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Surgical obstructive sleep apnea

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https://www.readbyqxmd.com/read/27906721/preoperative-evaluation-and-preparation-of-the-morbidly-obese-patient
#1
Andreas B Böhmer, Frank Wappler
PURPOSE OF REVIEW: This review aims to familiarize with the most current findings regarding preoperative evaluation and preparation of morbidly obese patients prior to elective, noncardiac surgery. In the light of the increasing number of surgical patients being morbidly obese, the knowledge of evidence-based preoperative evaluation strategies is profound for a rational approach. RECENT FINDINGS: Preoperative evaluation should be carried out with sufficient time before the day of surgery to allow modification of the perioperative management...
November 30, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27898430/an-update-on-the-various-practical-applications-of-the-stop-bang-questionnaire-in-anesthesia-surgery-and-perioperative-medicine
#2
Mahesh Nagappa, Jean Wong, Mandeep Singh, David T Wong, Frances Chung
PURPOSE OF REVIEW: The present review aims to provide an update on the various practical applications of the STOP-Bang questionnaire in anesthesia, surgery, and perioperative medicine. RECENT FINDINGS: The STOP-Bang questionnaire was originally validated as a screening tool to identify surgical patients who are at high-risk of obstructive sleep apnea (OSA). A recent meta-analysis confirmed that STOP-Bang is validated for use in the sleep clinic, surgical, and general population...
November 24, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27893557/changes-in-upper-airway-volume-following-orthognathic-surgery
#3
Lillian Marcussen, Kasper Stokbro, Esben Aagaard, Peter Torkov, Torben Thygesen
Reduced volume of the internal skeletal dimensions of the face is 1 of the main causes of obstructive sleep apnea, and attention to patients' airways is necessary when planning orthognathic treatment. This study aims to describe changes in upper airway volume following virtually planned orthognathic surgery.A retrospective pilot study was designed with 30 randomly selected patients (10 men and 20 women, aged 23.1 ± 6.8 years, molar-relations: 15 neutral, 8 distal, and 7 mesial). Cone-beam computed tomography scans were performed before surgery and 1 week following surgery...
November 23, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27893073/association-between-severity-of-obstructive-sleep-apnea-and-number-and-sites-of-upper-airway-operations-with-surgery-complications
#4
Zamzil Amin Asha'ari, Jamalludin Ab Rahman, Abdul Hadi Mohamed, Kahairi Abdullah, Wan Ishlah Leman
Importance: In patients with obstructive sleep apnea (OSA), operative risks depend on the severity of the underlying OSA and the invasiveness of the surgical procedure. Objective: To investigate the nature of the associations between the severity of OSA and the number and anatomical sites of upper airway operations with operative complications. Design, Setting, and Participants: This retrospective study included adult patients diagnosed with OSA (apnea-hypopnea index [AHI], >5) who underwent upper airway surgery at a single tertiary referral hospital between October 1, 2008, and October 1, 2015...
November 23, 2016: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/27885537/safety-analysis-of-bariatric-patients-undergoing-outpatient-upper-endoscopy-with-non-anesthesia-administered-propofol-sedation
#5
Tyler McVay, John C Fang, Linda Taylor, Alexander Au, Wesley Williams, Angela P Presson, Ragheed Al-Dulaimi, Eric Volckmann, Anna Ibele
BACKGROUND: Non-anesthesia administered propofol (NAAP) has been shown to be a safe and effective method of sedation for patients undergoing gastrointestinal endoscopy. Bariatric surgery patients are potentially at a higher risk for sedation-related complications due to co-morbidities including obstructive sleep apnea. The outcomes of NAAP in bariatric patients have not been previously reported. METHODS: In this retrospective cohort study, severely obese patients undergoing pre-surgical outpatient esophagogastroduodenoscopy (EGD) were compared to non-obese control patients (BMI ≤ 25 kg/m(2)) undergoing diagnostic EGD at our institution from March 2011-September 2015 using our endoscopy database...
November 24, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27879159/poor-interexaminer-agreement-on-friedman-tongue-position
#6
Joar Sundman, Johan Bring, Danielle Friberg
CONCLUSION: The Friedman tongue position demonstrated only a slight inter-examiner agreement among 15 medical doctors, indicating that the method is difficult to perform and could be an uncertain method to select patients for uvulopalatopharyngoplasty. OBJECTIVE: The Friedman staging system is a clinical tool for selecting patients with obstructive sleep apnea who are appropriate for uvulopalatopharyngoplasty. The objective of this study was to evaluate the staging system by determining the inter-examiner agreement of one of its key components, the Friedman tongue position...
November 23, 2016: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/27868462/lower-pole-intracapsular-tonsillectomy-in-obstructive-sleep-apnea-patients
#7
Su Jin Kim, Chul Kwon, Tae Kyung Koh, Kun Hee Lee, Sung Wan Kim
CONCLUSION: Lower-pole intracapsular tonsillectomy (LPIT) is a valuable surgical technique capable of decreasing post-operative bleeding in obstructive sleep apnea (OSA) patients. OBJECTIVE: This study performed LPIT to simultaneously reduce post-operative bleeding of lower pole and prevent recurrent tonsillitis of upper pole and compared its effects to extracapsular tonsillectomy (ET). METHODS: ET was performed in the extracapsular plane, with complete monopolar dissection...
