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Surgical obstructive sleep apnea

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https://www.readbyqxmd.com/read/28632506/adenotonsillectomy-for-the-management-of-pulmonary-hypertension-in-a-patient-with-complex-congenital-heart-disease-a-case-report
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/28562535/the-structural-changes-of-upper-airway-and-newly-developed-sleep-breathing-disorders-after-surgical-treatment-in-class-iii-malocclusion-subjects
#10
Ui Lyong Lee, Hoon Oh, Sang Ki Min, Ji Ho Shin, Yong Seok Kang, Won Wook Lee, Young Eun Han, Young Jun Choi, Hyun Jik Kim
Bimaxillary surgery is the traditional treatment of choice for correcting class III malocclusion which is reported to cause an alteration of oropharyngeal structures and upper airway narrowing that might be a predisposing factor for obstructive sleep apnea (OSA). This study aimed to analyze sleep parameters in class III malocclusion subjects and ascertain the prevalence of snoring or OSA following bimaxillary surgery.A total of 22 patients with Le Fort I osteotomy and mandibular setback for class III malocclusion were prospectively enrolled...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28558716/development-and-validation-of-a-score-for-preoperative-prediction-of-obstructive-sleep-apnea-sposa-and-its-perioperative-outcomes
#11
Christina H Shin, Stephanie D Grabitz, Fanny P Timm, Noomi Mueller, Khushi Chhangani, Karim Ladha, Scott Devine, Tobias Kurth, Matthias Eikermann
BACKGROUND: Postoperative respiratory complications (PRCs) are associated with significant morbidity, mortality, and hospital costs. Obstructive sleep apnea (OSA), often undiagnosed in the surgical population, may be a contributing factor. Thus, we aimed to develop and validate a score for preoperative prediction of OSA (SPOSA) based on data available in electronic medical records preoperatively. METHODS: OSA was defined as the occurrence of an OSA diagnostic code preceded by a polysomnography procedure...
May 30, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28543072/obstructive-sleep-apnea-in-the-irradiated-head-and-neck-cancer-patient
#12
Phillip Huyett, Seungwon Kim, Jonas T Johnson, Ryan J Soose
OBJECTIVES/HYPOTHESIS: To assess the prevalence of obstructive sleep apnea (OSA) in head and neck cancer (HNSCC) patients treated with radiation therapy. STUDY DESIGN: Prospective case series without comparison group. METHODS: Patients who underwent radiation therapy for oropharyngeal or laryngeal squamous cell carcinoma completed a 3-night home sleep test (HST), Epworth Sleepiness Scale, Functional Outcomes of Sleep Questionnaire, and University of Washington Quality of Life questionnaire...
May 23, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28531336/loop-gain-predicts-the-response-to-upper-airway-surgery-in-patients-with-obstructive-sleep-apnoea-ventilatory-control-abnormalities-predict-surgical-responsiveness
#13
Simon A Joosten, Paul Leong, Shane A Landry, Scott A Sands, Philip I Terrill, Dwayne Mann, Anthony Turton, Jhanavi Rangaswamy, Christopher Andara, Glen Burgess, Darren Mansfield, Garun S Hamilton, Bradley A Edwards
Study Objectives: Upper airway surgery is often recommended to treat OSA patients who cannot tolerate continuous positive airways pressure (CPAP). However, the response to surgery is variable, potentially because it does not improve the non-anatomical factors (i.e. loop gain and arousal threshold) causing OSA. Measuring these traits clinically might predict responses to surgery. Our primary objective was to test the value of loop gain and arousal threshold to predict surgical success defined as 50% reduction in apnea-hypopnea index (AHI) and AHI <10 events/hr post-surgery...
May 22, 2017: Sleep
https://www.readbyqxmd.com/read/28530876/research-continuous-surveillance-of-sleep-apnea-patients-in-a-medical-surgical-unit
#14
Dana Supe, Leah Baron, Tom Decker, Kyle Parker, Jeanne Venella, Sarah Williams, Kari Beaton, John Zaleski
This report consists of two separate studies on the use of continuous capnography monitoring conducted in an effort to improve patient safety at Virtua Health System. The desire for improved patient safety is motivating continuous monitoring and improved surveillance in clinical areas not traditionally equipped for such monitoring. We explored the use of remote monitoring of capnography, using enterprise middleware, in patients recovering from surgery in a medical-surgical unit. Continuous monitoring traditionally has been used in higher-acuity settings, such as intensive care units...
