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Surgical obstructive sleep apnea

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https://www.readbyqxmd.com/read/28323671/codeine-and-opioid-metabolism-implications-and-alternatives-for-pediatric-pain-management
#1
Vidya Chidambaran, Senthilkumar Sadhasivam, Mohamed Mahmoud
PURPOSE OF REVIEW: Use of perioperative opioids for surgical pain management of children presents clinical challenges because of concerns of serious adverse effects including life-threatening respiratory depression. This is especially true for children with history of obstructive sleep apnea. This review will explore current knowledge of clinically relevant factors and genetic polymorphisms that affect opioid metabolism and postoperative outcomes in children. RECENT FINDINGS: Within the past several years, an increasing number of case reports have illustrated clinically important respiratory depression, anoxic brain injuries and even death among children receiving appropriate weight-based dosages of codeine and other opioids for analgesia at home setting particularly following tonsillectomy...
March 18, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28299255/changes-in-posterior-airway-space-and-mandibular-plane-hyoid-distance-following-mandibular-advancement-do
#2
Pushpa Kumari, S K Roy, Indranil Dev Roy, A K Rajput, M P Prasanna Kumar, Sanjeev Datana, Serat Rahman
AIM: To study the changes in posterior airway space (PAS) and mandibular plane hyoid (MPH) distance following mandibular advancement using distraction osteogenesis (DO). SUBJECTS AND METHODS: A prospective study was conducted at a tertiary care dental center from May 2009 to May 2014. Twenty-five consecutively operated patients of mandibular hypoplasia who underwent mandibular advancement using distraction with at least 12 months follow-up were included in the study...
July 2016: Annals of Maxillofacial Surgery
https://www.readbyqxmd.com/read/28294946/continuing-the-original-stanford-sleep-surgery-protocol-from-upper-airway-reconstruction-to-upper-airway-stimulation-our-first-successful-case
#3
Stanley Yung Liu, Robert Wayne Riley
In 1993, a surgical protocol for dynamic upper airway reconstruction in patients with obstructive sleep apnea (OSA) was published, and it became commonly known as the Stanford phase 1 and 2 sleep surgery protocol. It served as a platform on which research and clinical studies have continued to perfect the surgical care of patients with OSA. However, relapse is inevitable in a chronic condition such as OSA, and a subset of previously cured surgical patients return with complaints of excessive daytime sleepiness...
February 20, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28293491/disparities-in-utilization-of-jaw-surgery-for-treatment-of-sleep-apnea-a-nationwide-analysis
#4
Ravi K Garg, Ying Shan, Jeffrey A Havlena, Ahmed M Afifi
BACKGROUND: Maxillomandibular advancement has been shown to be one of the most effective operations for management of severe obstructive sleep apnea, yet pharyngeal surgery is more commonly performed. The goal of this study was to identify socioeconomic factors associated with this phenomenon. METHODS: Patients aged 14 or older with a primary hospital diagnosis of sleep apnea were identified using the National Inpatient Sample from 2005 to 2012. ICD9 codes were used to determine whether a pharyngeal or jaw procedure was performed...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28292706/effect-of-airflow-and-material-models-on-tissue-displacement-for-surgical-planning-of-pharyngeal-airways-in-pediatric-down-syndrome-patients
#5
Dhananjay Radhakrishnan Subramaniam, Goutham Mylavarapu, Robert J Fleck, Raouf S Amin, Sally R Shott, Ephraim J Gutmark
Pharyngeal narrowing in obstructive sleep apnea (OSA) results from flow-induced displacement of soft tissue. The objective of this study is to evaluate the effect of airflow parameters and material model on soft tissue displacement for planning surgical treatment in pediatric patients with OSA and Down syndrome (DS). Anatomically accurate, three-dimensional geometries of the pharynx and supporting tissue were reconstructed for one pediatric OSA patient with DS using magnetic resonance images. Six millimeters of adenoid tissue was virtually removed based on recommendations from the surgeon, to replicate the actual adenoidectomy...