November 21, 2016: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/27867301/perioperative-evaluation-of-patients-with-pulmonary-conditions-undergoing-non-cardiothoracic-surgery
#8
REVIEW
Gilda Diaz-Fuentes, Hafiz Rizwan Talib Hashmi, Sindhaghatta Venkatram
This review describes the perioperative management of patients with suspected or established pulmonary conditions undergoing non-cardiothoracic surgery, with a focus on common pulmonary conditions such as obstructive airway disease, pulmonary hypertension, obstructive sleep apnea, and chronic hypoxic respiratory conditions. Considering that postoperative pulmonary complications are common and given the increasing number of surgical procedures and the size of the aging population, familiarity with current guidelines for preoperative risk assessment and intra- and postoperative patient management is recommended to decrease the morbidity and mortality...
2016: Health Services Insights
https://www.readbyqxmd.com/read/27865790/maxillomandibular-advancement-surgery-for-patients-who-are-refractory-to-continuous-positive-airway-pressure-are-there-predictors-of-success
#9
Igor Makovey, Anita Valanju Shelgikar, Jeffrey J Stanley, Adina Robinson, Sharon Aronovich
PURPOSE: This pilot study was conducted to determine the effectiveness of maxillomandibular advancement (MMA) in the treatment of patients with moderate to severe obstructive sleep apnea (OSA). The predictive value of clinical, radiographic, and treatment-related variables also was investigated in relation to the success or failure of MMA as treatment for OSA. MATERIALS AND METHODS: A retrospective study design was used to assess the outcomes of MMA in patients with moderate to severe OSA (apnea hypopnea index [AHI] >15 events per hour) at the University of Michigan (Ann Arbor, MI)...
October 26, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27863630/comparison-of-treatment-outcomes-between-intracapsular-and-total-tonsillectomy-for-pediatric-obstructive-sleep-apnea
#10
David T Chang, Allison Zemek, Peter J Koltai
BACKGROUND: Intracapsular tonsillectomy (IT) has been advocated as a treatment for pediatric obstructive sleep apnea (OSA). However, evidence in the literature utilizing polysomnography (PSG) is limited. OBJECTIVE: To examine the experience at a tertiary children's hospital to evaluate the effectiveness and risks of intracapsular tonsillectomy compared to total tonsillectomy (TT) for treating pediatric OSA. METHODS: A retrospective study was undertaken of pediatric tonsillectomy cases performed for OSA at a tertiary children's hospital from 2005 to 2010...
December 2016: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/27832683/a-prospective-study-of-the-surgical-outcome-of-simple-uvulopalatopharyngoplasty-uppp-uppp-combined-with-genioglossus-advancement-or-tongue-base-advancement-for-obstructive-sleep-apnea-hypopnea-syndrome-patients-with-multilevel-obstruction
#11
Shicai Chen, Song Shi, Yanghui Xia, Minhui Zhu, Caiyun Zhang, Siwen Xia, Hongliang Zheng
No abstract text is available yet for this article.
December 2016: Clinical and Experimental Otorhinolaryngology
https://www.readbyqxmd.com/read/27832273/minimally-invasive-single-stage-multilevel-surgery-for-obstructive-sleep-apnea-in-asian-patients
#12
Hsin-Ching Lin, Michael Friedman, Hsueh-Wen Chang, Lauren Bonzelaar, Anna M Salapatas, Meng-Chih Lin, Kuo-Tung Huang
Importance: This study adds to the literature on the efficacy and low complication rates associated with minimally invasive, single-stage, multilevel surgery for Asian adults with obstructive sleep apnea (OSA) for whom conservative treatment had failed. Overall, our experience has produced results that make this procedure an option for select patients with snoring and OSA. Objective: To investigate the effectiveness and safety of anatomy-based, minimally invasive, single-stage, multilevel surgery in the treatment of OSA in an Asian population...
November 10, 2016: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/27829262/-upper-airway-stimulation-in-osa
#13
B Bender
Anatomical basis of obstructive sleep apnea (OSA) is the collapse of the pharynx during sleep. It is considered as a result of complex interactions of structural and neuromuscular factors. Depth of sleep and body position have modulating effects. Although different areas of obstruction were identified, studies show that the sleep-mediated obstruction frequently occurs in the base of tongue area.Continuous positive airway pressure (CPAP) is the standard treatment for obstructive sleep apnea syndrome (OSAS) since more than 30 years...
