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upper airway obstruction

Charles W Lanks, Timothy L Van Natta, David W Hsia
Localized tracheobronchial amyloidosis is a rare disease that results from submucosal deposition of insoluble amyloid proteins in the large airways. Amyloidosis affecting the larynx and subglottic space typically results in unilateral, nodular vocal cord infiltration. It rarely can present with bilateral vocal cord involvement and can progress to lifethreatening respiratory failure due to upper airway obstruction. In these patients, typical treatment modalities such as CO2 laser ablation are often ineffectual...
October 2016: Journal of Bronchology & Interventional Pulmonology
Hsueh-Yu Li, Yu-Lun Lo, Chao-Jan Wang, Li-Jen Hsin, Wan-Ni Lin, Tuan-Jen Fang, Li-Ang Lee
Surgical success for obstructive sleep apnea (OSA) depends on identifying sites of obstruction in the upper airway. In this study, we investigated sites of obstruction by evaluating dynamic changes in the upper airway using drug-induced sleep computed tomography (DI-SCT) in patients with OSA. Thirty-five adult patients with OSA were prospectively enrolled. Sleep was induced with propofol under light sedation (bispectral index 70-75), and low-dose 320-detector row CT was performed for 10 seconds over a span of 2-3 respiratory cycles with supporting a continuous positive airway pressure model...
October 20, 2016: Scientific Reports
Kanika Gupta, Bhuvaneswari Venkatesan, Kiruba Shankar Manoharan, Vaithianathan Rajalakshmi, Maya Menon
Congenital high airway obstruction syndrome is a rare fetal anomaly with characteristic constellation of prenatal findings on ultrasound and MRI. The typical triad of imaging features are enlarged and echogenic lungs, flattening or inversion of diaphragm and fetal hydrops. Early prenatal recognition of congenital high airway obstruction syndrome by ultrasound and/or MRI is mandatory for the appropriate perinatal management. We report a case of a male fetus with typical imaging findings of congenital high airway obstruction syndrome on ultrasound and MRI at 19 weeks of gestation...
August 2016: Journal of Radiology Case Reports
Renata Rubinsztajn, Tadeusz Przybyłowski, Marta Maskey-Warzęchowska, Krzysztof Karwat, Ryszarda Chazan
: Body composition disorders are observed in chronic obstructive pulmonary disease (COPD) patients and have a significant impact the general condition and outcome in this disease. AIM: The aim of the study was to assess body composition in relation to airway obstruction severity in patients with COPD. MATERIALS AND METHODS: The study group consisted of 143 patients (58F, 85M) in the middle age The group was divided to two groups: group A FEV1<50% predicted and group B FEV1 ≥50% predicted; both groups were compared...
October 19, 2016: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Melinda A Ma, Rajesh Kumar, Paul M Macey, Frisca L Yan-Go, Ronald M Harper
INTRODUCTION: Obstructive sleep apnea (OSA) is a male-predominant condition, characterized by repeated upper-airway collapse with continued diaphragmatic efforts during sleep, and is accompanied by severe physiological consequences. Multiple morphological aspects, including epiglottis cross-sectional area (CSA) and oropharyngeal airway length (OPAL), can contribute to airway collapsibility in the condition. This study focused on the effects of OSA severity, sex, and race on OPA dimensions...
2016: Nature and Science of Sleep
Martin Wolley, Diane Cowley, Ashraf Ahmed, Richard Gordon, Michael Stowasser
OBJECTIVE: Obstructive sleep apnoea (OSA) is known to commonly co-exist with primary aldosteronism (PA), but it is unknown if treatment via mineralocorticoid receptor blockade or adrenalectomy (for aldosterone producing adenoma, APA), improves sleep apnoea parameters in these patients. We therefore aimed to determine if specific medical or surgical treatment of PA improves OSA, as measured by the apnoea hypopnoea index (AHI). DESIGN AND METHOD: Patients undergoing diagnostic workup for PA were recruited if they had symptoms suggestive of OSA...
September 2016: Journal of Hypertension
Gyeong Bo Kim, Sung Yeon Hwang, Tae Gun Shin, Tae Rim Lee, Won Chul Cha, Min Seob Sim, Ik Joon Jo, Keun Jeong Song, Joong Eui Rhee, Yeon Kwon Jeong
A 59-year-old man presented to the emergency department with a chief complaint of sore throat after swallowing sodium picosulfate/magnesium citrate powder for bowel preparation, without first dissolving it in water. The initial evaluation showed significant mucosal injury involving the oral cavity, pharynx, and epiglottis. Endotracheal intubation was performed for airway protection in the emergency department, because the mucosal swelling resulted in upper airway compromise. After conservative treatment in the intensive care unit, he underwent tracheostomy because stenosis of the supraglottic and subglottic areas was not relieved...