March 8, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28279632/drug-induced-sleep-endoscopy-a-new-gold-standard-for-evaluating-osas-part-ii-results
#6
M Blumen, E Bequignon, F Chabolle
Surgical results in obstructive sleep apnea syndrome (OSAS) vary greatly, whatever the surgical technique or site. Most authors agree that rigorous patient selection is logical and mandatory. Drug-induced sleep endoscopy (DISE) was introduced in 1991 and has been rediscovered and used extensively since the 2000s. It attempts to mimic natural sleep in order to observe the upper airway on flexible endoscopy in a situation in which obstruction may occur. A review of the DISE literature was performed, and is reported in two parts...
March 6, 2017: European Annals of Otorhinolaryngology, Head and Neck Diseases
https://www.readbyqxmd.com/read/28279631/drug-induced-sleep-endoscopy-a-new-gold-standard-for-evaluating-osas-part-i-technique
#7
M Blumen, E Bequignon, F Chabolle
Surgical results in obstructive sleep apnea syndrome (OSAS) vary greatly, whatever the surgical technique or site treated. Most authors agree that rigorous patient selection is logical and mandatory. Drug-induced sleep endoscopy (DISE) was introduced in 1991 and has been rediscovered and used extensively since the 2000s. It mimics sleep in order to observe the upper airway on flexible endoscopy. A review of the DISE literature was performed, and is reported in two parts. The present first part describes the technique: drugs, practical anesthesiologic and ENT modalities, reproducibility, and limitations...
March 6, 2017: European Annals of Otorhinolaryngology, Head and Neck Diseases
https://www.readbyqxmd.com/read/28254101/electroacupuncture-assisted-craniotomy-on-an-awake-patient
#8
Amritpal Sidhu, Trushna Murgahayah, Vairavan Narayanan, Hari Chandran, Vicknes Waran
Although acupuncture has existed for over 2000 years, its application as an anesthetic aid began in the 1950s in China. The first surgical procedure performed under acupuncture anesthesia was a tonsillectomy. Soon thereafter, major and minor surgical procedures took place with electroacupuncture alone providing the anesthesia. The procedures performed were diverse, ranging from cardiothoracic surgery to dental extractions. Usage of acupuncture anesthesia, specifically in neurosurgery, has been well documented in hospitals across China, especially in Beijing, dating back to the 1970s...
January 2017: Journal of Acupuncture and Meridian Studies
https://www.readbyqxmd.com/read/28237516/tongue-retaining-devices-for-obstructive-sleep-apnea-a-systematic-review-and-meta-analysis
#9
Edward T Chang, Camilo Fernandez-Salvador, Jeremy Giambo, Blaine Nesbitt, Stanley Yung-Chuan Liu, Robson Capasso, Clete A Kushida, Macario Camacho
OBJECTIVE: Tongue Retaining Devices (TRD) anteriorly displace the tongue with suction forces while patients sleep. TRD provide a non-surgical treatment option for patients with Obstructive Sleep Apnea (OSA). Our objective was to conduct a systematic review of the international literature for TRD outcomes as treatment for OSA. METHODS: Three authors independently and systematically searched four databases (including PubMed/MEDLINE) through June 26, 2016. We followed guidelines set within the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)...
January 18, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28235504/usefulness-and-diagnostic-value-of-the-nema-parameter-combined-with-other-selected-bedside-tests-for-prediction-of-difficult-intubation
#10
Kamil Torres, Marcin Błoński, Łukasz Pietrzyk, Małgorzata Piasecka-Twaróg, Ryszard Maciejewski, Anna Torres
STUDY OBJECTIVE: To assess the usefulness of the new NEMA (Neck Circumference Minus Acromion-Acromion Distance) parameter, in preoperative identification of patients' difficult intubation and compare it with other commonly used scales and tests. DESIGN: Prospective study. SETTING: District Specialist Hospital of Lublin, Poland. PATIENTS: Six hundreds twenty-nine patients underwent nonemergency surgical interventions...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28231591/predictive-success-factors-in-selective-upper-airway-stimulation
#11
Clemens Heiser, Benedikt Hofauer
Obstructive sleep apnea is one of the most common diseases in Western industrialized countries. A variety of conservative and surgical treatment options are available for its treatment. In recent years, selective upper airway stimulation (sUAS) has been shown to be effective and safe. Different biomarkers have been investigated as predictive clinical success factors in a number of clinical trials. Age does not matter in sUAS, as compared to its predictive role in other therapies. Weight seems to play a limited role, depending on drug-induced sleep endoscopy to rule out a complete concentric collapse with an increased body mass index...
