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By Fernando Arredondo Otorrinolaringologia y medicina del sueño Estudios de postgrado Iner UNAM
David S Cohen, Garren M I Low, Antoine E Melkane, Sean A Mutchnick, Jonathan A Waxman, Sagar Patel, Mahdi A Shkoukani, Ho-Sheng Lin
OBJECTIVES/HYPOTHESIS: To contrast the changes in measurement of the hypoglossal/lingual artery neurovascular bundle (HLNVB) to constant surface landmarks in the base of tongue (BOT) during surgically simulated retraction versus resting anatomic position, and to identify a safe zone for BOT robotic surgery to avoid injury to the HLNVB. STUDY DESIGN: Human cadaver study. METHODS: Five fresh-frozen head and neck complexes were obtained, and seven HLNVBs were dissected...
January 2017: Laryngoscope
Sylwia Chwieśko-Minarowska, Łukasz Minarowski, Wojciech Aleksander Szewczak, Elżbieta Chyczewska, Anna Kuryliszyn-Moskal
Obstructive sleep apnea syndrome (OSAS) is characterized by hypotonia of lingual and suprahyoid muscles. Genioglossus muscle is responsible for protrusion and depression of the tongue. Its dysfunction results in occlusion of the upper airways and greater incidence of apnea-hypopnea events during sleep. The aim of this prospective study was to compare the effects of daytime transcutaneous electrical stimulation of the genioglossus muscle and standard continuous positive airway pressure (CPAP) therapy on the quality of sleep, in patients with OSAS...
November 2016: European Archives of Oto-rhino-laryngology
Robson Capasso, Talita Rosa, David Yung-An Tsou, Vladimir Nekhendzy, David Drover, Jeremy Collins, Soroush Zaghi, Macario Camacho
OBJECTIVE: To compare VOTE classification findings (velum, oropharyngeal-lateral walls, tongue base, and epiglottis) for drug-induced sleep endoscopy (DISE) among patients with obstructive sleep apnea (OSA) using 2 sedation protocols. STUDY DESIGN: Case series with chart review. SETTING: Single tertiary institution. SUBJECTS: Patients with OSA who underwent DISE. METHODS: A total of 216 patients underwent DISE between November 23, 2011, and May 1, 2015...
April 2016: Otolaryngology—Head and Neck Surgery
Hyung-Ju Cho, Do-Yang Park, Hyun Jin Min, Hyo Jin Chung, Jeung-Gweon Lee, Chang-Hoon Kim
BACKGROUND: Multilevel obstruction in obstructive sleep apnea commonly includes retroglossal obstruction. To improve surgical success rates, tongue volume reduction with posterior midline glossectomy and/or lingual tonsillectomy is widely performed. METHODS: Nasotracheal intubation was utilized, and the combined tongue procedure was performed as a final step after palatal surgery. The tongue was pulled maximally by a retraction suture and a McIVOR (Karl Storz, Tuttlingen, Germany) or Davis mouth gag (Karl Storz,Tuttlingen, Germany), and a medium-length tongue blade was applied to expose the tongue base...
April 2016: Head & Neck
Byung-Woo Yoon, Jeong-Min Hong, Sung-Lyong Hong, Soo-Kweon Koo, Hwan-Jung Roh, Kyu-Sup Cho
OBJECTIVES/HYPOTHESIS: In this study, we compared the effects of propofol and dexmedetomidine on the upper airway collapse pattern and cardiopulmonary parameters of patients with obstructive sleep apnea (OSA) undergoing drug-induced sleep endoscopy (DISE). STUDY DESIGN: Prospective, single center, observational study MATERIALS AND METHODS: The 50 patients with OSA underwent 30 minutes of DISE on 2 different days, the first time with propofol target-controlled infusion (TCI) and the second time with dexmedetomidine TCI...