May 2017: Biomedical Instrumentation & Technology
https://www.readbyqxmd.com/read/28529812/diabetic-muscle-infarction-masquerading-as-necrotizing-fasciitis
#15
Kalyana C Janga, Ankur Sinha, Perry Wengrofsky, Phone Oo, Sheldon Greenberg, Regina Tarkovsky, Kavita Sharma
A 43-year-old male patient with past medical history of diabetes mellitus (DM), end stage renal disease (ESRD) on hemodialysis (HD), congestive heart failure (CHF), obstructive sleep apnea (OSA), and chronic anemia presented with complaints of left thigh pain. A computerized tomogram (CT) of the thigh revealed evidence of edema with no evidence of a focal collection or gas formation noted. The patient's clinical symptoms persisted and he underwent magnetic resonance imaging (MRI) of his thigh which was reported to show small areas of muscle necrosis with fluid collection...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/28528369/effect-of-physical-stress-on-drug-induced-sleep-endoscopy-for-obstructive-sleep-apnea
#16
Sang Min Park, Dong-Kyu Kim
Drug-induced sleep endoscopy (DISE) is a reliable upper airway evaluation tool, widely used to improve surgical results in patients with obstructive sleep apnea (OSA). Several factors, including sleeping position and depth of sedation, affect DISE findings. This study aimed to evaluate the impact of physical stress on DISE findings. Eighty-five patients with OSA underwent two DISE examinations at the same level of sedation. The "first DISE" (control group) was performed after polysomnography, while the "second DISE" (test group) performed immediately after a treadmill stress test...
May 20, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28508712/changing-rates-of-morbidity-and-mortality-in-obstructive-sleep-apnea-surgery
#17
Jacob J Friedman, Anna M Salapatas, Lauren B Bonzelaar, Michelle S Hwang, Michael Friedman
Objective Whereas uvulopalatopharyngoplasty (UPPP) was the standard surgical procedure for obstructive sleep apnea prior to 2007, multilevel surgery has become the standard since that time. This study compares morbidity and mortality rates of the stand-alone UPPP with those of multilevel sleep surgery that includes UPPP. Methods Patients undergoing UPPP between 2007 and 2014 were identified in the American College of Surgeons National Surgical Quality Improvement Program database. UPPP was defined by Current Procedural Terminology codes 42145 and 42950...
May 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28504992/trends-in-perioperative-practice-and-resource-utilization-in-patients-with-obstructive-sleep-apnea-undergoing-joint-arthroplasty
#18
Crispiana Cozowicz, Jashvant Poeran, Ashley Olson, Madhu Mazumdar, Eva E Mörwald, Stavros G Memtsoudis
BACKGROUND: Emerging evidence associating obstructive sleep apnea (OSA) with adverse perioperative outcomes has recently heightened the level of awareness among perioperative physicians. In particular, estimates projecting the high prevalence of this condition in the surgical population highlight the necessity of the development and adherence to "best clinical practices." In this context, a number of expert panels have generated recommendations in an effort to provide guidance for perioperative decision-making...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28498266/use-of-positive-airway-pressure-following-middle-ear-surgery-a-practice-survey-of-otologists
#19
Douglas S Ruhl, Anthony M Tolisano, Bradley W Kesser, George T Hashisaki, Macario Camacho
BACKGROUND: Positive airway pressure (PAP) devices are used as treatment for obstructive sleep apnea (OSA). PAP may increase middle ear pressure which is of interest to otologic surgeons. There is a lack of data to guide management of PAP therapy after middle ear surgery. OBJECTIVE: To elucidate how otologic surgeons manage PAP in their patients after ear surgery. STUDY DESIGN: A survey e-mailed to practicing members of the American Neurotology Society...
July 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28493179/where-to-position-osteotomies-in-genioglossal-advancement-surgery-based-on-locations-of-the-mental-foramen-canine-lateral-incisor-central-incisor-and-genial-tubercle
#20
Joshua S Park, Christopher Lee, Jason M Rogers, Ho-Hyun Sun, Yuan F Liu, Jeffrey A Elo, Jared C Inman
PURPOSE: The study aimed to provide precise measurements of anterior mandibular structural anatomy and to explore potential osteotomies for genioglossal advancement. METHODS: Cone beam computed tomography was used to analyze 33 randomly selected patients undergoing surgery for obstructive sleep apnea (OSA) between 2014 and 2016 at an academic surgical hospital. The locations of relevant mandibular structures were measured and statistical modeling was performed. RESULTS: Mean horizontal distances from midline to the mental foramina and the roots of the canine, lateral incisor, and central incisor were 22...
May 11, 2017: Oral and Maxillofacial Surgery
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