2017: ORL; Journal for Oto-rhino-laryngology and its related Specialties
https://www.readbyqxmd.com/read/28231365/alteration-of-serum-levels-of-inflammatory-cytokines-and-polysomnographic-indices-after-uvulopalatal-flap-surgery-in-obstructive-sleep-apnea
#12
Murad Mutlu, Erkan Vuralkan, Istemihan Akin, Hikmet Firat, Sadik Ardic, Sevgi Akaydin, Ece Miser
The aim of the current study was to compare the changes in polysomnographic indices and serum levels of C-reactive protein (CRP), cystatin C, tumor necrosis factor-α (TNF-α), and intercellular adhesion molecule-1 (ICAM-1) in patients with obstructive sleep apnea (OSA) who were treated surgically via a uvulopalatal flap (UPF) technique. Twenty-five patients (14 men, 11 women), average age 46.2 ± 9.3 years, who underwent UPF surgery were included in this study. Serum biochemical analyses and polysomnographic examinations were performed before and 6 months after the surgery...
February 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28224280/predictors-of-success-in-combination-of-tongue-base-resection-and-lateral-pharyngoplasty-for-obstructive-sleep-apnea
#13
Chi Sang Hwang, Jin Won Kim, Sang Chul Park, Hyo Jin Chung, Chang-Hoon Kim, Joo-Heon Yoon, Hyung-Ju Cho
The base of the tongue has been recognized as a significant site of obstruction in patients with obstructive sleep apnea (OSA). Our aim was to determine the independent predictors of surgical success in tongue base resection combined with lateral pharyngoplasty for OSA. Thirty-one OSA patients who underwent endoscopie-guided coblator or transoral robotic tongue base resection in combination with lateral pharyngoplasty for the treatment of retroglossal obstruction between March 2012 and December 2015 were enrolled in this study...
February 21, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28220307/drug-induced-sedation-endoscopy-in-children-2%C3%A2-years-with-obstructive-sleep-apnea-syndrome-upper-airway-findings-and-treatment-outcomes
#14
A Boudewyns, P Van de Heyning, S Verhulst
Few data are available about the pattern of upper airway (UA) obstruction in children <2 years with obstructive sleep apnea syndrome (OSAS). Also, the role of adenoidectomy versus adenotonsillectomy (AT) is poorly defined in this age group. We performed drug-induced sedation endoscopy (DISE) in young OSAS children to investigate the pattern of UA obstruction and the value of DISE in therapeutic decision making. Retrospective analysis of ≤2-year-old children undergoing DISE-directed UA surgery. OSAS severity and the treatment outcomes were documented by polysomnography...
February 20, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28213776/the-importance-of-drug-induced-sedation-endoscopy-d-i-s-e-techniques-in-surgical-decision-making-conventional-versus-target-controlled-infusion-techniques-a-prospective-randomized-controlled-study-and-a-retrospective-surgical-outcomes-analysis
#15
Andrea De Vito, Vanni Agnoletti, Gianluca Zani, Ruggero Massimo Corso, Giovanni D'Agostino, Elisabetta Firinu, Chiara Marchi, Ying-Shuo Hsu, Stefano Maitan, Claudio Vicini
Drug-Induced Sedation Endoscopy (DISE) consists of the direct observation of the upper airways during sedative-induced sleep, allowing the identification of the sites of pharyngeal collapse, which is the main pathological event in Obstructive Sleep Apnea (OSA). The Authors have compared Target Controlled Infusion (TCI) sedation endoscopy (TCI-DISE) technique to conventional DISE (CDISE), performed by a manual bolus injection of sedative agent, to recreate accurately and safely snoring and apnea patterns comparable to natural sleep...
