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https://www.readbyqxmd.com/read/28807529/correlation-of-soft-palate-length-with-velum-obstruction-and-severity-of-obstructive-sleep-apnea-syndrome
#1
Ju-Shin Lim, Jae Woo Lee, Chun Han, Jang-Woo Kwon
OBJECTIVE: Our aim in this study was to analyze whether soft palate length and velum obstruction during sleep are correlated and to determine the effects of related parameters on obstructive sleep apnea syndrome (OSAS) severity. We used computed tomography to measure soft palate length and drug-induced sleep endoscopy (DISE) to evaluate velum obstruction severity. Patients also underwent polysomnography (PSG) for evaluation of OSAS severity. METHODS: A retrospective cohort of 67 patients with OSAS treated between May 1st, 2013 and July 31st, 2016 was analyzed...
August 11, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/28776718/analysis-of-factors-associated-with-electing-endoscopic-sinus-surgery
#2
Adam S DeConde, Jess C Mace, Vijay R Ramakrishnan, Jeremiah A Alt, Timothy L Smith
OBJECTIVE: Medically refractory chronic rhinosinusitis (CRS) can be managed with appropriate continued medical therapy (CMT) or surgery followed by CMT. Patients who initially elect CMT and do not experience adequate symptom resolution may "cross over" to endoscopic sinus surgery (ESS). Our objective was to identify patient covariates associated with this subset of patients who elect this change in treatment modality. STUDY DESIGN: Retrospective analysis of a prospective, multi-center cohort of adult patients with CRS enrolled between March 2011 and June 2015 in academic, tertiary referral clinics...
August 4, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28760191/does-sleep-endoscopy-staging-pattern-correlate-with-outcome-of-advancedpalatopharyngoplasty-for-moderate-to-severe-obstructive-sleep-apnea
#3
Ying-Shuo Hsu, Ofer Jacobowitz
STUDY OBJECTIVES: Although drug-induced sleep endoscopy (DISE) is an accepted method to localize upper airway obstruction, it is not known whether allsites identified by DISE must be treated to achieve sufficient apnea-hypopnea index (AHI) improvement. The aim of this study was to compare outcomes forunilevel (upper) versus multilevel DISE collapse patterns in a patient cohort that only underwent modern palatopharyngoplasty. Our hypothesis was that notall tongue base-level obstructions on DISE must be treated...
July 28, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28738388/updated-friedman-staging-system-for-obstructive-sleep-apnea
#4
Michael Friedman, Anna M Salapatas, Lauren B Bonzelaar
In the practice of sleep medicine, the first step is identification of those patients at high risk for sleep apnea. Nearly every physician and every hospital has preferred methods of screening. Many patient questionnaires or surveys as well as some objective physical measurements have been suggested to predict the presence of sleep apnea. Screening is well established, and laboratory and home testing are widely available. An early assessment with a physical examination can help direct treatment planning. The Friedman tongue position, lingual tonsil hypertrophy grading, and the effects of oral positioning on the hypopharynx should be used in early assessment for treatment planning, and as screening tools to assess the sight of obstruction...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28738362/advances-in-the-diagnosis-of-obstructive-sleep-apnea-drug-induced-sleep-endoscopy
#5
Madeline J L Ravesloot, Linda Benoist, Peter van Maanen, Eric J Kezirian, Nico de Vries
Drug-induced sleep endoscopy was introduced in 1991 and has recently evolved into a pivotal instrument for patients in whom obstructive sleep apnea surgery is considered. Here, we discuss the indications, contraindications, technique, anesthesia, scoring systems, validity, and insights of the literature.
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28645668/titration-technique-using-endoscopy-for-an-oral-appliance-treatment-of-obstructive-sleep-apnea
#6
Kentaro Okuno, Kazuki Ikai, Erika Matsumura-Ai, Takafumi Araie
The degree of mandibular protrusion for an oral appliance (OA) should be customized for each patient with obstructive sleep apnea (OSA). This article describes the mandibular titration technique for OAs to effectively treat OSA by using endoscopy to evaluate the change in the airway at the velopharynx. This technique may minimize the degree of mandible protrusion and contribute to both the efficacy of and compliance with OA therapy.
June 20, 2017: Journal of Prosthetic Dentistry
https://www.readbyqxmd.com/read/28643999/dexmedetomidine-and-general-anesthesia-a-narrative-literature-review-of-its-major-indications-for-use-in-adults-undergoing-non-cardiac-surgery
#7
Arthur Davy, Julien Fessler, Marc Fischler, Morgan le Guen
BACKGROUND: In Europe, dexmedetomidine has marketing approval only for sedation in intensive care units. However, its use during general anesthesia has been widely reported. The aim of this narrative review is to draw a picture of potential indications in anesthesia. METHODS: We searched in MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials using the keywords "Dexmedetomidine, Dexdor, Precedex and Dexdomitor". The research ended in December 2016...
