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Surgical obstructive sleep apnea

Jeong-Whun Kim, Seung Hoon Lee, Hong Joong Kim, Chae-Seo Rhee, Seung-No Hong
OBJECTIVE: Our aim was to radiographically and histologically characterize the tongue base tissues removed after robotic surgery and to analyze their relationship with polysomnographic measurements in obstructive sleep apnea. METHODS: Medical records, radiographs and histologic specimen of the patients who underwent transoral robotic tongue base reduction surgery were retrospectively reviewed. Findings in computed tomography (CT) images, histopathological features of the removed tongue base tissues, and respiratory parameters in polysomnography were compared and analyzed...
June 18, 2018: Auris, Nasus, Larynx
J Su, J H Tian, X X Gao, Y F Wu, J M Zu, K F Dong, L G Duan
Objective: To observe the value of multimodal analgesia in patients with OSAHS undergoing multiplanar surgery. Method: A total number of 90 patients with obstructive sleep apnea hypopnea syndrome with tongue hypertrophy or hyperplasia of the root lymphoid tissue were collected. All patients underwent improved uvulatopharyngeal angioplasty (H-UPPP) and tongue root partial resection, or simultaneous tongue ablation at the same time, and they were randomly divided into two groups,45 patients in each group.In multi-modal analgesic group, the parrixibub sodium 40 mg were given intravenously 0...
June 5, 2018: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
Helen H Lee, Nicholas M Dalesio, Anthony T Lo Sasso, William C Van Cleve
BACKGROUND: Pediatric adenotonsillectomies are common and carry known risks of potentially severe complications. Complications that require a revisit, to either the emergency department or hospital readmission, increase costs and may be tied to lower reimbursements by federal programs. In 2011 and 2012, recommendations by pediatric and surgical organizations regarding selection of candidates for ambulatory procedures were issued. We hypothesized that guideline-associated changes in practice patterns would lower the odds of revisits...
June 12, 2018: Anesthesia and Analgesia
Michael W Noller, Christian Guilleminault, Christopher J Gouveia, Douglas Mack, Cindy L Neighbors, Soroush Zaghi, Macario Camacho
OBJECTIVES: Mandibular distraction osteogenesis and mandibular advancement, collectively referred to as mandibular advancement surgeries (MAS), have been used to treat children with mandibular insufficiency and obstructive sleep apnea (OSA). The objective is to perform a systematic review and meta-analysis for MAS as treatment for obstructive sleep apnea. METHODS: Three authors searched multiple databases (including PubMed/Medline) from inception through April 25, 2018...
May 4, 2018: Journal of Cranio-maxillo-facial Surgery
M Däzlä, M Yilmaz, F Karaloglu, R Karamert, V C Goksu, S A Kahraman, Y K Kemaloglu
Objective: : We aimed to present our clinical experience with maxillomandibular advancement (MMA) for the treatment of obstructive sleep apnea (OSA) syndrome and to compare our results with literature data. Materials and Methods: : The patients who were operated for OSA in the last 10 years were included in the study. A detailed patient's charts review was retrospectively performed. Inclusion criteria were to be available with preoperative and postoperative polysomnography data...
June 2018: Nigerian Journal of Clinical Practice
Yung-An Tsou, Chen-Wei Huang, Tsu-Fang Wu, Lung-Wen Hung, Wen-Dien Chang
The objective was to investigate whether tongue base suspension with uvulopalatopharyngoplasty (UPPP) is beneficial on polysomnography analysis for sleep quality in patients with obstructive sleep apnea (OSA) anatomically classified as Fujita type III (small tonsils and a bulky tongue base). In the retrospective study, the charts of 36 patients with OSA that underwent tongue base suspension with UPPP from 2012 through 2015 were reviewed. The surgical outcome measured according to Sher's classification (AHI reduction > 50% and AHI < 20 per hour as success group, otherwise as failure group)...
June 8, 2018: Scientific Reports
Nicoleta Aurelia Popescu, Marcela Daniela Ionescu, Georgiana Balan, Simina Visan, Eliza Cinteza, Diana Stanescu, Ionut Gobej, Mihaela Balgradean
Central sleep apnea is characterized by frequent cessation of breathing during sleep, resulting in repetitive episodes of insufficient ventilation and abnormalities of acid-base balance. It may be primary or secondary, and it is uncommon in children, with limited data for this population. We present here the case of a five-year-old girl, known to have thoracolumbar myelomeningocele (for which she underwent a surgical procedure in infancy), secondary hydrocephalus (with a ventriculoperitoneal shunt) and flaccid paralysis, who was admitted in our hospital with prolonged fever syndrome, productive cough, severe dyspnea and perioral cyanosis...
