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Surgical obstructive sleep apnea

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https://www.readbyqxmd.com/read/28822675/precise-osteotomies-for-mandibular-distraction-in-infants-with-robin-sequence-using-virtual-surgical-planning
#1
C M Resnick
Mandibular distraction osteogenesis (MDO) has become the first-line operation in many centers for the management of obstructive sleep apnea (OSA) in infants with (Pierre) Robin sequence (RS) not relieved by non-surgical approaches. Preoperative virtual surgical planning (VSP) may improve precision and decrease complications for this operation. This article reports a retrospective study of RS infants who underwent MDO for OSA using preoperative VSP and three-dimensionally printed cutting guides performed by one surgeon...
August 16, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28822411/-effect-of-treating-obstructive-sleep-apnea-hypopnea-syndrome-on-chronic-cough-in-children
#2
C Pang, J Q Liang, Q L Gu
Objective: To understand the effect of treating obstructive sleep apnea hypopnea syndrome (OSAHS) on chronic cough in children. Methods: A total of 100 consecutive children with OSAHS diagnosed by polysomnography(PSG) and chronic cough were included in this study. All children underwent cough condition assessment, OSA-18 scales and MS-IOS before and after surgery, and all children were followed-up for 3 months. Children were separated into three groups according to the severity of OSAHS. Related parameters like Zr, Rf, R5, R20, X5, X35, Rc, Rp obtained from MS-IOS, OSA-18 scores and cough scores were compared between different groups using paired t-test or Wilcoxon sum test...
August 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/28818154/physiology-based-modeling-may-predict-surgical-treatment-outcome-for-obstructive-sleep-apnea
#3
Yanru Li, Jingying Ye, Demin Han, Xin Cao, Xiu Ding, Yuhuan Zhang, Wen Xu, Jeremy Orr, Rachel Jen, Scott Sands, Atul Malhotra, Robert Owens
STUDY OBJECTIVES: To test whether the integration of both anatomical and nonanatomical parameters (ventilatory control, arousal threshold, muscle responsiveness) in a physiology-based model will improve the ability to predict outcomes after upper airway surgery for obstructive sleep apnea (OSA). METHODS: In 31 patients who underwent upper airway surgery for OSA, loop gain and arousal threshold were calculated from preoperative polysomnography (PSG). Three models were compared: (1) a multiple regression based on an extensive list of PSG parameters alone; (2) a multivariate regression using PSG parameters plus PSG-derived estimates of loop gain, arousal threshold, and other trait surrogates; (3) a physiological model incorporating selected variables as surrogates of anatomical and nonanatomical traits important for OSA pathogenesis...
August 14, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28817421/association-of-stop-bang-questionnaire-as-a-screening-tool-for-sleep-apnea-and-postoperative-complications-a-systematic-review-and-bayesian-meta-analysis-of-prospective-and-retrospective-cohort-studies
#4
Mahesh Nagappa, Jayadeep Patra, Jean Wong, Yamini Subramani, Mandeep Singh, George Ho, David T Wong, Frances Chung
BACKGROUND: The risk of postoperative complications increases with undiagnosed obstructive sleep apnea (OSA). The high-risk OSA (HR-OSA) patients can be easily identified using the STOP-Bang screening tool. The aim of this systematic review and meta-analysis is to determine the association of postoperative complications in patients screened as HR-OSA versus low-risk OSA (LR-OSA). METHODS: The following data bases were searched from January 1, 2008, to October 31, 2016, to identify the eligible articles: Cochrane Central Register of Controlled Trials, MEDLINE, PubMed, Cochrane Databases of Systematic Reviews, Medline-in-Process & other nonindexed citations, Google Scholar, Embase, Web of Sciences and Scopus...
