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Surgical obstructive sleep apnea

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https://www.readbyqxmd.com/read/28070780/laparoscopic-sleeve-gastrectomy-in-adolescents-with-or-without-syndromic-obesity-two-years-follow-up
#1
Angelo Iossa, Francesco De Peppo, Romina Caccamo, Brad Michael Watkins, Francesca Abbatini, Emanuela Ceriati, Gianfranco Silecchia
INTRODUCTION: Childhood obesity is an emerging health problem. Surgical treatment of obese adolescents, particularly those affected by congenital syndrome, represents a controversial issue. The aim of this multicenter study was to retrospectively assess the results of laparoscopic sleeve gastrectomy (LSG) in a cohort of adolescents affected by morbid obesity, with or without congenital syndromes. MATERIALS AND METHODS: Forty-one obese (BMI 49 ± 6 kg/m(2)) adolescents with mean age of 16 ± 3 years (58...
January 9, 2017: Eating and Weight Disorders: EWD
https://www.readbyqxmd.com/read/28063275/a-survey-of-sleep-medicine-physician-perceptions-on-the-surgical-treatment-of-obstructive-sleep-apnea
#2
Jonathan J Swope, Marcus A Couey, James W Wilson, Jonathon S Jundt
PURPOSE: Surgical treatment for obstructive sleep apnea (OSA) varies by specialty. Our survey sought to answer 3 principal questions: 1) To which surgical specialists are sleep physicians referring patients for upper airway surgery? 2) Which surgical treatment do sleep specialists find to be most effective in treating OSA? 3) Do sleep medicine physicians believe that maxillomandibular advancement (MMA) is worthwhile to patients who are surgical candidates? MATERIALS AND METHODS: We formulated a cross-sectional survey...
December 18, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28060088/maxillary-expansion-and-mandibular-setback-surgery-with-and-without-mandibular-anterior-segment-osteotomy-to-correct-mandibular-prognathism-with-obstructive-sleep-apnea
#3
Jeong Joon Han, Dong Hwan Hong, Soon Jung Hwang
Mandibular prognathism is usually treated with mandibular setback surgery. However, this approach reduces the pharyngeal airway space, and can aggravate obstructive phenomena in patients with obstructive sleep apnea (OSA). While maxillary expansion is known to lead to an increase in the pharyngeal airway volume (PAS), its effect on the PAS in mandibular setback surgery has not yet been reported. The authors report a surgical approach with maxillary expansion in 2 patients with mandibular prognathism that was accompanied by OSA: maxillary midsagittal expansion with minimum maxillary advancement and minor mandibular setback without mandibular anterior segmental osteotomy (ASO) or major mandibular setback with mandibular ASO...
January 5, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28053912/management-of-obstructive-sleep-apnea-in-a-treacher-collins-syndrome-patient-using-distraction-osteogenesis-of-the-mandible
#4
İbrahim Damlar, Ahmet Altan, Berk Turgay, Soydan Kiliç
In this study, we present the surgical treatment of obstructive sleep apnea in a child with Treacher Collins syndrome. A 10-year-old girl with a past history of Treacher Collins syndrome presented to our clinic with her parents for respiratory distress and insomnia. The patient was referred to a sleep laboratory where she was diagnosed with obstructive sleep apnea, which was a consequence of her Treacher Collins syndrome. The patient underwent mandibular distraction osteogenesis under general anesthesia. The mandible was expanded by 15 mm using internal bilateral distractors...
December 2016: Journal of the Korean Association of Oral and Maxillofacial Surgeons
https://www.readbyqxmd.com/read/28050204/emotional-stress-evaluation-of-patients-with-moderate-and-severe-sleep-apnea-syndrome
#5
Micheli Aparecida Gomes Dos Santos, Tatiana de Cássia Nakano, Felipe Almeida Mendes, Bruno Bernardo Duarte, Silvio Antonio Monteiro Marone
Introduction The scientific literature has shown that the damage caused by sleep fragmentation in people affected by Obstructive Sleep Apnea (OSA) can reflect emotionally, generating not only physical symptoms such as drowsiness and tiredness, but also psychical symptoms, such as stress. Objective This study aimed at comparing symptoms of stress in patients with moderate or severe OSA, before and after two months of treatment (clinical or surgical). Method This isx an Individual, prospective, longitudinal, and interventional study...