March 2018: Mædica
Amanda Lucas da Costa, Denise Manica, Cláudia Schweiger, Gabriel Kuhl, Leo Sekine, Simone Chaves Fagondes, Marcus Vinicius Collares, Paulo Jose Cauduro Marostica
INTRODUCTION: The optimal surgical technique for the management of patients with Robin Sequence (RS) has not been established. One of the most commonly used surgical techniques, mandibular distraction osteogenesis (MDO), is still controversial because of its potential risks and the lack of clear evidence of its efficacy. OBJECTIVES: To assess variations in airway patency, clinical symptoms, and polysomnographic parameters in children with RS who underwent MDO. METHODS: In this prospective cohort study, 38 patients with RS were evaluated before and after MDO...
May 18, 2018: Journal of Cranio-maxillo-facial Surgery
Morgan Bliss, Swati Yanamadala, Peter Koltai
OBJECTIVES: The goal of this report was to find the frequency of synchronous airway lesions (SAL) identified during microdirect laryngoscopy and bronchoscopy (MDLB) that influenced treatment decisions beyond the information provided by drug induced sleep endoscopy (DISE) alone in children with obstructive sleep apnea (OSA) at a tertiary care pediatric hospital. METHODS: This was a retrospective chart review of all pediatric patients who underwent drug induced sleep endoscopy in conjunction with direct laryngoscopy and bronchoscopy as part of a comprehensive airway evaluation for obstructive sleep apnea at a tertiary care pediatric hospital...
July 2018: International Journal of Pediatric Otorhinolaryngology
Jennifer Best, Sean Mutchnick, Jonathan Ida, Kathleen R Billings
INTRODUCTION: Residual obstructive sleep apnea (OSA) after adenotonsillectomy (T&A) is a common problem in children with Down Syndrome (DS). Our objective was to describe trends in surgical and medical management of OSA in pediatric patients with DS, and to present an algorithmic approach to managing these children. METHODS: Retrospective case series of children with DS seen at a tertiary care medical center between 1/2008-6/2016 who underwent polysomnography (PSG) after having a T&A performed for sleep disordered breathing (SDB)...
July 2018: International Journal of Pediatric Otorhinolaryngology
Johan Fehrm, Pia Nerfeldt, Joar Sundman, Danielle Friberg
Importance: Adenotonsillectomy (ATE) is the primary surgical method for treating obstructive sleep apnea (OSA) in children. However, children with severe OSA have an increased risk for residual OSA after ATE. Previous studies indicate that adenopharyngoplasty (APP), a modified ATE with closure of the tonsillar pillars, might improve the surgical outcome, but the overall evidence is weak. Objective: To determine whether APP is more effective than ATE for treating severe OSA in otherwise healthy children...
May 31, 2018: JAMA Otolaryngology—Head & Neck Surgery
Hind A Beydoun, May A Beydoun, Hong Cheng, Anjum Khan, Shaker M Eid, Carolina Alvarez-Garriga, Colin Anderson-Smits, Alan B Zonderman, Danica Marinac-Dabic
The purpose of this cross-sectional study is to examine the relationship between surgical treatments for sleep-disordered breathing (SDB) and composite measure of surgical complications in a nationally representative sample of hospital discharges among U.S. adults. We performed secondary analyses of 33,679 hospital discharges from the 2002-2012 Nationwide Inpatient Sample that corresponded to U.S. adults (≥18 years) who were free of head-and-neck neoplasms, were diagnosed with SDB and had undergone at least one of seven procedures...
May 24, 2018: Journal of Cranio-maxillo-facial Surgery
Suresh Mohan, Jennifer C Fuller, Stephanie Friree Ford, Robin W Lindsay
Importance: Nasal airway obstruction (NAO) is a common complaint in the otolaryngologist's office and can have a negative influence on quality of life (QOL). Existing diagnostic methods have improved, but little consensus exists on optimal tools. Furthermore, although surgical techniques for nasal obstruction continue to be developed, effective outcome measurement is lacking. An update of recent advances in diagnostic and therapeutic management of NAO is warranted. Objective: To review advances in diagnosis and treatment of NAO from the last 5 years...
