scholarly journals P100 Modified BRP and Tongue Channelling: Can we cure Friedman III?

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A53-A53
Author(s):  
M Nasserallah
Keyword(s):  
Success Rate ◽  
Prognostic Index ◽  
Staging System ◽  
Sleep Apnoea ◽  
Adult Patients ◽  
Cure Rate ◽  
Surgical Success ◽  
Obstructive Sleep ◽  
Predictor Of Success ◽  
Secondary Objective

Abstract Aim The primary aim of this study was to determine the success rate of modified barbed reposition pharyngoplasty (BRP) and coblation tongue channelling (CCT) in adult patients with obstructive sleep apnoea (OSA). The secondary objective was to determine the anatomical sites that were most amenable to surgical intervention. We predicted that Friedman would be a poor predictor of success for this surgical technique and that a new prognostic index would be required. Methodology Adult patients with OSA underwent combined MODIFIED BRP and CCT (n = 40) in this prospective, 2-centre cohort trial. Data analysed included pre- and post-operative (3 months) polysomnography, Epworth sleepiness scale (ESS) and VOTE anatomy assessment (using awake nasoendoscopy) performed by a single investigator. Results 40 participants have enrolled in this study. So far, 26 patients have pre- and post-operative data. 42% of these patients had Friedman 3 anatomy. Statistically significant decreases in AHI 20.3 + 24 to 4.9 + 8.6 (p=0.001) and ESS 12.4 + 4.9 to 4.8±3.4 (p=0.001) were observed in pre- to post-operative measurements. Friedman stage 3 patients had an 82% surgical success rate and 64% cure rate. Oropharyngeal lateral collapse and velum anteroposterior collapse were the most correctable forms of anatomical collapse. Conclusion MODIFIED BRP with CCT is a safe and effective surgical option for patients with OSA, as indicated by the reduction in AHI and ESS. Friedman stage III is no longer a barrier for surgical success, and therefore a newer staging system is required to help prognosticate success with modern sleep surgery techniques.

Obstructive Sleep Apnoea in Adult Patients Post-tonsillectomy

2020 ◽  
Author(s):  
Renata L. Riha ◽  
Serafeim – Chrysovalantis Kotoulas ◽  
Athanasia Pataka ◽  
John Arthur Kvamme ◽  
Pavel Joppa ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Adult Patients ◽  
Obstructive Sleep

Anterior Palatoplasty for Obstructive Sleep Apnea: A Systematic Review and Meta-analysis

2017 ◽  
Vol 158 (3) ◽  
pp. 443-449 ◽  
Author(s):  
Murat Binar ◽  
Omer Karakoc
Keyword(s):  
Systematic Review ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Success Rate ◽  
Meta Analysis ◽  
Long Term Results ◽  
Published Data ◽  
Surgical Success ◽  
Obstructive Sleep ◽  
Anterior Palatoplasty

Objective The aim of this study was to determine the general outcomes and surgical success rates of anterior palatoplasty (AP) in patients with obstructive sleep apnea (OSA). Data Sources A systematic review of the literature and meta-analysis of published data were performed by searching the Cochrane, SAGE, MEDLINE, and Google Scholar databases, from January 1, 2007, to March 27, 2017, using relevant keywords. Review Methods The search scanned for studies with patients who had undergone AP (with or without tonsillectomy) as a single-stage, single-level surgical intervention for treatment of OSA. Two independent reviewers (M.B. and O.K.) inspected titles and abstracts of the studies according to established criteria. The full texts were then reviewed to extract the clinical and polysomnographic data. The primary outcome was the surgical success rate, defined as a reduction in the apnea-hypopnea index (AHI) of 50% or greater and an AHI of less than 20 postoperatively. The PRISMA statement was followed. Results After systematic evaluation of potentially relevant articles, 14 studies were downloaded, and 6 studies, consisting of 170 patients, met the study criteria. A fixed effects model was used to analyze the data. The surgical success rate of AP was 60.6%. No serious complications were reported in the literature. Conclusion The results of the present meta-analysis support AP as a moderately effective surgical method for the treatment of OSA. Comparative and randomized controlled prospective studies showing long-term results, with pre- and postoperative data, should be conducted to demonstrate the exact outcomes and reliability of this surgical technique.