February 17, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28211992/thirty-day-outcomes-for-children-and-adolescents-undergoing-laparoscopic-sleeve-gastrectomy-at-a-free-standing-children-s-hospital
#16
A L Speer, J Parekh, F G Qureshi, E P Nadler
The obesity epidemic continues to affect millions of children and adolescents. Non-surgical options do not result in significant or sustained weight loss; thus bariatric surgery has become increasingly utilized. Limited data exist regarding safety for paediatric bariatric surgery, especially outside of National Institutes of Health (NIH)-funded centres. We hypothesized that the perioperative outcomes of paediatric patients undergoing laparoscopic sleeve gastrectomy (LSG) at our free-standing children's hospital would provide adequate safety profiles...
April 2017: Clinical Obesity
https://www.readbyqxmd.com/read/28208178/lingual-tonsillectomy-for-treatment-of-pediatric-obstructive-sleep-apnea-a-meta-analysis
#17
Kun-Tai Kang, Peter J Koltai, Chia-Hsuan Lee, Ming-Tzer Lin, Wei-Chung Hsu
Importance: Evidence indicates correlations between lingual tonsil hypertrophy and pediatric obstructive sleep apnea (OSA). However, to our knowledge, a meta-analysis of surgical outcomes for lingual tonsillectomy in children with OSA has not been conducted. Objective: To evaluate the therapeutic outcomes of lingual tonsillectomy for treatment of pediatric OSA. Data Sources: The study protocol was registered on PROSPERO (CRD42015027053). PubMed, MEDLINE, EMBASE, and the Cochrane Reviews databases were searched independently by 2 authors for relevant articles published by September 2016...
February 16, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28198643/the-role-of-curvilinear-distraction-system-in-pediatric-obstructive-sleep-apnea-a-case-report
#18
David Serrano Faustino Ângelo, Bruno Rosa, Rogério Santos, Carlos Diogo Matos
OBJECTIVE: The authors present a case of obstructive sleep apnea associated with severe mandibular micrognathia treated by mandibular bone distraction with curvilinear system planned under computer assistance. CLINICAL PRESENTATION: A 15-year-old child with limited compliance to continuous positive airway therapy was referred to the authors' department. Observation revealed severe mandibular micrognathia as the major cause for obstructive sleep apnea syndrome. The first polysomnography study revealed 14 obstructive apneas, 16 obstructive hypopneas, and 4...
February 15, 2017: Cranio: the Journal of Craniomandibular Practice
https://www.readbyqxmd.com/read/28195824/sleep-surgery-in-the-elderly
#19
Christopher J Gouveia, John D Cramer, Stanley Yung-Chuan Liu, Robson Capasso
Objective Assess the frequency and nature of postoperative complications following sleep surgery. Examine these issues specifically in elderly patients to provide guidance for their perioperative care. Study Design Retrospective cohort study. Setting American College of Surgeons National Surgical Quality Improvement Program. Methods We identified patients with obstructive sleep apnea undergoing sleep surgery procedures from 2006 to 2013 in the American College of Surgeons National Surgical Quality Improvement Program, a multi-institutional outcomes program designed to improve surgical quality...
February 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28195009/the-combination-of-anatomy-and-genioglossus-activity-in-predicting-the-outcomes-of-velopharyngeal-surgery
#20
Di Zhao, YanRu Li, JunFang Xian, Yue Qu, Xin Cao, JingYing Ye
Objective This study aims to evaluate the combination of genioglossus (GG) activity and anatomical characteristics in predicting outcomes of velopharyngeal surgery in patients with obstructive sleep apnea (OSA). Study Design Case series with planned data collection. Setting Sleep medical center. Subjects and Methods Forty patients with OSA underwent overnight polysomnography with synchronous genioglossus electromyography (GGEMG) using intraoral electrodes. The upper airway anatomy was evaluated by 3-dimensional computed tomography in patients with OSA...
March 2017: Otolaryngology—Head and Neck Surgery
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