November 2016: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/27823709/the-utility-of-perioperative-polygraphy-in-the-diagnosis-of-obstructive-sleep-apnea
#14
Ivan Cundrle, Milos Belehrad, Milan Jelinek, Lyle J Olson, Ondrej Ludka, Vladimir Sramek
OBJECTIVE/BACKGROUND: Obstructive sleep apnea (OSA) is highly prevalent and often undiagnosed in surgical patients. The aim of this study was to compare polygraphy (PG) performed on sedated patients during surgery to overnight polysomnography (PSG). It was hypothesized that perioperative PG may be used to diagnose OSA. PATIENTS/METHODS: Overnight PSG was performed three days prior to surgery. For surgery, spinal anesthesia and sedation with propofol infusion were used...
September 2016: Sleep Medicine
https://www.readbyqxmd.com/read/27815593/-treating-nasal-obstruction-in-obstructive-sleep-apnea-patients
#15
T Verse, S Wenzel
The impact of treating nasal obstruction in obstructive sleep apnea (OSA) patients is still intensively discussed at congresses. This is likely due to the highly conflicting results of nasal treatments in regard to restorative sleep on the one hand, and their influence on the severity of OSA on the other. Both conservative and surgical nasal treatments result in a highly significant improvement of sleep quality. Patients' sleep is more restorative, which has a huge impact on several quality of life parameters...
November 4, 2016: HNO
https://www.readbyqxmd.com/read/27811597/predictors-of-at-home-arterial-oxygen-desaturation-events-in-ambulatory-surgical-patients
#16
Chuck Biddle, Charles Elam, Laura Lahaye, Gordon Kerr, Laura Chubb, Brad Verhulst
OBJECTIVES: Little is known about the early recovery phase occurring at-home after anesthesia and surgery in ambulatory surgical patients. We studied quantitative oximetry and quality-of-life metrics in the first 48 hours after same-day orthopedic surgery examining the association between the recovery metrics and specific patient and procedural factors. METHODS: We used the STOP-Bang score to quantify patient risk for obstructive sleep apnea in 50 adult patients at 2 centers using continuous portable oximetry and patient journaling...
November 2, 2016: Journal of Patient Safety
https://www.readbyqxmd.com/read/27810188/drug-induced-sedation-endoscopy-in-surgically-naive-children-with-down-syndrome-and-obstructive-sleep-apnea
#17
Mieke Maris, Stijn Verhulst, Vera Saldien, Paul Van de Heyning, Marek Wojciechowski, An Boudewyns
OBJECTIVE: To describe the pattern of upper airway (UA) obstruction in surgically naive children with Down syndrome and obstructive sleep apnea (OSA), and to evaluate the outcome of drug-induced sedation endoscopy (DISE)-directed treatment. METHODS: A prospective study of DISE in surgically naive children with Down syndrome and OSA was performed. Treatment was individually tailored based on the DISE findings and was evaluated by control polysomnography (PGS). Results are presented as median (lower-upper quartile) unless otherwise stated...
August 2016: Sleep Medicine
https://www.readbyqxmd.com/read/27810015/pediatric-obstructive-sleep-apnea
#18
REVIEW
Zarmina Ehsan, Stacey L Ishman
Screening for obstructive sleep apnea (OSA) with in-laboratory polysomnography is recommended for children with sleep disordered breathing. Adenotonsillectomy is the first-line therapy for pediatric OSA, although intranasal steroids and montelukast can be considered for those with mild OSA and continuous positive airway pressure for those with moderate to severe OSA awaiting surgery, poor surgical candidates or persistent OSA. Bony or soft tissue upper airway surgery is reasonable for children failing medical management or those with persistent OSA following adenotonsillectomy...
December 2016: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27796047/does-drug-induced-sleep-endoscopy-predict-surgical-success-in-transoral-robotic-multilevel-surgery-in-obstructive-sleep-apnea
#19
Taha S Meraj, Daniel G Muenz, Tiffany A Glazer, Rebecca S Harvey, Matthew E Spector, Paul T Hoff
OBJECTIVES/HYPOTHESIS: The aim of this study was to determine if drug-induced sleep endoscopy (DISE) was predictive of success for patients undergoing transoral robotic surgery (TORS) and multilevel procedures for sleep apnea. STUDY DESIGN: Retrospective case series of patients who underwent TORS surgery for sleep apnea METHODS: Before and after polysomnograms were analyzed to assess improvement, success, and cure. Improvement was defined as any decrease in apnea-hypopnea index (AHI), success as an AHI <20 with a decrease >50%, and cure as an AHI <5...
October 31, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27784411/interventional-drug-induced-sleep-endoscopy-a-novel-technique-to-guide-surgical-planning-for-obstructive-sleep-apnea
#20
Andrew Jacob Victores, Krista Olson, Masayoshi Takashima
STUDY OBJECTIVE: One of the challenges of surgery for obstructive sleep apnea (OSA) is identifying the correct surgical site for each patient. The objective of this study was to use drug-induced sleep endoscopy (DISE) and nasopharyngeal tube (NPT) placement to determine the effect of eliminating palatal collapse on the obstruction seen on other segments of the upper airway. METHODS: Forty-one OSA patients were enrolled in this prospective study. All patients had a polysomnogram followed by DISE...
October 20, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
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