One-stage nasal and multi-level pharyngeal surgery for obstructive sleep apnoea: safety and efficacy

2005 ◽  
Vol 119 (4) ◽  
pp. 272-276 ◽  
Author(s):  
Kenny P Pang
Keyword(s):  
Sleep Apnoea ◽  
Upper Respiratory Tract ◽  
Safety And Efficacy ◽  
Surgical Success ◽  
One Stage ◽  
Obstructive Sleep ◽  
Upper Respiratory ◽  
Multi Level ◽  
Group 2 ◽  
Group 1

A collapsible airway is often the common denominator in sleep-disordered breathing (SDB). The upper respiratory tract includes the nasal passage, nasopharynx, oral cavity, oropharynx, base-of-tongue region and the hypopharynx. It is believed that the highest amount of resistance in the upper respiratory tract is in the nasal cavities, and particularly the nasal valve. Most authors believe that when considering surgical options for patients with obstructive sleep apnoea (OSA) it is imperative to correct nasal pathology together with the other sites of airway obstruction. In this retrospective study, I sought to investigate the safety and efficacy of one-stage nasal and multi-level pharyngeal surgery. I compared two groups of patients: group 1, receiving one-stage nasal and multi-level pharyngeal surgery; and group 2, receiving only multi-level pharyngeal surgery. In group 1, nine out of 12 patients (75 per cent) met the criteria for surgical success, with a mean pre-operative apnoea-hypopnoea index (AHI) decreasing from 36.3 to 8.9 post-operatively (p<0.0002), while in group 2, 25 out of 40 patients met the surgical success criteria (62.5 per cent), with their mean AHI decreasing from 52.6 to 10.2 (p<0.0000). When comparing the surgical success rates between the two groups, it was not statistically significant, at p>0.106. There were no postoperative respiratory-related complications despite having bilateral nasal Merocel (tampon) packing in place (in group 1), and none of the patients in either group had any desaturation, hypoxaemia, apnoea or OSA-related complications. This series suggests that, with adequate post-operative monitoring, it is both safe and efficacious to perform both nasal and multi-level pharyngeal surgery in the one surgical session.

Comparing Upper Airway Stimulation to Expansion Sphincter Pharyngoplasty: A Single University Experience

2018 ◽  
Vol 127 (6) ◽  
pp. 379-383 ◽  
Author(s):  
Colin Huntley ◽  
David W. Chou ◽  
Karl Doghramji ◽  
Maurits Boon
Keyword(s):  
Success Rate ◽  
Upper Airway ◽  
Upper Airway Stimulation ◽  
Surgical Success ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Expansion Sphincter Pharyngoplasty ◽  
The Mean ◽  
Sphincter Pharyngoplasty ◽  
Surgical Option

