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Surgical obstructive sleep apnea

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https://www.readbyqxmd.com/read/28697968/update-on-pathophysiology-and-treatment-of-childhood-obstructive-sleep-apnea-syndrome
#1
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
#2
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
#3
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
https://www.readbyqxmd.com/read/28665848/change-in-posterior-pharyngeal-space-after-counterclockwise-rotational-orthognathic-surgery-for-class-ii-dentofacial-deformity-diagnosed-with-obstructive-sleep-apnea-based-on-cephalometric-analysis
#4
Woo Shik Jeong, Young Chul Kim, Yoo Sam Chung, Chang Yeol Lee, Jong Woo Choi
Although maxillomandibular advancement (MMA) is an orthognathic surgical procedure used to manage obstructive sleep apnea (OSA) in individuals who are noncompliant with continuous positive airway pressure therapy, simple MMA encounters problems in terms of aesthetic outcomes in Asian populations with preexisting dentoalveolar protrusion. Our current prospective investigation describes changes in posterior pharyngeal space and aesthetic outcomes after counterclockwise rotational orthognathic surgery, which is known to be quite difficult in terms of the maintenance of the skeletal stability in skeletal class II patients with OSA...
June 29, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28663657/continuous-positive-airway-pressure-prevents-hypoxia-in-dental-patient-with-obstructive-sleep-apnea-syndrome-under-intravenous-sedation
#5
Anton A Kasatkin, Aleksei P Reshetnikov, Aleksandr L Urakov, Dmitrii Y Baimurzin
Use of sedation in patients with obstructive sleep apnea (OSA) in dentistry is limited. Hypoxia may develop during medication sleep in dental patients with OSA because of repetitive partial or complete obstruction of the upper airway. In this regard, anesthesiologists prefer not to give any sedative to surgical patients with OSA or support the use of general anesthesia due to good airway control. We report a case where we could successfully sedate a dental patient with OSA using intraoperative continuous positive airway pressure (CPAP) without hypoxia...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28662233/control-of-pain-after-tonsillectomy-in-children-a-review
#6
Grace X Tan, David E Tunkel
Importance: The relief of pain after tonsillectomy in children remains challenging and even controversial. While the need for pain control after this surgery is understood, recent debate has centered around the risks of opioids in children with obstructive sleep apnea syndrome (OSAS) and the possible increases in posttonsillectomy hemorrhage with the use of alternative nonsteroidal anti-inflammatory drugs (NSAIDs). Observations: We discuss the multiple facets of posttonsillectomy pain control in children...
June 29, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28659977/facial-mobility-after-maxilla-mandibular-advancement-in-patients-with-severe-obstructive-sleep-apnea-syndrome-a-three-dimensional-study
#7
Laura Verzé, Francesca Antonella Bianchi, Niccolò Barla, Serena Maria Curti, Giovanni Gerbino, Guglielmo Amedeo Ramieri
Introduction. The functional results of surgery in terms of facial mobility are key elements in the treatment of patients. Little is actually known about changes in facial mobility following surgical treatment with maxillomandibular advancement (MMA). Objectives. The three-dimensional (3D) methods study of basic facial movements in typical OSAS patients treated with MMA was the topic of the present research. Materials and Methods. Ten patients affected by severe obstructive sleep apnea syndrome (OSAS) were engaged for the study...
2017: International Journal of Dentistry
https://www.readbyqxmd.com/read/28652832/cognitive-behavioral-therapy-to-aid-weight-loss-in-obese-patients-current-perspectives
#8
REVIEW
Gianluca Castelnuovo, Giada Pietrabissa, Gian Mauro Manzoni, Roberto Cattivelli, Alessandro Rossi, Margherita Novelli, Giorgia Varallo, Enrico Molinari
Obesity is a chronic condition associated with risk factors for many medical complications and comorbidities such as cardiovascular diseases, some types of cancer, osteoarthritis, hypertension, dyslipidemia, hypercholesterolemia, type-2 diabetes, obstructive sleep apnea syndrome, and different psychosocial issues and psychopathological disorders. Obesity is a highly complex, multifactorial disease: genetic, biological, psychological, behavioral, familial, social, cultural, and environmental factors can influence in different ways...