August 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28802380/can-telemetry-data-obviate-the-need-for-sleep-studies-in-pierre-robin-sequence
#5
Nicole Leigh Aaronson, Noel Jabbour
OBJECTIVE: This study looks to correlate telemetry data gathered on patients with Pierre Robin Sequence (PRS) with sleep study data. Strong correlation might allow obstructive sleep apnea (OSA) to be reasonably predicted without the need for sleep study. METHODS: Charts from forty-six infants with PRS who presented to our children's hospital between 2005 and 2015 and received a polysomnogram (PSG) prior to surgical intervention were retrospectively reviewed. Correlations and scatterplots were used to compare average daily oxygen nadir, overall oxygen nadir, and average number of daily desaturations from telemetry data with apnea-hypopnea index (AHI) and oxygen nadir on sleep study...
September 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28800204/comparison-of-robotic-and-coblation-tongue-base-resection-for-obstructive-sleep-apnea
#6
Chi Sang Hwang, Jin Won Kim, Jin Woong Kim, Eun Jung Lee, Chang-Hoon Kim, Joo-Heon Yoon, Hyung-Ju Cho
OBJECTIVES: To compare the efficacy and safety of transoral robotic surgery (TORS) with endoscope-guided coblation tongue base resection. DESIGN: Retrospective case-control study. SETTING: University-based tertiary care medical center. PARTICIPANTS: OSA patients who underwent endoscope-guided tongue base coblation resection or TORS in combination with lateral pharyngoplasty at a single institution in South Korea between April 2013 and December 2016 were investigated...
August 11, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28795409/upper-airway-surgery-for-obstructive-sleep-apnea-reduces-blood-pressure
#7
Kenny P Pang, Edward B Pang, Kathleen A Pang, Claudio Vicini, Yiong Huak Chan, Brian W Rotenberg
OBJECTIVES/HYPOTHESIS: To evaluate if upper airway surgery reduces blood pressure in patients with obstructive sleep apnea (OSA). STUDY DESIGN: Prospective series. METHODS: A prospective series of 112 consecutive OSA patients with hypertension (HTN). All patients were > 18 years old, respiratory disturbance index >5, all levels of apnea-hypopnea index (AHI), with a history of HTN treated with medication for at least 6 months. Surgical procedures included septoplasty, turbinate reduction, palate surgery, and tongue base reduction...
August 10, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28771734/modified-surgical-approach-to-hypoglossal-nerve-stimulator-implantation-in-the-pediatric-population
#8
Sarah N Bowe, Gillian R Diercks, Christopher J Hartnick
Upper airway stimulation with the hypoglossal nerve stimulator is a promising treatment modality for severe obstructive sleep apnea in carefully selected patients with Down syndrome. The pediatric population presents a greater variety in body habitus, including thorax size. A modified surgical approach, utilizing a medially placed, single chest incision, instead of two separate chest incisions, provides an alternative that is particularly useful for pediatric patients with small stature. As this technology is evaluated for Food and Drug Administration clearance in the pediatric population, it is important to consider modifications in surgical technique, partnering prior surgical experience with the technical support of company representatives...
August 3, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28755274/regression-of-left-ventricular-mass-after-bariatric-surgery
#9
REVIEW
Thierry H Le Jemtel, Rohan Samson, Abhishek Jaiswal, Eliza B Lewine, Suzanne Oparil
Notwithstanding the presence of hypertension, obstructive sleep apnea, or both, obesity is associated with increased left ventricular (LV) mass. The effects of bariatric surgery on LV mass have been sparsely investigated by M-mode and two-dimensional (2D) echocardiography. Overall, Roux-en-Y gastric bypass, adjustable gastric banding, and sleeve gastrectomy reduce LV mass. However, the reduction in LV mass is extremely variable. Besides duration and severity of obesity, presence of hypertension, obstructive sleep apnea or both, and type of surgical procedures, the inaccuracy of M-mode and 2D echocardiography for assessment of LV mass contributes to the variable effects of bariatric surgery on LV mass...
