scholarly journals The effect of upper airway surgery on the underlying physiological causes of obstructive sleep apnoea

2019 ◽  
Vol 28 (S1) ◽  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Upper Airway Surgery ◽  
Airway Surgery ◽  
Obstructive Sleep

Upper airway surgery benefits patients with obstructive sleep apnoea who cannot tolerate nasal continuous positive airway pressure

2004 ◽  
Vol 118 (4) ◽  
pp. 270-274 ◽  
Author(s):  
Melanie A. Souter ◽  
Scott Stevenson ◽  
Bryn Sparks ◽  
Chris Drennan
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Obstructive Sleep Apnoea ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Upper Airway Surgery ◽  
Nasal Cpap ◽  
Airway Surgery ◽  
Obstructive Sleep

Nasal continuous positive airway pressure (CPAP) is the mainstay of treatment for patients with moderate to severe obstructive sleep apnoea (OSA). However, tolerance and compliance are poor.An audit using the Christchurch Hospital ORL surgery database identified patients who underwent upper airway surgery for OSA. Tracheostomy and bimaxillary advancement patients were excluded. Adults with moderate to severe OSA (Desaturation Index (DI) >10 n.h-1), who had failed atrial of nasal CPAP, and had pre-operative and post-operative sleep study data were identified. Objective (DI) and Subjective (Epworth Sleepiness Score (ESS)) outcome measures were recorded.The database identified 69 patients who underwent surgery for snoring or OSA; of these, 25 patients formed the study group. Sixteen out of 25 improved (64 per cent) after surgery, seven out of 25 showed no change (28 per cent), two patients (eight per cent) showed deterioration in their DI. Forty-eight per cent of patients had >50 per cent post-operative improvement in DI. Fourteen out of 25 (56 per cent) had a post-operative DI <20 n.h-1. Seven out of 25 (28 per cent) had a post-operative DI <10 n.h-1. Upper airway surgery has a role in the managementof selected patients with OSA who cannot tolerate nasal CPAP.

CPAP therapy prevents increase in blood pressure after upper airway surgery for obstructive sleep apnoea

2013 ◽  
Vol 17 (4) ◽  
pp. 1289-1299 ◽  
Author(s):  
Maria Teresa Martins de Araújo ◽  
Nazaré Sousa Bissoli ◽  
Sônia Alves Gouvêa ◽  
Maria Christina Thomé Pacheco ◽  
Bernard Meyer ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Obstructive Sleep Apnoea ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Cpap Therapy ◽  
Upper Airway Surgery ◽  
Airway Surgery ◽  
Obstructive Sleep

scholarly journals Predictors of perioperative complications following single or combination nasal-palatopharyngeal surgery for severe obstructive sleep apnoea

2016 ◽  
Vol 15 (1) ◽  
Author(s):  
Zamzil Amin Asha'ari ◽  
Jamalludin Ab Rahman ◽  
Wan Ishlah Wan Leman
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Perioperative Complications ◽  
Upper Airway ◽  
Cardiovascular Complications ◽  
Sleep Apnoea ◽  
Complication Rates ◽  
Tertiary Referral Hospital ◽  
Upper Airway Surgery ◽  
Airway Surgery ◽  
Obstructive Sleep

Introduction: To assess the relationship between perioperative complications and upper airway surgeries for obstructive sleep apnoea (OSA). Methods: The records of 118 adult patients, diagnosed with obstructive sleep apnoea (apnoea-hypopnoea index (AHI) >5), who underwent upper airway surgery at a single tertiary referral hospital from 2007 to 2015 were reviewed. Pulmonary, surgical, and cardiovascular complications within the first 30 postoperative days were analyzed according to types of upper airway surgery. Upper airway surgery types were single surgery or combinations of surgeries to the tonsils, pharyngeal adenoids, soft palate, tongue base and nose. Logistic regression was used to assess the multivariable association of age, sex, BMI, OSA severity, medical comorbidity, and types of upper airway surgery with postoperative complications. Results: At least one perioperative complications occurred in 48 of 128 patients (37.5%). In a multivariable model, the overall complication rate was increased with age, obesity, smoking and underlying comorbid medical problems. Complication rates were not associated with AHI severity, types of procedures performed and whether the surgery was a single or combination surgery. Conclusions: In OSA patients undergoing upper airway surgery, the severity of OSA as assessed by the AHI, and the sites and numbers of concurrent surgery performed were not associated with the rate of perioperative complications.

Identifying patients who need close monitoring during and after upper airway surgery for obstructive sleep apnoea

2006 ◽  
Vol 120 (8) ◽  
pp. 655-660 ◽  
Author(s):  
K P Pang
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Oxygen Desaturation ◽  
Prior History ◽  
Close Monitoring ◽  
Upper Airway Surgery ◽  
Airway Surgery ◽  
High Dependency ◽  
Obstructive Sleep

Potentially serious complications have been documented in patients undergoing upper airway surgery for obstructive sleep apnoea (OSA). Consensus is lacking regarding peri- and post-operative monitoring and identification of those patients likely to suffer post-operative complications.This retrospective review of 118 patients treated and 152 surgical procedures undertaken, from January 1998 to December 2003, addresses this issue. The overall peri- and post-operative complication rate was 13.8 per cent, with one patient experiencing upper airway compromise, five patients experiencing post-operative oxygen desaturation within 150 minutes of extubation, six patients experiencing persistent hypertension and four patients suffering secondary haemorrhage. All patients were treated accordingly and recovered well, with no mortality. From these results, it is concluded that patients with severe OSA (apnoea–hypopnoea index > 60 and lowest oxygen saturation <80 per cent) are at higher risk of post-operative oxygen desaturation. Post-operative hypertension is more likely in patients with a prior history of hypertension. Routine post-operative admission to an intensive care unit for all OSA patients is unnecessary (including patients with severe OSA). However, all patients with OSA should be closely monitored in the post-anaesthesia care area for at least three hours after surgery; based on the outcome of this period and the clinical judgment of the clinician, the patient can then be observed overnight in either the high dependency unit or on a general ward. Patients with mild OSA may be admitted to the 23-hour ambulatory unit post-operatively. Use of continuous positive airway pressure in the immediate post-operative period can reduce the incidence of post-operative respiratory compromise and complications and is strongly recommended.

scholarly journals Respiration in NREM and REM sleep after upper airway surgery for obstructive sleep apnoea

1995 ◽  
Vol 4 (3) ◽  
pp. 189-195 ◽  
Author(s):  
ORESTE MARRONE ◽  
ADRIANA SALVAGGIO ◽  
GIUSEPPE INSALACO ◽  
MARIA ROSARIA BONSIGNORE ◽  
MARIA CIMINO ◽  
...  
Keyword(s):  
Obstructive Sleep Apnoea ◽  
Rem Sleep ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Upper Airway Surgery ◽  
Airway Surgery ◽  
Obstructive Sleep
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