2017: Psychology Research and Behavior Management
https://www.readbyqxmd.com/read/28650781/rapid-maxillary-expansion-in-obstructive-sleep-apnea-in-young-patients-cardio-respiratory-monitoring
#9
Alfio Buccheri, Fabio Chinè, Giovanni Fratto, Licia Manzon
OBJECTIVE(S): Obstructive sleep apnea syndrome (OSAS) is a respiratory disorder which affects from 1 to 3 % of people during development. OSAS treatment may be pharmacological, surgical or based on application of intraoral devices to increase nasal respiratory spaces. The purpose of this study was to determine the efficacy of the Rapid Maxillary Expander in OSAS young patients by measuring cardio-respiratory monitoring parameters (AHI, the average value of complete and incomplete obstructed respiration per hour of sleep, and SAO2, the percentage of oxygen saturation)...
2017: Journal of Clinical Pediatric Dentistry
https://www.readbyqxmd.com/read/28648251/immune-thrombocytopenia-of-childhood-responsive-to-tonsillectomy-in-the-setting-of-chronic-tonsillitis-a-case-report-and-literature-review
#10
Richard William Thompson, Anil Gungor
OBJECTIVES: Immune thrombocytopenia of childhood (platelet count <100,000/μL) is the most common cause of thrombocytopenia in children. Patients typically present with bruising and bleeding in the setting of thrombocytopenia. Although it is usually short-lived, some cases persist and are unresponsive to treatment. This can lead to exposure to a variety of treatment regimens including immunosuppressants and splenectomy. The goal of this report is to present a case of chronic ITP of childhood that responded to tonsillectomy addressing the tonsils as a source of chronic infection and inflammation triggering ITP...
November 23, 2016: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28647143/a-tertiary-center-experience-with-velopharyngeal-surgical-techniques-for-treatment-of-snoring-and-obstructive-sleep-apnea
#11
Omer Karakoc, Murat Binar, Umit Aydin, Hakan Genc, Timur Akcam, Mustafa Gerek
OBJECTIVES: The aim of this study was to assess the outcomes of patients who treated with the relatively new surgical procedures; anterior palatoplasty (AP), Cahali lateral pharyngoplasty (CLP), and expansion sphincter pharyngoplasty (ESP) for habitual snoring or obstructive sleep apnea (OSA). METHODS: Prospective series of 93 patients were evaluated. The performed surgical techniques, polysomnographic outcomes, pre- and postoperative clinical parameters, and complication rates were assessed...
June 21, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/28632506/adenotonsillectomy-for-the-management-of-pulmonary-hypertension-in-a-patient-with-complex-congenital-heart-disease-a-case-report
#12
Adam C Adler, Yuan-Jiun Nicole Chao
Pulmonary hypertension is a feared complication in congenital heart disease patients. Patients with pulmonary hypertension are at risk for major perioperative cardiopulmonary complications when undergoing any surgical procedure, especially airway and laparoscopic procedures. We present the anesthetic management for a 2-year old with Down syndrome and complex cyanotic congenital heart disease undergoing tonsillectomy and adenoidectomy for severe obstructive sleep apnea.
June 19, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28623540/identification-of-surgical-patients-at-high-risk-of-osas-using-the-berlin-questionnaire-to-detect-potential-high-risk-of-adverse-respiratory-events-in-post-anesthesia-care-unit
#13
Fei Liu, Li Liu, Fang Zheng, Xiangdong Tang, Yongxin Bao, Yunxia Zuo
Obstructive sleep apnea syndrome (OSAS) increases the risk of post-surgery complications. This study uses Berlin Questionnaire (BQ) to identify Chinese adult surgical patients who are at a high risk of OSAS and to determine if the BQ could be used to detect potential high risk of adverse respiratory events in the post anesthesia care unit (PACU). Results indicated that only 11.4% of the patients were considered at a high risk of OSAS. Age and body mass index are the key factors for the risk of OSAS prevalence in China and also gender specific...
June 7, 2017: Frontiers of Medicine
https://www.readbyqxmd.com/read/28622177/postoperative-respiratory-complications-in-patients-at-risk-for-obstructive-sleep-apnea-a-single-institution-cohort-study
#14
Satya Krishna Ramachandran, Jaideep Pandit, Scott Devine, Aleda Thompson, Amy Shanks
BACKGROUND: Obstructive sleep apnea (OSA) is a prevalent condition that is associated with early postoperative respiratory complications (PRCs). As the majority of patients with OSA are undiagnosed, preoperative screening remains the most efficient method to identify suspected OSA. METHODS: This retrospective study was performed on patients undergoing anesthesia in a single academic medical center. We assigned OSA risk class retrospectively to all patients in the study by using the Perioperative Sleep Apnea Prediction (PSAP) score...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28611549/mutation-c-943g-t-p-ala315ser-in-fgfr2-causing-a-mild-phenotype-of-crouzon-craniofacial-dysostosis-in-a-three-generation-family
#15
Luitgard M Graul-Neumann, Eva Klopocki, Nicolai Adolphs, Martin A Mensah, Wolfram Kress
Crouzon syndrome craniofacial dysostosis type I [OMIM 123500] is caused by mutations in the gene encoding fibroblast growth factor receptor-2 (FGFR2). An overlapping phenotype with Muenke and Crouzon syndrome with acanthosis nigricans (FGFR3 mutations) is known. The clinical diagnosis can be corroborated by molecular studies in about 80-90% of the cases. No clear genotype/phenotype correlation has been identified yet. Here, we describe a second family with a mild phenotype in which the FGFR2 mutation c.943G>T leading to the amino acid substitution p...