September 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/28740786/virtual-surgical-planning-for-mandibular-distraction-in-infants-with-robin-sequence
#10
Cory M Resnick
Mandibular distraction osteogenesis (MDO) successfully relieves obstructive sleep apnea in many infants with Robin sequence. Preoperative virtual surgical planning and fabrication of three-dimensionally printed cutting guides may lead to further improvements in the MDO technique and decrease the risk for damage to adjacent structures such as developing teeth and the inferior alveolar nerve. This report presents an algorithm for virtual surgical planning and three-dimensionally printing of cutting guides for MDO in infants with RS...
June 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28739170/bilateral-buccinator-myomucosal-flap-outcomes-in-nonsyndromic-patients-with-repaired-cleft-palate-and-velopharyngeal-insufficiency
#11
Rafael Denadai, Anelise Sabbag, Cassio Eduardo Raposo-Amaral, Joao Carlos P Filho, Mirian H Nagae, Cesar Augusto Raposo-Amaral
BACKGROUND: The purpose of this study was to assess speech outcomes and complication rate in nonsyndromic repaired cleft palate patients undergoing bilateral buccinator myomucosal flaps for velopharyngeal insufficiency management. METHODS: A prospective study of consecutive repaired cleft palate patients with velopharyngeal insufficiency who underwent bilateral buccinator myomucosal flaps was conducted. Three experienced evaluators performed a blinded perceptual speech evaluation (hypernasality, audible nasal emission, and intraoral pressure)...
June 28, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28738391/updated-palate-surgery-for-obstructive-sleep-apnea
#12
Hsueh-Yu Li
Initially described in 1981, uvulopalatopharyngoplasty was the first surgical procedure specially designed at the palatal level for snoring and obstructive sleep apnea (OSA). To date, palatal surgery remains the most commonly used surgery for OSA. The advancement of this surgery over the past 30 years has been a process of evolution in concepts, examination, and technique to increase safety and effectiveness in the treatment of OSA. Concept changes have emerged in the disease etiology, purpose of surgery, treatment priorities, staging of operations, integration therapy, and surgical endpoints...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28738377/updated-nasal-surgery-for-obstructive-sleep-apnea
#13
David M Johnson, Ryan J Soose
Numerous studies report that difficulty breathing through the nose is associated with reduced sleep quality, increased daytime dysfunction, and increased risk of snoring and obstructive sleep apnea (OSA). Additionally, chronic nasal obstruction often complicates and limits successful medical device therapy for OSA, particularly with continuous positive airway pressure (CPAP). When medical evaluation and management of the nose is inadequate, surgical therapy to lower nasal resistance has been shown to substantially improve sleep and breathing outcome measures...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28738374/multilevel-obstructive-sleep-apnea-surgery
#14
Hsin-Ching Lin, Edward M Weaver, Ho-Sheng Lin, Michael Friedman
Continuous positive airway pressure (CPAP) is the primary treatment of obstructive sleep apnea/hypopnea syndrome (OSA). Most sleep physicians are in agreement that a certain number of OSA patients cannot or will not use CPAP. Although other conservative therapies, such as oral appliance, sleep hygiene, and sleep positioning, may help some of these patients, there are many who fail all conservative treatments. As sleep surgeons, we have the responsibility to screen patients for both symptoms and signs of OSA...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28738371/robotic-obstructive-sleep-apnea-surgery
#15
Song Tar Toh, Pon Poh Hsu
Since the first report of the use of the da Vinci robotic system (Intuitive Surgical, Sunnyvale, CA, USA) in transoral robotic tongue base reduction for obstructive sleep apnea (OSA) was published in 2010, this surgical tool and technique has been used worldwide for the resection of tongue base tissue in the multilevel surgical treatment of OSA. The combined knowledge of the published literature on its use has enlightened sleep surgeons worldwide on this new yet evolving surgical tool. Here we will discuss the use of the da Vinci robotic system in the treatment of OSA, the pertinent surgical anatomy for a safe surgical procedure, the primary and secondary outcomes to expect in the multilevel and primary use of this technology in treating the tongue base, the predictors for success or failure, and the complications associated with this technique...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28738365/advances-in-box-surgery-for-obstructive-sleep-apnea-genioglossus-advancement-hyoid-suspension-and-maxillomandibular-advancement
