODS: We performed a retrospective review of children who underwent fluoroscopy and endoscopic evaluation of the airway in the operating room for suspected laryngotracheal anatomic abnormalities...
June 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28482650/obesity-and-perioperative-noninvasive-ventilation-in-bariatric-surgery
#15
Michele Carron, Francesco Zarantonello, Giovanna Ieppariello, Carlo Ori
The incidence and prevalence of obesity continues to increase globally. Physicians will therefore provide care for an increasing number of obese patients in their clinical practice. Optimal management of these patients is required to minimize the risk of perioperative complications that increase morbidity and mortality. Obesity affects the respiratory function. It is generally associated with reduced lung volume with increased atelectasis, decreased lung and chest wall compliance, increased airway resistance, and moderate to severe hypoxemia...
June 2017: Minerva Chirurgica
https://www.readbyqxmd.com/read/28468149/study-on-the-short-time-remolding-of-upper-airway-after-uvulopalatopharyngoplasty
#16
Kan Yao, Meng Wang, Wenwen Yu, Xiaofeng Lu
OBJECTIVE: To verify the short-time remolding of upper airway in patients diagnosed with obstructive sleep disordered breathing after Uvulopalatopharyngoplasty (UPPP). METHODS: Twenty-one male adult patients aged 27 to 52 years followed up ranged from preoperation to 6 months after the operation. Lateral cephalometric radiographs (conventional and when pronouncing "i") were obtained 2 weeks preoperatively, 3 days postoperatively, and 1, 2, 3, 6 months after the surgery...
May 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28459282/use-of-nasal-high-flow-in-stable-copd-rationale-and-physiology
#17
Lara Pisani, Maria Laura Vega
High-flow nasal cannula (HFNC) is a device able to deliver heated and humidified oxygen at high flows (up to 60 L/minutes). Potential benefits of HFNC are several and include the improvement of lung mucociliary clearance, the washout of upper airway dead space, the generation of a low level of positive airway pressure (PEEP effect), the decrease in inspiratory resistance and at the same time the increase in expiratory resistance. The present review aimed to describe the evidence surrounding the use of HFNC in stable chronic obstructive pulmonary disease patients...
May 1, 2017: COPD
https://www.readbyqxmd.com/read/28457272/three-dimensional-upper-airway-changes-with-mandibular-advancement-device-in-patients-with-obstructive-sleep-apnea
#18
Chandrakant Shivkumar Shete, Wasundhara Ashok Bhad
INTRODUCTION: A mandibular advancement device effectively increases upper airway size in patients with obstructive sleep apnea. Three-dimensional volumetric upper airway changes, exact amounts of change in obstructed upper airways (smallest cross-sectional area), and anteroposterior and transverse changes with mandibular advancement devices are not clear. METHODS: Thirty-seven patients with obstructive sleep apnea diagnosed with polysomnography were evaluated with the subjective Epworth sleepiness scale, percentage of oxygen saturation, and cone-beam computed tomography...
May 2017: American Journal of Orthodontics and Dentofacial Orthopedics
https://www.readbyqxmd.com/read/28448643/the-10-commandments-of-management-for-acute-upper-airway-obstruction-in-infants-and-children
#19
Kenneth M Grundfast, Louis F Insalaco, Jessica Levi
No abstract text is available yet for this article.
April 27, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28440911/unnoticed-aspiration-of-palate-plate-impression-material-in-a-neonate-diagnosis-therapy-outcome
#20
Friedrich Reichert, Peter Amrhein, Frank Uhlemann
A 7 week old infant was admitted with respiratory failure. Chest X-ray showed an atelectatic right upper lobe, herniation of right middle and lower lobe into the left thorax, and compression-atelectasis of the left lung. Thoracic CT showed complete occlusion of the right superior bronchus with a radiopaque foreign material. Six weeks prior, an impression for a palate plate using polyvinylsiloxane was taken. The material was removed with a rigid endoscopy, in readiness of extracorporeal oxygenation in case of tracheal obstruction or bronchial rupture...
April 25, 2017: Pediatric Pulmonology
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