June 22, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28623043/nasal-airway-evaluation-in-obstructive-sleep-apnoea-patients-volumetric-tomography-and-endoscopic-findings
#8
M M Rodrigues, M F R Gabrielli, O A Garcia Junior, V A Pereira Filho, L A Passeri
Obstructive sleep apnoea (OSA) results from the recurrent collapse of the upper airway during sleep. Nasal abnormalities influence the stability of the pharynx. The aim of this study was to evaluate the volumetric and anatomical changes of the nasal cavity in patients with OSA. The Nasal Obstruction Symptom Evaluation (NOSE) scale was used to grade nasal obstruction. Sleep-related breathing disorders were evaluated by polysomnography. The nasal airway volume was obtained from computed tomography scans through volumetric reconstruction of the nasal airway...
June 13, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28584940/drug-induced-sedation-endoscopy-dise-classification-systems-a-systematic-review-and-meta-analysis
#9
REVIEW
Esuabom Dijemeni, Gabriele D'Amone, Israel Gbati
PURPOSE: Drug-induced sedation endoscopy (DISE) classification systems have been used to assess anatomical findings on upper airway obstruction, and decide and plan surgical treatments and act as a predictor for surgical treatment outcome for obstructive sleep apnoea management. The first objective is to identify if there is a universally accepted DISE grading and classification system for analysing DISE findings. The second objective is to identify if there is one DISE grading and classification treatment planning framework for deciding appropriate surgical treatment for obstructive sleep apnoea (OSA)...
June 6, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28583487/considerations-for-the-successful-decannulation-of-the-pediatric-patient-a-single-surgeon-s-experience
#10
Jonathan T Maslan, Kenneth R Feehs, Daniel J Kirse
OBJECTIVE: To characterize the steps and interventions necessary for successful decannulation of the chronic pediatric tracheostomy patient. METHODS: This retrospective review analyzed one surgeon's (DJK) pediatric tracheostomy decannulation methods and results at a tertiary academic medical center over a thirteen-year period, from October 2002 through November 2015. It also examined which tests and procedures were conducted on patients prior to their successful decannulation...
July 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28561345/outcome-after-one-year-of-upper-airway-stimulation-for-obstructive-sleep-apnea-in-a-multicenter-german-post-market-study
#11
Armin Steffen, J Ulrich Sommer, Benedikt Hofauer, Joachim T Maurer, Katrin Hasselbacher, Clemens Heiser
OBJECTIVE/HYPOTHESIS: Upper airway stimulation (UAS) of the hypoglossal nerve has been implemented in the routine clinical practice for patients with moderate-to-severe obstructive sleep apnea (OSA) who could not adhere to continuous positive airway pressure. This study reports objective and patient-reported outcome after 12 months of implantation. STUDY DESIGN: Multicenter prospective single-arm study. METHODS: Consecutive patients who received the UAS system (Inspire Medical Systems, Inc...
May 31, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28528369/effect-of-physical-stress-on-drug-induced-sleep-endoscopy-for-obstructive-sleep-apnea
#12
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...
August 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28490038/pediatric-sleep-disordered-breathing-an-update-on-diagnostic-testing
#13
Brian McGrath, Jerrold Lerman
PURPOSE OF REVIEW: Recent advances in diagnostic testing for obstructive sleep apnea in children have refined the standard tests while identifying several new tools that hold promise to radically change how we diagnose sleep apnea. RECENT FINDINGS: Studies have demonstrated that the polysomnogram may be modified to permit home assessment of sleep disturbed breathing in children to ensure more widespread access to the test. Alternately, questionnaires, nocturnal oximetry, and diagnostic urinary biomarkers have shown great promise as both sensitive and specific tools to diagnose sleep apnea in children as well as track the severity of the disease...
June 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28476166/predictors-of-failure-of-dise-directed-adenotonsillectomy-in-children-with-sleep-disordered-breathing
#14
Noura Alsufyani, Andre Isaac, Manisha Witmans, Paul Major, Hamdy El-Hakim
BACKGROUND: Adenotonsillectomy (AT) is the most commonly performed procedure for sleep disordered breathing (SDB) in pediatrics. However, 20-40% of patients will have persistent signs and symptoms of SDB after AT. Drug-induced sleep endoscopy (DISE) has the potential to individualize surgical treatments and avoid unnecessary or unsuccessful surgeries. The objective of this study was to determine the predictors of failure of DISE-directed adenoidectomy and/or tonsillectomy in otherwise healthy children with SDB...
