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sleep endoscopy

J S Park, D K Chan, S R Parikh, A K Meyer, K W Rosbe
OBJECTIVE: To study the efficacy of surgical management for obstructive sleep apnea (OSA) syndrome in children with hypotonia, and to identify common anatomic sites of airway obstruction. METHODS: Retrospective chart review of polysomnographic parameters and quality of life instrument scores for seventy eight children with hypotonia who underwent surgical intervention for sleep-disordered breathing at two tertiary children's hospitals, and analysis of drug-induced sleep endoscopy data using a previously validated scoring system...
November 2016: International Journal of Pediatric Otorhinolaryngology
Denise Manica, Cláudia Schweiger, Leo Sekine, Simone Chaves Fagondes, Marisa Gasparin, Deborah Salle Levy, Gabriel Kuhl, Marcus Vinicius Collares, Paulo José Cauduro Marostica
OBJECTIVE: To evaluate the performance of two glossoptosis airway obstruction classifications in predicting symptom severity and laryngeal exposure difficulty in Robin Sequence (RS) patients. SETTING: Public tertiary hospital otolaryngology section (Hospital de Clínicas de Porto Alegre - HCPA). PATIENTS: All RS patients diagnosed at HCPA from October 2012 to February 2015 were enrolled, a total of 58 individuals. They were classified in isolated RS, RS-Plus and syndromic RS...
November 2016: International Journal of Pediatric Otorhinolaryngology
Natamon Charakorn, Eric J Kezirian
Drug-induced sleep endoscopy (DISE) is an upper airway evaluation technique in which fiberoptic examination is performed under conditions of unconscious sedation. Unique information obtained from this 3-dimensional examination of the airway potentially provides additive benefits to other evaluation methods to guide treatment selection. This article presents recommendations regarding DISE technique and the VOTE Classification system for reporting DISE findings and reviews the evidence concerning DISE test characteristics and the association between DISE findings and treatment outcomes...
October 6, 2016: Otolaryngologic Clinics of North America
Glenn Harvin, Eslam Ali, Amit Raina, William Leland, Sabeen Abid, Zahid Vahora, Hossein Movahed, Sumyra Kachru, Rick Tee
BACKGROUND: This pilot study examined airway characteristics during upper endoscopy to determine who is at high risk for obstructive sleep apnea. METHODS: Patients undergoing routine upper endoscopy were divided into 2 groups according to the Berlin Questionnaire (high and low risk for sleep disordered breathing). Patients underwent routine upper endoscopy using propofol sedation. The airway was then evaluated for no, partial, or complete collapse at the levels of the palate/uvula/tonsils, the tongue base, the hypopharynx, and the larynx...
October 2016: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Austin S Lam, Sarah K Wise, Raj C Dedhia
OBJECTIVE: To assess the practice characteristics of adult sleep otolaryngologists within US otolaryngology residency training programs. STUDY DESIGN: Cross-sectional online survey. SETTING: Otolaryngology residency training programs. SUBJECTS AND METHODS: Program directors from 106 otolaryngology training programs in the United States were contacted. Program directors were instructed to forward a survey to otolaryngologists within the institution who provided Accreditation Council for Graduate Medical Education (ACGME) Otolaryngology Milestone Project feedback in "sleep-disordered breathing...
September 27, 2016: Otolaryngology—Head and Neck Surgery
Cigdem Fırat Koca, Tamer Erdem, Tuba Bayındır
BACKGROUND: Deformity in the dental arc and facial skeleton by adenoid hypertrophy due to chronic mouth breathing is a well-known process. Most of the related studies have been based on cephalometric analyses. The aim of this study is to detect the presence of skeletal deformities on the soft tissue by analyzing distances and angles on photographs. METHODS: Ninety-seven children having between 25 and 100 % of adenoids, ages 4-12 years (48 boys, 49 girls), and 90 cases having 0-25 % adenoid tissue, ages 4-12 years (54 boys, 36 girls), were studied by clinical history, physical examination (including endoscopy), and standardized clinical photographs...
September 20, 2016: Journal of Otolaryngology—Head & Neck Surgery
Sharon H Gnagi, David R White
PURPOSE OF REVIEW: To discuss current modalities of endoscopic airway management beyond balloon dilation therapy. RECENT FINDINGS: Advances continue to be made through technology and bioengineering with exciting potential in the pediatric airway. Smaller robots and instrumentation allow increased endoscopic surgical success. Biodegradable stents and bioengineered grafts are on the horizon for use in airway surgery. Dysphonia following airway reconstruction is of increasing recognition with new endoscopic treatments being performed...