June 2016: Clin Exp Emerg Med
Ruofei Bu, Hillel Price, Sorin Mitran, Carlton Zdanski, Amy L Oldenburg
Quantitative endoscopic imaging is at the vanguard of novel techniques in the assessment upper airway obstruction. Anatomic optical coherence tomography (aOCT) has the potential to provide the geometry of the airway lumen with high-resolution and in 4 dimensions. By coupling aOCT with measurements of pressure, optical coherence elastography (OCE) can be performed to characterize airway wall stiffness. This can aid in identifying regions of dynamic collapse as well as informing computational fluid dynamics modeling to aid in surgical decision-making...
2016: Proceedings of SPIE
Paola Serio, Raffaella Nenna, Valentina Fainardi, Laura Grisotto, Annibale Biggeri, Roberto Leone, Luigi Arcieri, Marco Di Maurizio, Denise Colosimo, Roberto Baggi, Bruno Murzi, Lorenzo Mirabile, Fabio Midulla
OBJECTIVES: Surgery for vascular anomalies can occasionally fail to relieve symptoms, especially when severe tracheobronchial malacia persists. We studied outcomes in children who underwent airway stenting for severe post-surgical airway malacia and tested known clinical and surgical prognostic factors. METHODS: Among 257 children evaluated for tracheobronchial vascular compression, we reviewed the clinical charts for the 59 patients (23%) who underwent surgery...
October 15, 2016: European Journal of Cardio-thoracic Surgery
Jeffrey Dorrity, Nicholas Wirtz, Oleg Froymovich, David Hamlar
Surgical intervention for obstructive sleep apnea (OSA) is a complex topic. The discussion involves intricate procedures targeting specific areas of the upper airway. Because of the wide variety of physiologic and anatomic causes of this disorder it is important to tailor the treatment to offer the patient the best possible outcome. Genioglossus, hyoid, and tongue base procedures should be considered among theses treatment options.
October 11, 2016: Otolaryngologic Clinics of North America
Joseph Em van Agteren, Kristin V Carson, Leong Ung Tiong, Brian J Smith
BACKGROUND: Lung volume reduction surgery (LVRS) performed to treat patients with severe diffuse emphysema was reintroduced in the nineties. Lung volume reduction surgery aims to resect damaged emphysematous lung tissue, thereby increasing elastic properties of the lung. This treatment is hypothesised to improve long-term daily functioning and quality of life, although it may be costly and may be associated with risks of morbidity and mortality. Ten years have passed since the last version of this review was prepared, prompting us to perform an update...
October 14, 2016: Cochrane Database of Systematic Reviews
Diane C Lim, Allan I Pack
Obstructive sleep apnea (OSA) is a worldwide disease whose prevalence is increasing as obesity rates increase. The link between obesity and OSA is likely to be the deposition of fat in the tongue, compromising upper airway size. The role of obesity varies in different ethnic groups, with Chinese being particularly sensitive to increases in weight. OSA lends itself to a personalized approach to diagnosis and therapy. For example, different clinical OSA subtypes likely benefit from therapy in different ways. Hypoglossal nerve stimulation is a useful second-line therapy in patients who cannot tolerate continous positive airway pressure (CPAP) machines or intraoral devices...
October 5, 2016: Annual Review of Medicine
Christian Guilleminault, Shehlanoor Huseni, Lauren Lo
A short lingual frenulum has been associated with difficulties in sucking, swallowing and speech. The oral dysfunction induced by a short lingual frenulum can lead to oral-facial dysmorphosis, which decreases the size of upper airway support. Such progressive change increases the risk of upper airway collapsibility during sleep. Clinical investigation of the oral cavity was conducted as a part of a clinical evaluation of children suspected of having sleep disordered breathing (SDB) based on complaints, symptoms and signs...