May 10, 2018: JAMA Facial Plastic Surgery
Mahmoud A K Ebrahim, Osamah AlSanea, Abdulmohsen E Al-Terki
Obstructive sleep apnea (OSA) is a disease that is associated with high morbidity and mortality and can significantly impact the quality of life in a patient. OSA is strongly associated with obesity, and literature showed that weight loss will lead to improvement in OSA. The gold standard treatment for OSA is continuous positive airway pressure (CPAP). However, other methods of treatment are available. One of these methods is multilevel sleep surgery (MLS). Literature showed that bariatric surgery can also improve OSA...
2018: Case Reports in Otolaryngology
Sanjay Naran, Derek M Steinbacher, Jesse A Taylor
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Identify skeletal differences that are treated with orthognathic surgery; describe the goals of orthognathic surgery; and understand modern virtual surgical planning of orthognathic movement of the mandible, maxilla, and chin. 2. Appreciate the surgical principles of maxilla- versus mandible-first surgery, and orthognathic surgery before orthodontic correction; and understand when an osseous genioplasty may be beneficial, and the potency of this bony movement...
June 2018: Plastic and Reconstructive Surgery
Dhananjay Radhakrishnan Subramaniam, Raanan Arens, Mark E Wagshul, Sanghun Sin, David M Wootton, Ephraim J Gutmark
Highly compliant tissue supporting the pharynx and low muscle tone enhance the possibility of upper airway occlusion in children with obstructive sleep apnea (OSA). The present study describes subject-specific computational modeling of flow-induced velopharyngeal narrowing in a female child with polycystic ovarian syndrome (PCOS) with OSA and a non-OSA control. Anatomically accurate three-dimensional geometries of the upper airway and soft-palate were reconstructed for both subjects using magnetic resonance (MR) images...
May 17, 2018: Journal of Biomechanics
Ross F Harrison, Erin E Medlin, Chase B Petersen, Stephen L Rose, Ellen M Hartenbach, David M Kushner, Ryan J Spencer, Laurel W Rice, Ahmed N Al-Niaimi
BACKGROUND: Women with a gynecologic cancer tend to be older, obese, and postmenopausal, characteristics that are associated with an increased risk for obstructive sleep apnea. However, there is limited investigation regarding the condition's prevalence in this population or its impact on postoperative outcomes. In other surgical populations, patients with obstructive sleep apnea have been observed to be at increased risk for adverse postoperative events. OBJECTIVES: To estimate the prevalence of obstructive sleep apnea among gynecologic oncology patients undergoing elective surgery and to investigate for a relationship between obstructive sleep apnea and postoperative outcomes...
May 21, 2018: American Journal of Obstetrics and Gynecology
Rodrigo Iturriaga
PURPOSE OF REVIEW: An abnormal heightened carotid body (CB) chemoreflex, which produces autonomic dysfunction and sympathetic overactivation, is the common hallmark of obstructive sleep apnea (OSA), resistant hypertension, systolic heart failure (HF), and cardiometabolic diseases. Accordingly, it has been proposed that the elimination of the CB chemosensory input to the brainstem may reduce the autonomic and cardiorespiratory alterations in sympathetic-associated diseases in humans. RECENT FINDINGS: A growing body of evidence obtained in preclinical animal models support that an enhanced CB discharge produces sympathetic hyperactivity, baroreflex sensitivity and heart rate variability impairment, breathing instability, hypertension, and insulin resistance...
May 22, 2018: Current Hypertension Reports
Cody D Legler
PURPOSE: Obstructive sleep apnea (OSA) is a common cause of intraoperative and postoperative complications in the surgical setting. DESIGN: Retrospective chart analysis. METHODS: Complete review of 150 patient charts over a 3-month period. FINDING: Findings indicated that of the 150 charts reviewed, 87 (58%) screened high (STOP-Bang score of 3 or greater) for OSA. Patients at a high risk for OSA preoperatively had a higher rate of postoperative complications compared with patients at low risk (79...
June 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Sherif M Askar, Mohammad W El-Anwar, Ali Awad
BACKGROUND: Retropalatal region might be considered the most common site of obstruction in patients with snoring and OSA. We aimed at presentation of two combined techniques: modified anterior palatoplasty (MAP) and bilateral double suspension suture (DSS). METHODS: This prospective study was conducted on OSA patients with retro-palatal collapse only that was confirmed by nasoendoscopy during Muller's maneuver and drug induced sleep endoscopy. MAP and DSS were performed for all patients...
May 18, 2018: Sleep & Breathing, Schlaf & Atmung
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