September 15, 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
Nitin Kumar
Obesity and its comorbidities - including diabetes and obstructive sleep apnea - have taken a large and increasing toll on the United States and the rest of the world. The availability of commercial, clinical, and operative therapies for weight management have not been effective at a societal level. Endoscopic bariatric therapy is gaining acceptance as more effective than diet and lifestyle measures, and less invasive than bariatric surgery. Various endoscopic therapies are analogues of the restrictive or bypass components of bariatric surgery, utilizing gastric remodeling or intestinal anastomosis to achieve proven weight loss and metabolic benefits...
August 21, 2016: World Journal of Gastroenterology: WJG
Masatsugu Okuyama, Osamu Takaishi, Kenichi Nakahara, Narika Iwakura, Tomoki Hasegawa, Maizumi Oyama, Ayumi Inoue, Hirotaka Ishizu, Hiroshi Satoh, Yasuhiro Fujiwara
BACKGROUND AND AIM: Gastroesophageal reflux disease (GERD) and psychological stress are associated with sleep disturbances. The aim of the present study was to examine the prevalence of sleep disturbances, anxiety, and depression by GERD subtypes and to identify factors associated with sleep disturbances in general population. METHODS: A total of 2002 Japanese subjects, who underwent annual health checkups, were enrolled and asked to fill out a questionnaire, including the frequency scale for the symptoms of GERD (FSSG), Athens Insomnia Scale (AIS), Rome III questionnaire, and Hospital Anxiety and Depression Scale (HADS)...
August 30, 2016: Scandinavian Journal of Gastroenterology
Jui-Sheng Hung, Wei-Yi Lei, Chih-Hsun Yi, Tso-Tsai Liu, Chien-Lin Chen
BACKGROUND: This study was conducted to investigate whether there is a direct association between subjective sleep quality and esophageal acid reflux in patients with gastroesophageal reflux disease. METHODS: We enrolled patients with classic reflux symptoms for endoscopy and ambulatory pH monitoring. The severity of esophageal mucosal injury was assessed by upper endoscopy. Distal esophageal acid exposure was determined by ambulatory 24-hour pH monitoring. Sleep disturbance was assessed by using the Pittsburgh Sleep Quality Index...
August 2016: American Journal of the Medical Sciences
Sung Hoon Jung, Soo Kweon Koo, Jang Won Choi, Ji Seung Moon, Sang Hoon Lee
We studied upper airway structural changes induced by continuous positive airway pressure (CPAP) in obstructive sleep apnea syndrome (OSAS) patients using drug-induced sleep endoscopy (DISE). This prospective study was conducted at an academic secondary referral center. In total, 28 male OSAS patients (mean age 41.1 years) with only retropalatal level obstructions were enrolled. Measurements of the obstruction site were obtained in two steps: first a measurement was taken of the obstruction site in accordance with sleep apnea, then, a measurement was taken of the obstruction site in accordance with DISE-assisted CPAP titration, including quantitative changes in the occlusion site before and after CPAP in pixel format using an area calculation program...
July 29, 2016: European Archives of Oto-rhino-laryngology
Li-Ang Lee, Yu-Lun Lo, Jen-Fang Yu, Gui-She Lee, Yung-Lun Ni, Ning-Hung Chen, Tuan-Jen Fang, Chung-Guei Huang, Wen-Nuan Cheng, Hsueh-Yu Li
Snoring sounds generated by different vibrators of the upper airway may be useful indicators of obstruction sites in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). This study aimed to investigate associations between snoring sounds, obstruction sites, and surgical responses (≥50% reduction in the apnea-hypopnea index [AHI] and <10 events/hour) in patients with OSAHS. This prospective cohort study recruited 36 OSAHS patients for 6-hour snoring sound recordings during in-lab full-night polysomnography, drug-induced sleep endoscopy (DISE), and relocation pharyngoplasty...
2016: Scientific Reports
Christopher Clark, Seckin O Ulualp
OBJECTIVES/HYPOTHESIS: Children with obstructive sleep apnea (OSA) may have multiple sites of upper airway obstruction (UAO). A wide variety of techniques has been used to evaluate UAO. Our aim was to compare findings of cine magnetic resonance imaging (MRI) and drug-induced sleep endoscopy (DISE) in identifying UAO sites in children with persistent OSA after adenotonsillectomy (AT). STUDY DESIGN: Retrospective chart review. MATERIAL AND METHODS: The medical records of children who underwent DISE and cine MRI were reviewed...