March 2017: Molecular Syndromology
https://www.readbyqxmd.com/read/28606658/various-combinations-of-velopharyngeal-and-hypopharyngeal-surgical-procedures-for-treatment-of-obstructive-sleep-apnea-single-stage-multilevel-surgery
#16
Murat Binar, Omer Karakoc, Timur Akcam, Burak Asik, Mustafa Gerek
OBJECTIVE: The aim of this study was to investigate the safety and outcomes of velopharyngeal surgeries combined with hypopharyngeal surgeries as single-stage interventions for treatment of obstructive sleep apnea (OSA). METHODS: Retrospective analysis of operated patients. The velopharyngeal surgical interventions were uvulopalatal flap, anterior palatoplasty, expansion sphincter pharyngoplasty, transpalatal advancement pharyngoplasty, Cahali lateral pharyngoplasty, Z-palatoplasty, and modified uvulopalatopharyngoplasty...
June 6, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28587728/incidence-of-children-at-risk-for-obstructive-sleep-apnea-undergoing-common-day-surgery-procedures
#17
Emma M Holmes, Heena H K Singh, Valerie G Kirk, Mary Brindle, Jeremy Luntley, Bryce A Weber, Warren K Yunker
OBJECTIVE: The purpose of this study was to evaluate the prevalence of sleep-related breathing disorders (SRBD) in children undergoing elective day surgery procedures. METHODS: A validated Pediatric Sleep Questionnaire (PSQ) was distributed to the parents of children aged 2months to 18 years who met inclusion criteria and were undergoing urologic, otolaryngologic, and general surgical day surgery procedures a 3-month period of time. The prevalence of children at risk for pediatric SRBD was determined from PSQ results...
May 28, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28582308/modified-genioglossal-advancement-for-isolated-treatment-of-obstructive-sleep-apnea
#18
James D Vargo, W Scott Ogan, Neil Tanna, Damien Stevens, Brian T Andrews
INTRODUCTION: Genioglossal advancement is a surgical procedure for obstructive sleep apnea (OSA) that has lost favor as a primary treatment strategy. The authors describe utilization of a modified genioglossal advancement (MGA), combining a geniotubercle advancement via sliding genioplasty and a glossopexy. METHODS: A retrospective review was performed. Preoperative and postoperative apnea-hypopnea indices (AHIs) were compared to determine OSA treatment success...
June 2, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28582304/surgical-outcomes-for-speech-surgery-in-22q11-2-deletion-syndrome-the-dilemma-of-persistent-velopharyngeal-insufficiency-after-pharyngeal-flap-operation
#19
Ryan D Wagner, Erik M Wolfswinkel, Edward P Buchanan, David Y Khechoyan
INTRODUCTION: The majority of patients with 22q11.2 deletion syndrome suffer from velopharyngeal insufficiency (VPI). Patients with 22q11.2 deletion syndrome (22qDS) commonly present with a large central velopharyngeal gap in the setting of poor velar and pharyngeal wall motion. The posterior pharyngeal flap is considered the most effective technique to treat VPI in this complex patient group. This study aims to critically evaluate success rates of surgical management of VPI in 22qDS patients and discuss options for management of a failed posterior pharyngeal flap (PPF) with persistent VPI...
June 2, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28582294/autologous-fat-injection-for-treatment-of-velopharyngeal-insufficiency
#20
Evan Nigh, Gustavo A Rubio, Jeffery Hillam, Misha Armstrong, Luca Debs, Seth R Thaller
BACKGROUND: Management of velopharyngeal insufficiency (VPI) has traditionally involved surgical repair to improve speech. Posterior pharyngeal augmentation using injectable synthetic materials has been advocated. However, outcomes have been equivocal. More recently, autologous fat injection (AFI) has been advocated for correction of mild to moderate VPI. However, long-term efficacy and safety of this procedure remain unsettled. METHODS: A systematic review of the literature was performed...
June 2, 2017: Journal of Craniofacial Surgery
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