Introduction: Expansion sphincter pharyngoplasty (ESP) is a surgical option for patients with obstructive sleep apnea (OSA). Upper airway stimulation (UAS) is an alternative that has shown success in initial outcomes studies. We compare outcomes of a cohort of patients undergoing UAS to ESP. Methods: We compared demographic and polysomnographic data of the UAS to ESP cohorts. We also calculated the proportion of patients achieving surgical success. Results: The ESP cohort consisted of 33 patients. The mean preoperative Apnea-Hypopnea Index (AHI), O2 nadir, Epworth Sleepiness Scale (ESS), and BMI were 36.47 ± 20.01, 82.63 ± 5.37, 10.69 ± 4.42, and 29.6 ± 4.49, which improved to 13.47 ± 18.74, 84.84 ± 5.48, 7.00 ± 5.81, and 29.92 ± 4.59 postoperatively. There was a 63.64% success rate. The UAS cohort consisted of 75 patients. The mean preoperative AHI, O2 nadir, ESS, and BMI were 36.76 ± 20.72, 80.24 ± 8.43, 11.18 ± 4.16, and 29.50 ± 3.96, which improved to 7.25 ± 11.19, 88.71 ± 3.25, 5.36 ± 3.35, and 29.36 ± 3.68 postoperatively. The success rate was 86.67%. We found a significant difference in gender, age, preoperative AHI, postoperative AHI, postoperative O2 nadir, surgical success, and patients reaching an AHI less than 10 and 5. Conclusion: Upper airway stimulation is a new surgical option for select patients with OSA showing comparable or improved outcomes to a cohort of patients undergoing ESP.

scholarly journals Prevalence, awareness and reporting of symptoms of obstructive sleep apnoea among hospitalized adult patients in Nigeria: A multicenter study

2016 ◽  
Vol 26 (4) ◽  
pp. 321 ◽  
Author(s):  
Olufemi Desalu ◽  
Cajetan Onyedum ◽  
Emmanuel Sanya ◽  
Joseph Fadare ◽  
Adekunle Adeoti ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Multicenter Study ◽  
Sleep Apnoea ◽  
Adult Patients ◽  
Obstructive Sleep

The epiglottis and obstructive sleep apnoea syndrome

1998 ◽  
Vol 112 (10) ◽  
pp. 940-943 ◽  
Author(s):  
Frank J. Catalfumo ◽  
Avishay Golz ◽  
S. Thomas Westerman ◽  
Liane M. Gilbert ◽  
Henry Z. Joachims ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Airway Obstruction ◽  
Obstructive Sleep Apnoea ◽  
Carbon Dioxide Laser ◽  
Sleep Apnoea ◽  
Obstructive Sleep Apnoea Syndrome ◽  
Fibre Optic ◽  
Cure Rate ◽  
Sleep Apnoea Syndrome ◽  
Obstructive Sleep

AbstractObstructive sleep apnoea syndrome (OSAS) is caused by obstruction or narrowing of the airway at various levels. The repair of one site only will not alleviate the syndrome if there are obstructions in other sites. Epiglottis prolapse during inspiration is an unusual cause of airway obstruction and a rare cause of OSA.Twelve cases of OSAS due to an abnormal epiglottis are presented. We present our approach to the diagnosis using fibre-optic examination of the hypopharynx, and our treatment using endoscopic carbon dioxide laser partial epiglottidectomy.We found in our series that in 11.5 per cent of patients who failed the uvulopalatopharyngoplasty procedure, the reason was a narrow airway at the hypopharyngeal level caused by an abnormal epiglottis. It is our suggestion that in these cases a laser partial epiglottidectomy should be performed. The results of this study show that partial epiglottidectomy can increase the cure rate of patients with obstructive sleep apnoea syndrome by 10–15 per cent.

scholarly journals Considerations in Surgical Management of Pediatric Obstructive Sleep Apnea: Tonsillectomy and Beyond

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 944
Author(s):  
T. C. Uwiera
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Success Rate ◽  
Surgical Management ◽  
Cure Rate ◽  
Obese Children ◽  
Obstructive Sleep ◽  
History Of ◽  
Surgical Options

Obstructive sleep apnea (OSA) is an increasingly recognized disorder with a reported incidence of 5.7% in children. Tonsillectomy (with or without adenoidectomy) in pediatric OSA in otherwise healthy non-obese children has a success rate of approximately 75%. However, the cure rate reported for all children undergoing tonsillectomy varies from 51% to 83%. This article reviews the history of tonsillectomy, its indications, techniques, various methods, risks, and successes. The article also explores other surgical options in children with residual OSA post-tonsillectomy.

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