July 14, 2016: Laryngoscope
Yakup Yegïn, Mustafa Çelik, Kamïl Hakan Kaya, Arzu Karaman Koç, Fatma Tülin Kayhan
INTRODUCTION: Knowledge of the site of obstruction and the pattern of airway collapse is essential for determining correct surgical and medical management of patients with Obstructive Sleep Apnea Syndrome (OSAS). To this end, several diagnostic tests and procedures have been developed. OBJECTIVE: To determine whether drug-induced sleep endoscopy (DISE) or Müller's maneuver (MM) would be more successful at identifying the site of obstruction and the pattern of upper airway collapse in patients with OSAS...
June 20, 2016: Brazilian Journal of Otorhinolaryngology
Nicholas Horton, Ari Garber, Henrietta Hasson, Rocio Lopez, Carol A Burke
OBJECTIVES: There are little data on bowel movement (BM) kinetics induced by bowel preparation. Whether single-dose (SID) or split-dose (SPD) regimens differ in terms of patient convenience is unclear. We compared BM kinetics, sleep and travel disruptions, and polyp detection rates in patients undergoing colonoscopy assigned to SID vs. SPDs. METHODS: Patients were randomly assigned to 2-L SID or SPD (SPD1 and SPD2) bowel preparations. Surveys were completed querying the onset, duration, cessation, and intensity of BMs, along with sleep and travel disruption en route to the endoscopy center...
September 2016: American Journal of Gastroenterology
Furkan Karaloğlu, Yusuf K Kemaloğlu, Metin Yilmaz, Tansu Ulukavak Çiftçi, Bülent Çiftçi, Faruk K Bakkal
The localization of the obstruction is crucial in determining the appropriate surgical treatment for obstructive sleep apnea syndrome (OSAS); ApneaGraph has been introduced for diagnosis of OSAS and localization of airway obstruction level. This study aims to evaluate the diagnostic value of ApneaGraph for both clinical staging and site of obstruction. Thirty male OSAS patients were prospectively enrolled in this clinical trial. The following parameter were included to the study: Body mass indexes and neck circumferences of the subjects, Epworth sleepiness scale, site of obstruction detected by flexible endoscopy and ApneaGraph, apnea hypopnea index (AHI), apnea index, hypopnea index, maximal oxygen desaturation and average oxygen saturation which were detected by both polysomnography (PSG) and ApneaGraph devices...
July 4, 2016: European Archives of Oto-rhino-laryngology
Pichamol Jirapinyo, Christopher C Thompson
This article reviews the data for diagnostic and uncomplicated therapeutic upper endoscopy, which show it is safe and effective to perform the procedure under moderate sedation with a combination of benzodiazepine and opioids. For more complex procedures or for superobese patients anesthesia support is recommended. Performing endoscopy in this population should alert providers to plan carefully and individualize sedation plans because there is no objective way to quantify this risk pre-endoscopically.
July 2016: Gastrointestinal Endoscopy Clinics of North America
Jack W Shteamer, Raj C Dedhia
OBJECTIVE: To examine the suitability of commonly used agents for drug-induced sleep endoscopy (DISE) based on agent-specific neuropharmacology. DATA SOURCES: PubMed. REVIEW METHODS: A literature search of the PubMed database was performed on January 1, 2016. A two-layered search strategy was performed to identify relevant pharmacologic agents and articles related to neuropharmacology for these agents. The first search identified relevant pharmacologic agents; the second search examined agents with greater than five results from search 1, along with medical subject headings "respiration," "sleep," "pharmacology," and/or "[respective agent] (e...
July 1, 2016: Laryngoscope
Clemens Heiser, Benedikt Hofauer, Luke Lozier, B Tucker Woodson, Thomas Stark
OBJECTIVE/HYPOTHESIS: Selective stimulation of the upper airway is a new therapy for obstructive sleep apnea. The aim of the study was to determine if a selective nerve integrity monitoring (NIM) system could aid in precise placement of the cuff electrode in selective upper-airway stimulation. STUDY DESIGN: Single-center, prospective clinical trial. METHODS: Twenty patients who received a selective upper-airway stimulation system (Inspire Medical Systems, Maple Grove, MN) were implanted by using a NIM system...
June 27, 2016: Laryngoscope
Norman R Friedman, Sanjay R Parikh, Stacey L Ishman, Amanda G Ruiz, Hamdy El-Hakim, Seckin O Ulualp, Christopher T Wootten, Peter J Koltai, Dylan K Chan
OBJECTIVES/HYPOTHESIS: The purpose of this investigation was to assess current drug-induced sleep endoscopy (DISE) practice patterns at centers that have published on the technique, to identify areas of agreement, and to identify areas of disagreement that may represent opportunities for improvement and standardization. STUDY DESIGN: Multi-institutional survey. METHODS: A survey was designed in two phases to evaluate preoperative assessment, intraoperative performance, and postoperative management of patients undergoing DISE...
June 16, 2016: Laryngoscope
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