March 2016: Laryngoscope
C-H Lee, W-C Hsu, W-H Chang, M-T Lin, K-T Kang
BACKGROUND: Use of polysomnography (PSG) is the gold standard of diagnosis and measurement of treatment effectiveness for paediatric obstructive sleep apnoea (OSA). Although adenotonsillectomy (T&A) is effective in diminishing the apnoea-hypopnoea index (AHI), a meta-analysis of postoperative changes for all other PSG parameters and outcome comparisons between obese and non-obese children following T&A have never been conducted. OBJECTIVE OF REVIEW: To comprehensively review polysomnographic findings after surgery for obese and non-obese children with OSA...
October 2016: Clinical Otolaryngology
Salma Batool-Anwar, James L Goodwin, Clete A Kushida, James A Walsh, Richard D Simon, Deborah A Nichols, Stuart F Quan
Obstructive sleep apnea is a chronic illness with increasing prevalence. In addition to associated cardiovascular comorbidities, obstructive sleep apnea syndrome has been linked to poor quality of life, occupational accidents, and motor vehicle crashes secondary to excessive daytime sleepiness. Although continuous positive airway pressure is the gold standard for sleep apnea treatment, its effects on quality of life are not well defined. In the current study we investigated the effects of treatment on quality of life using the data from the Apnea Positive Pressure Long-term Efficacy Study (APPLES), a randomized controlled trial of continuous positive airway pressure (CPAP) versus sham CPAP...
December 2016: Journal of Sleep Research
Macario Camacho, Dongcai Li, Makoto Kawai, Soroush Zaghi, Jeffrey Teixeira, Andrew J Senchak, Scott E Brietzke, Samuel Frasier, Victor Certal
OBJECTIVES/HYPOTHESIS: To determine if sleepiness and sleep study variables (e.g., Apnea-Hypopnea Index [AHI] and lowest oxygen saturation) improve following isolated tonsillectomy for adult obstructive sleep apnea (OSA). STUDY DESIGN: Systematic review and meta-analysis. METHODS: Nine databases (PubMed/MEDLINE included) were searched through November 24, 2015. RESULTS: Seventeen studies (n = 216 patients, 34.4 ± 10...
September 2016: Laryngoscope
Victor F Certal, Rui Pratas, Lidia Guimarães, Rodolfo Lugo, Yungan Tsou, Macario Camacho, Robson Capasso
OBJECTIVE: Traditionally, upper airway examination is performed while the patient is awake. However, in the past two decades, drug-induced sleep endoscopy (DISE) has been used as a method of tridimensional evaluation of the upper airway during pharmacologically induced sleep. This study aimed to systematically review the evidence regarding the usefulness of DISE compared with that of traditional awake examination for surgical decision making in patients with obstructive sleep apnea (OSA)...
March 2016: Laryngoscope
Stanley Yung-Chuan Liu, Leh-Kiong Huon, Tomonori Iwasaki, Audrey Yoon, Robert Riley, Nelson Powell, Carlos Torre, Robson Capasso
OBJECTIVES: To use drug-induced sedation endoscopy (DISE) and computational fluid dynamics (CFD) modeling to study dynamic airway and airflow changes after maxillomandibular advancement (MMA), and how the changes correlate with surgical success based on polysomnography parameters. STUDY DESIGN: Retrospective cohort study. SETTING: University medical center. METHODS: DISE was rated with the VOTE (velum, oropharynx, tongue, epiglottis) classification, and CFD was used to model airflow velocity and negative pressure exerted on pharyngeal wall...
January 2016: Otolaryngology—Head and Neck Surgery
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December 15, 2015: American Journal of Respiratory and Critical Care Medicine
Fré Bauters, Ernst R Rietzschel, Katrien B C Hertegonne, Julio A Chirinos
Obstructive sleep apnea (OSA) is common in the general population and highly prevalent in patients with cardiovascular disease. In this paper, we review (1) the pathophysiological mechanisms of OSA that may causally contribute to cardiovascular disease; (2) current evidence regarding the association between OSA and hypertension, stroke, ischemic heart disease, heart failure, atrial fibrillation, and cardiovascular mortality; and (3) the impact of continuous positive airway pressure (CPAP) treatment on cardiovascular risk factors and outcomes...
