Radiofrequency surgery of the soft palate in the treatment of mild obstructive sleep apnea is not effective as a single-stage procedure: A randomized single-blinded placebo-controlled trial

Objective Plasma is formed by creating a high-density energy field within an electrically conductive fluid such as saline. Sometimes ablated bits of tissue get stuck between the electrodes of the wand, obstructing the suction channel. The purpose of this study is to investigate the effect of cooling the irrigating saline during ablation of the hypertrophied tongue base in patients with obstructive sleep apnea. Study Design Prospective randomized controlled trial. Setting An otorhinolaryngology department in Main University hospitals. Methods Sixty adult patients with obstructive sleep apnea and tongue base hypertrophy underwent tongue base ablation surgery. Patients were randomly divided into 2 groups of 30 patients each: cooled saline and room temperature saline. The Coblation wand used was the EVac 70 Xtra HP (Smith & Nephew). Results In this study, a significant difference in operative time (mean ± SD) was seen between groups: 21.2 ± 5.5 minutes in the cold group and 47 ± 9.5 minutes in the control group ( P = .001). The wands in the cold group did not obstruct, while all the wands in the control group were obstructed by tissue clogs with variable degrees, hence wasting more time to clean the wands’ tips. Conclusion Cooling the irrigating saline overcame the problem of wand clogs, and the wand tip did not occlude at all during the procedures, thus saving time lost in wand cleaning and demonstrating a faster and safer surgical procedure. Further studies are needed to identify the hemostatic effect of the cooled saline over the regular one.

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Cardiac imageology changes in patients with mild obstructive sleep apnea without cardiovascular disease

Sleep And Breathing ◽

10.1007/s11325-021-02421-0 ◽

2021 ◽

Author(s):

Zuogeng Hong ◽

Qiong Ou ◽

Yilu Cheng ◽

Yanxia Xu ◽

Hongwen Fei ◽

...

Keyword(s):

Cardiovascular Disease ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Obstructive Sleep ◽

Mild Obstructive Sleep Apnea

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A deep cascaded segmentation of obstructive sleep apnea-relevant organs from sagittal spine MRI

International Journal of Computer Assisted Radiology and Surgery ◽

10.1007/s11548-021-02333-0 ◽

2021 ◽

Vol 16 (4) ◽

pp. 579-588

Author(s):

Tatyana Ivanovska ◽

Amro Daboul ◽

Oleksandr Kalentev ◽

Norbert Hosten ◽

Reiner Biffar ◽

...

Keyword(s):

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Soft Palate ◽

High Speed ◽

Sleep Apnea Syndrome ◽

Epidemiological Data ◽

Epidemiological Studies ◽

Obstructive Sleep ◽

Validation Set ◽

Spine Mri

Abstract Purpose The main purpose of this work was to develop an efficient approach for segmentation of structures that are relevant for diagnosis and treatment of obstructive sleep apnea syndrome (OSAS), namely pharynx, tongue, and soft palate, from mid-sagittal magnetic resonance imaging (MR) data. This framework will be applied to big data acquired within an on-going epidemiological study from a general population. Methods A deep cascaded framework for subsequent segmentation of pharynx, tongue, and soft palate is presented. The pharyngeal structure was segmented first, since the airway was clearly visible in the T1-weighted sequence. Thereafter, it was used as an anatomical landmark for tongue location. Finally, the soft palate region was extracted using segmented tongue and pharynx structures and used as input for a deep network. In each segmentation step, a UNet-like architecture was applied. Results The result assessment was performed qualitatively by comparing the region boundaries obtained from the expert to the framework results and quantitatively using the standard Dice coefficient metric. Additionally, cross-validation was applied to ensure that the framework performance did not depend on the specific selection of the validation set. The average Dice coefficients on the test set were $$0.89\pm 0.03$$ 0.89 ± 0.03 , $$0.87\pm 0.02$$ 0.87 ± 0.02 , and $$0.79\pm 0.08$$ 0.79 ± 0.08 for tongue, pharynx, and soft palate tissues, respectively. The results were similar to other approaches and consistent with expert readings. Conclusion Due to high speed and efficiency, the framework will be applied for big epidemiological data with thousands of participants acquired within the Study of Health in Pomerania as well as other epidemiological studies to provide information on the anatomical structures and aspects that constitute important risk factors to the OSAS development.

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