May 5, 2017: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28442168/the-evaluation-of-pattern-and-quality-of-sleep-in-patients-with-chronic-rhinosinusitis-with-nasal-polyps
#15
Uzdan Uz, Kıvanç Günhan, Hikmet Yılmaz, Halis Ünlü
OBJECTIVE: The goal of this study is to evaluate the impact of chronic rhinosinusitis with nasal polyps (CRSwNP) on sleep pattern and sleep quality before and after functional endoscopic sinus surgery using subjective and objective parameters. METHODS: Twenty-two patients with CRSwNP were evaluated. All subjects underwent assessment by nasal endoscopy, rhinomanometry and computed tomography. Sleep pattern and sleep quality were evaluated by Pittsburgh sleep quality index (PSQI) and polysomnography (PSG)...
April 22, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/28440921/pediatric-pulmonology-year-in-review-2016-part-1
#16
REVIEW
David J Birnkrant, Jane B Black, Ignacio E Tapia, Thomas Nicolai, William A Gower, Terry L Noah
Pediatric Pulmonology continues to publish research and clinical topics related to the entire range of children's respiratory disorders. As we have done annually in recent years, we here summarize the past year's publications in our major topic areas, as well as selected literature in these areas from other core journals relevant to our discipline. This review (Part 1) covers selected articles on sleep, diagnostic testing/endoscopy, respiratory complications of neuromuscular disorders, and rare lung diseases...
September 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28397553/preoperative-drug-induced-sleep-endoscopy-improves-the-surgical-approach-to-treatment-of-obstructive-sleep-apnea
#17
Colin Huntley, David Chou, Karl Doghramji, Maurits Boon
OBJECTIVE: Drug induced sleep endoscopy (DISE) allows for preoperative evaluation of the specific site and character of upper airway obstruction in obstructive sleep apnea (OSA). We aim to assess the impact DISE has on customizing the surgical plan and evaluate its role in surgical success. METHODS: We retrospectively reviewed patients undergoing surgery for OSA. We compared those patients undergoing preoperative DISE to those that did not to assess procedures performed and surgical outcomes...
June 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28364198/drug-induced-sleep-endoscopy-with-target-controlled-infusion-using-propofol-and-monitored-depth-of-sedation-to-determine-treatment-strategies-in-obstructive-sleep-apnea
#18
Clemens Heiser, Phillippe Fthenakis, Alexander Hapfelmeier, Sebastian Berger, Benedikt Hofauer, Winfried Hohenhorst, Eberhard F Kochs, Klaus J Wagner, Guenther M Edenharter
BACKGROUND: Drug-induced sleep endoscopy (DISE) has become an important diagnostic examination tool in the treatment decision process for surgical therapies in the treatment of obstructive sleep apnea (OSA). Currently, there is a variety of regimes for the performance of DISE, which renders comparison and assessment across results difficult. It remains unclear how the different regimes influence the findings of the examination and the resulting conclusions and treatment recommendations...
March 31, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28359259/propofol-and-sufentanil-may-affect-the-patients-sleep-quality-independently-of-the-surgical-stress-response-a-prospective-nonrandomized-controlled-trial-in-1033-patients-undergone-diagnostic-upper-gastrointestinal-endoscopy
#19
Ming Lei, Peng Zhang, Yunfei Liu, Fangfang Fu, Ling Ye, Tao Zhu
BACKGROUND: It is unknown whether sedative per se contributes to the postoperative sleep disturbance. Diagnostic upper gastrointestinal endoscopy (UGE) is a minimally invasive procedure which is not likely to cause tissue trauma and pain. The purpose of this study was to evaluate the sleep quality of patients undergoing routine (without sedative) diagnostic UGE or UGE with sedative, before, 1 week, and 1 month after the procedure. METHODS: One thousand and thirty-three patients undergoing UGE were enrolled...
March 31, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28329099/effect-of-sleeping-position-on-upper-airway-patency-in-obstructive-sleep-apnea-is-determined-by-the-pharyngeal-structure-causing-collapse
#20
Melania Marques, Pedro R Genta, Scott A Sands, Ali Azarbazin, Camila de Melo, Luigi Taranto-Montemurro, David P White, Andrew Wellman
Objectives: In some patients, obstructive sleep apnea (OSA) can be resolved with improvement in pharyngeal patency by sleeping lateral rather than supine, possibly as gravitational effects on the tongue are relieved. Here we tested the hypothesis that the improvement in pharyngeal patency depends on the anatomical structure causing collapse, with patients with tongue-related obstruction and epiglottic collapse exhibiting preferential improvements. Methods: Twenty-four OSA patients underwent upper airway endoscopy during natural sleep to determine the pharyngeal structure associated with obstruction, with simultaneous recordings of airflow and pharyngeal pressure...
March 1, 2017: Sleep
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