January 2016: Current Atherosclerosis Reports
Björn Lemmer, Joachim Scholtze, Judith Schmitt
INTRODUCTION: Seventeen male patients with severe obstructive sleep apnea syndrome (OSAS; apnea-hypopnea index>30/h) were monitored by polysomnography in the sleep lab before and after about 8 weeks of continuous positive airway pressure (CPAP). Twelve of the patients were hypertensive, but treated by antihypertensive drugs. The circadian rhythms in blood pressure (BP) and heart rate were determined by ambulatory BP monitoring and motor activity was monitored by a motion logger. As the sympathetic tone is reported to be increased in sleep apnea, the circadian rhythm in plasma norepinephrine was studied in parallel and as a marker rhythm of the biological clock plasma melatonin was determined around the clock by radioimmunoassay...
June 2016: Blood Pressure Monitoring
Pierre Escourrou, Ludger Grote, Thomas Penzel, Walter T Mcnicholas, Johan Verbraecken, Rosa Tkacova, Renata L Riha, Jan Hedner
Polygraphy (PG) and polysomnography (PSG) are used in clinical settings in Europe for diagnosing obstructive sleep apnea (OSA), but their equivalence in unselected clinical cohorts is unknown. We hypothesized that the method would affect both diagnostic outcomes and disease severity stratification. Data from 11 049 patients in the multi-centre European Sleep Apnea Cohort (ESADA) with suspected OSA (male and female, aged 18-80 years) were used in two groups of patients to compare PG (n = 5745) and PSG (n = 5304)...
December 2015: Journal of Sleep Research
Sheila Sivam, Paul K Witting, Camilla M Hoyos, Aung M Maw, Brendon J Yee, Ronald R Grunstein, Craig L Phillips
Dyslipidaemia and increased oxidative stress have been reported in severe obstructive sleep apnea, and both may be related to the development of cardiovascular disease. We have previously shown in a randomized crossover study in patients with moderate to severe obstructive sleep apnea that therapeutic continuous positive airway pressure treatment for 8 weeks improved postprandial triglycerides and total cholesterol when compared with sham continuous positive airway pressure. From this study we have now compared the effect of 8 weeks of therapeutic continuous positive airway pressure and sham continuous positive airway pressure on oxidative lipid damage and plasma lipophilic antioxidant levels...
June 2015: Journal of Sleep Research
Sandra Van den Broecke, Olivier Jobard, Gilles Montalescot, Marie Bruyneel, Vincent Ninane, Isabelle Arnulf, Thomas Similowski, Valérie Attali
BACKGROUND: Obstructive sleep apnea (OSA) is frequently associated with acute coronary syndrome (ACS). Screening of sleep-disordered breathing (SDB) has not been previously evaluated in ACS within 72 h in intensive care settings and its management could potentially enhance patients' prognosis. This pilot study assessed the feasibility of SDB screening at the early phase of ACS. METHODS: All consecutive patients admitted to the coronary care unit (CCU) for ACS without acute heart failure underwent one overnight-attended polysomnography (PSG) within 72 h after admission...
December 2014: Sleep Medicine
Victor Certal, Macario Camacho, João C Winck, Robson Capasso, Inês Azevedo, Altamiro Costa-Pereira
The objective of this study was to systematically assess the evidence for the diagnostic accuracy of unattended type 2 or type 3 multichannel studies for predicting and monitoring pediatric obstructive sleep apnea (OSA). Four medical databases were searched for eligible studies. Only studies that evaluated the ability of unattended multichannel devices to accurately diagnose or monitor OSA in children were included. Those with appropriate data were selected for meta-analysis. Study quality was assessed by using the Quality Assessment Tool for Diagnostic Accuracy Studies tool...
January 2015: Laryngoscope
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