January 2017: International Archives of Otorhinolaryngology
https://www.readbyqxmd.com/read/28045827/bone-substitutes-in-le-fort-i-osteotomy-to-promote-bone-union-and-skeletal-stability
#6
Leonardo Matos Santolim Zanettini, Guilherme Genehr Fritscher, Ricardo Giacomini De Marco, Fernando de Oliveira Andriola, Rogério Miranda Pagnoncelli
Maxillary advancement by Le Fort I osteotomy has become the standard procedure to restore function and facial esthetics, correct skeletal and occlusal discrepancies, and treat obstructive sleep apnea in patients with facial deformities. Incomplete ossification between the bone segments at the jaw osteotomy site has proven to be a major problem in these patients. There are several studies in the literature that address orthognathic surgery, but only a limited number that discuss the use of graft materials in maxillary osteotomy...
December 30, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28043111/nocturia-improvement-with-surgical-correction-of-sleep-apnea
#7
Hyoung Keun Park, Sung Hyun Paick, Hyeong Gon Kim, Doo-Heum Park, Jae Hoon Cho, Seok-Chan Hong, Woo Suk Choi
PURPOSE: To evaluate changes in nocturia after surgical correction of obstructive sleep apnea (OSA). METHODS: A total of 66 patients were included in the present study. All had been diagnosed with OSA syndrome by polysomnography and underwent uvulopalatopharyngoplasty (UPPP). Preoperative and postoperative lower urinary tract symptoms (LUTS), quality of life (QoL), and nocturia episodes were evaluated using the International Prostate Symptom Score (IPSS) and overactive bladder symptom score (OABSS) questionnaires...
December 2016: International Neurourology Journal
https://www.readbyqxmd.com/read/28025918/outcomes-of-upper-airway-stimulation-for-obstructive-sleep-apnea-in-a-multicenter-german-postmarket-study
#8
Clemens Heiser, Joachim T Maurer, Benedikt Hofauer, J Ulrich Sommer, Annemarie Seitz, Armin Steffen
Objective Selective stimulation of the hypoglossal nerve is a new surgical therapy for obstructive sleep apnea, with proven efficacy in well-designed clinical trials. The aim of the study is to obtain additional safety and efficacy data on the use of selective upper airway stimulation during daily clinical routine. Study Design Prospective single-arm study. Setting Three tertiary hospitals in Germany (Munich, Mannheim, Lübeck). Subjects and Methods A multicenter prospective single-arm study under a common implant and follow-up protocol took place in 3 German centers (Mannheim, Munich, Lübeck)...
December 1, 2016: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28012827/comparison-of-level-and-degree-of-upper-airway-obstruction-by-m%C3%A3-ller-s-maneuver-and-drug-induced-sleep-endoscopy-in-obstructive-sleep-apnea-patients
#9
Ah Ra Jung, Tae Kyung Koh, Su Jin Kim, Kun Hee Lee, Joong Saeng Cho, Sung Wan Kim
OBJECTIVE: This study aimed to compare and analyze the level and degree of observed upper airway obstruction in patients with obstructive sleep apnea (OSA) using Müller's maneuver (MM) and drug-induced sleep endoscopy (DISE). We sought to find a method for evaluating the upper airway that could be used to determine surgical sites. METHODS: This study included 80 OSA patients who visited Kyung Hee Medical Center and underwent polysomnography (PSG) from March 2013 to March 2014...
December 21, 2016: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/28007620/postoperative-oxygen-therapy-in-patients-with-obstructive-sleep-apnea-a-randomized-controlled-trial
#10
Pu Liao, Jean Wong, Mandeep Singh, David T Wong, Sazzadul Islam, Maged Andrawes, Colin M Shapiro, David P White, Frances Chung, Frances Chung
BACKGROUND: Surgical patients with obstructive sleep apnea (OSA) are at increased risk for perioperative complications. Postoperative supplemental oxygen is commonly used but it may contribute to respiratory depression in OSA patients receiving opioids. The objective of the study is to investigate the effect of postoperative supplemental oxygen on SaO2, sleep respiratory events, and CO2 level in patients with untreated OSA. METHODS: Consented patients with an apnea hypopnea index (AHI) >5 events/h on a preoperative polysomnography were randomized (1:1) to oxygen (O2) or no oxygen (Control)...