#16
Yau Hong Goh, Winston Tan, Victor James Abdullah, Sung Wan Kim
Box surgery for obstructive sleep apnea (OSA) patients consists of mandibular surgery, including genioglossus advancement, hyoid suspension, and maxillomandibular advancement, as an airway reconstruction. This surgery was developed in the early 1980s. Thereafter, techniques were modified in each surgery for the enhancement of outcome and prevention of complications. However, the indication for surgery remains poorly defined due to the dynamicity of the upper airway, variability of the phenotype in OSA patients, and absence of a representative method for the obstruction site in the upper airway...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28738337/the-history-of-sleep-surgery
#17
Kathleen Yaremchuk, Laura Garcia-Rodriguez
Snoring and the subsequent diagnosis of obstructive sleep apnea (OSA) was a life-threatening medical condition with no available treatment until the late 20th century. An early description of OSA was provided by Charles Dickens in his 1836 novel Pickwick Papers with the description of a "fat boy" who was thought to be lazy and always falling asleep but likely displayed hypersomnolence from OSA. It was not until 1976 that Ikematsu first described uvulopalatopharyngoplasty (UPPP) as an alternative surgical treatment of "snoring," with a reported cure rate of 81%...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28697968/update-on-pathophysiology-and-treatment-of-childhood-obstructive-sleep-apnea-syndrome
#18
REVIEW
Justin C Brockbank
Obstructive sleep apnea syndrome (OSAS) is common in childhood and is characterized by recurrent upper airway obstructive events during sleep that produce significant neurocognitive and cardiovascular sequelae. The pathophysiology of childhood OSAS is complex and involves mechanical airway obstruction often secondary to adenotonsillar hypertrophy. However, neuromotor abnormalities and instability of central ventilatory control are also implicated. Several surgical and non-surgical treatment options for childhood OSAS are available, and will be discussed...
June 12, 2017: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/28682951/preoperatively-screened-obstructive-sleep-apnea-is-associated-with-worse-postoperative-outcomes-than-previously-diagnosed-obstructive-sleep-apnea
#19
Ana Fernandez-Bustamante, Karsten Bartels, Claudia Clavijo, Benjamin K Scott, Rachel Kacmar, Kenneth Bullard, Angela F D Moss, William Henderson, Elizabeth Juarez-Colunga, Leslie Jameson
BACKGROUND: Obstructive sleep apnea (OSA) affects up to 26% of US adults, is often undiagnosed, and increases perioperative morbidity. We hypothesized that patients screened on the day of surgery as moderate/high risk for OSA (S-OSA) present similar perioperative respiratory complications, hospital use, and mortality than patients with previously diagnosed OSA (D-OSA). Second, we hypothesized that both OSA groups have more respiratory complications than No-OSA patients. METHODS: The electronic medical database from 1 academic and 2 community hospitals was retrospectively queried to identify adults undergoing nonemergent inpatient surgery (January 1, 2012, to December 31, 2014)...
August 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28675811/effects-of-expansion-sphincter-pharyngoplasty-on-the-apnea-hypopnea-index-and-heart-rate-variability
#20
Ahmet Emre Süslü, Gözde Pamuk, Ahmet Erim Pamuk, Serdar Özer, Shamkhal Jafarov, T Metin Önerci
PURPOSE: Heart rate variability (HRV) is a noninvasive and sensitive method used to evaluate autonomic function of the heart based on specific polysomnographic parameters. This study aimed to determine the effect of expansion sphincter pharyngoplasty (ESP) on HRV and the apnea-hypopnea index (AHI) in patients with obstructive sleep apnea (OSA). MATERIALS AND METHODS: This retrospective cohort study included patients who presented to the Department of Otorhinolaryngology, Hacettepe University Hospital (Ankara, Turkey), were diagnosed with OSA, and underwent ESP...
June 10, 2017: Journal of Oral and Maxillofacial Surgery
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