July 2016: ERJ Open Research
Nikita Kohli, Dana DeCarlo, Nira A Goldstein, Joshua Silverman
OUTCOME OBJECTIVE: For over fifty years, otolaryngologists, allergists, and immunologists have debated the effect of adenoidectomy or adenotonsillectomy on asthma outcomes in children. Although some have suggested that adenotonsillectomy may contribute to the subsequent development of asthma in children, others have argued that a common mechanism may cause both upper and lower airway disease, and that children who have symptoms severe enough to warrant adenotonsillectomy are also at increased risk of asthma and atopic disease...
November 2016: International Journal of Pediatric Otorhinolaryngology
Xingli Liu, Weiwei Yan, Yang Liu, Yat Sze Choy, Yikun Wei
The flow characteristics in the realistic human upper airway (HUA) with obstruction that resulted from pharyngeal collapse were numerically investigated. The 3D anatomically accurate HUA model was reconstructed from CT-scan images of a Chinese male patient (38 years, BMI 25.7). The computational fluid dynamics (CFD) with the large eddy simulation (LES) method was applied to simulate the airflow dynamics within the HUA model in both inspiration and expiration processes. The laser Doppler anemometry (LDA) technique was simultaneously adopted to measure the airflow fields in the HUA model for the purpose of testifying the reliability of LES approach...
2016: Computational and Mathematical Methods in Medicine
Katherine Koral Green, B Tucker Woodson
Traditional upper airway surgery directly modifies skeletal and soft tissue structures surrounding the airway to treat obstructive sleep apnea (OSA). Upper airway stimulation (UAS) attempts to treat upper airway obstruction and OSA by stimulating the hypoglossal nerve. The Inspire II implant has been approved for clinical UAS. Basic science data support that UAS prevents obstruction and improves airflow. Clinical results demonstrate that UAS improves respiratory sleep metrics and improves both objective and subjective self-reported sleep and quality-of-life outcomes...
October 6, 2016: Otolaryngologic Clinics of North America
Shinya Miura, Nao Hamamoto, Masaki Osaki, Satoshi Nakano, Chisato Miyakoshi
BACKGROUND: The purpose of this study was to explore the prevalence, etiology, and risk factors of extubation failure (EF) in post-cardiac surgery neonates. METHODS: Neonates (30 days old or younger) who underwent cardiac surgery and were admitted to the cardiac intensive care unit between September 2010 and February 2016 were included. The prevalence and etiology of EF, defined as reintubation within 48 hours, were reviewed. Demographic, operative, and perioperative data were retrospectively collected...
October 6, 2016: Annals of Thoracic Surgery
Simon Veldhoen, Andreas M Weng, Janine Knapp, Andreas S Kunz, Daniel Stäb, Clemens Wirth, Florian Segerer, Helge Hebestreit, Uwe Malzahn, Herbert Köstler, Thorsten A Bley
Purpose To assess the clinical feasibility of self-gated non-contrast-enhanced functional lung (SENCEFUL) magnetic resonance (MR) imaging for quantitative ventilation (QV) imaging in patients with cystic fibrosis (CF). Materials and Methods Twenty patients with CF and 20 matched healthy volunteers underwent functional 1.5-T lung MR imaging with the SENCEFUL imaging approach, in which a two-dimensional fast low-angle shot sequence is used with quasi-random sampling. The lungs were manually segmented on the ventilation-weighted images to obtain QV measurements, which were compared between groups...
October 6, 2016: Radiology
Ali Yilmaz, Melike Akçaalan
BACKGROUND: Clinical detection of anatomic narrowing of the upper airway may faciliate early recognition of obstructive sleep apnea (OSA). The aim of this study was to investigate whether anthropometric measurement can be used to predict OSA. MATERIALS AND METHODS: 147 subject were included from those who were referred patients for suspected sleep apnea to our sleep laboratory. All patients were divided 2 groups with respect to the apnea-hypopnea index. The first group was diagnosed as OSA, AHI greater than 5...
October 7, 2016: Folia Morphologica (Warsz)
Hoang Kim Tu Trinh, Ga-Young Ban, Ji-Ho Lee, Hae-Sim Park
Elderly asthma (EA) is regarded as a distinct phenotype of asthma and is associated with age-related changes in airway structure and alterations in lung function and immune responses. EA is difficult to diagnose because of aging and co-morbidities, and overlaps with fixed airway obstructive disease. Novel modalities to differentiate between EA and chronic obstructive pulmonary disease (COPD) are necessary. A multifaceted approach, including clinical history, smoking habits, atopy, and measurement of lung function, is mandatory to differentiate asthma from COPD...
October 6, 2016: Drugs & Aging
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