December 19, 2016: Chest
https://www.readbyqxmd.com/read/28005735/subtypes-of-maxillomandibular-advancement-surgery-for-patients-with-obstructive-sleep-apnea
#11
Won-June Lee, Dong-Hyun Hwang, Stanley Yung-Chuan Liu, Su-Jung Kim
Maxillomandibular advancement (MMA) surgery, which is the most effective treatment modality for patients with moderate-to-severe obstructive sleep apnea with apparent skeletal discrepancies, has been modified in conjunction with segmental osteotomies, counterclockwise rotation of maxillomandibular complex, and other adjunctive procedures. However, any single type of MMA could not treat or cure all the patients with obstructive sleep apnea showing different dentofacial and pharyngeal patterns. We aimed to suggest critical decision factors for the selective application of MMA subtypes, categorized as straight MMA with genioplasty, rotational MMA, segmental MMA, and segmental-rotational MMA, in the surgical treatment objective process: anteroposterior position of maxilla, upper lip projection, overjet, lower incisor inclination as sagittal factors, and upper incisor exposure and occlusal plane angle as vertical factors...
November 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27997447/combined-counterclockwise-maxillomandibular-advancement-and-uvulopalatopharyngoplasty-surgeries-for-severe-obstructive-sleep-apnea
#12
Wenwen Yu, Meng Wang, Jiande He, Liyan Lu, Ming Cai, Hongxia Sun, Xiaofeng Lu
As the most effective surgical technique maxillomandibular advancement (MMA) has been used to treat severe obstructive sleep apnea (OSA) in adults, particularly for those who are intolerant of continuous positive airway pressure. Yet for large-scale advancement, it is faced with esthetic problems with marked skeletal protrusion especially for people with convex facial profile. In this study, the authors performed counterclockwise MMA combined with quantified uvulopalatopharyngoplasty (UPPP) surgeries on Chinese adult patients with severe OSA, in order to initially explore the efficacy of these procedures on Chinese populations and provide evidence for esthetic advantages...
December 16, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27987225/arrhythmias-in-adults-with-congenital-heart-disease-what-are-risk-factors-for-specific-arrhythmias
#13
Rohit S Loomba, Matthew W Buelow, Saurabh Aggarwal, Rohit R Arora, Joshua Kovach, Salil Ginde
INTRODUCTION: An increasing number of patients with congenital heart disease are now surviving into adulthood. This has also led to the emergence of complications from the underlying congenital heart disease, related surgical interventions, and associated combordities. While the prevalence of particular arrhythmias with specific congenital heart disease has been previously described, a detailed analysis of all lesions and a large number of comorbidities has not been previously published...
December 16, 2016: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/27933351/-modern-modifications-of-uvulopalatopharyngoplasty
#14
T Verse, B A Stuck
Uvulopalatopharyngoplasty (UPPP) was first described in 1964 with regard to surgical treatment of snoring and in 1981 with regard to treatment of obstructive sleep apnea (OSA). The initial surgical techniques for OSA were very invasive, frequently leading to significant morbidity and complications. Wolfgang Pirsig et al. were the first in Germany to recognize that a radical surgical technique increased only the complications, not the efficacy of UPPP. The less invasive surgical technique developed based on these findings is still established in Germany...
December 8, 2016: HNO
https://www.readbyqxmd.com/read/27930509/current-challenges-in-providing-bariatric-surgery-in-france-a-nationwide-study
#15
Sébastien Czernichow, Michel Paita, David Nocca, Simon Msika, Arnaud Basdevant, Bertrand Millat, Anne Fagot-Campagna
Bariatric surgery is a well-accepted procedure for severe and massive obesity management. We aimed to determine trends, geographical variations, and factors influencing bariatric surgery and the choice of procedure in France in a large observational study.The Health Insurance Fund for Salaried Workers (Caisse National Assurance Maladie Travailleurs Salariés) covers about 86% of the French population. The Système National d'Information Inter-régimes de l'Assurance Maladie database contains individualized and anonymized patient data on all reimbursements for healthcare expenditure...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27906721/preoperative-evaluation-and-preparation-of-the-morbidly-obese-patient
#16
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...
February 2017: 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
#17
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...
February 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27893557/changes-in-upper-airway-volume-following-orthognathic-surgery
#18
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
#19
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
#20
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
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