The effect of altered head and tongue posture on upper airway volume based on a validated upper airway analysis—An MRI pilot study

Respiration rate (RR) dynamics entrains brain neural networks. RR differences between mild cognitive impairment (MCI) and Alzheimer’s disease (AD) in response to oral appliance therapy (OAT) is unknown. This pilot study investigated if RR during stable sleep shows a relationship to pathological severity in subjects with MCI and AD who snore and if RR is influenced following stabilization of the upper airway using OAT. The study cohort was as follows: cognitively normal (CN; n = 14), MCI (n = 14) and AD (n = 9); and a sub-population receiving intervention, CN (n = 5), MCI (n = 7), AD (n = 6) subjects. The intervention used was an oral appliance plus a mouth shield (Tx). RR maximum (max) rate (breaths/minute) and RR fluctuation during 2116 stable sleep periods were measured. The Montreal cognitive assessment (MoCA) was administered before and after 4 weeks with Tx. Baseline data showed significantly higher RR fluctuation in CN vs. AD (p < 0.001) but not between CN vs. MCI (p = 0.668). Linear mixed model analysis indicated Tx effect (p = 0.008) for RR max. Tx after 4 weeks lowered the RR-max in MCI (p = 0.022) and AD (p < 0.001). Compared with AD RR max, CN (p < 0.001) and MCI (p < 0.001) were higher with Tx after 4 weeks. Some MCI and AD subjects improved executive and memory function after 4 weeks of Tx.

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Simple Car Seat Insert to Prevent Upper Airway Narrowing in Preterm Infants: A Pilot Study

PEDIATRICS ◽

10.1542/peds.112.4.907 ◽

2003 ◽

Vol 112 (4) ◽

pp. 907-913 ◽

Cited By ~ 26

Author(s):

S. L. Tonkin ◽

C. G. McIntosh ◽

W. Hadden ◽

C. Dakin ◽

S. Rowley ◽

...

Keyword(s):

Pilot Study ◽

Preterm Infants ◽

Upper Airway ◽

Airway Narrowing ◽

Car Seat ◽

Seat Insert

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Are All Manikins Created Equal? A Pilot Study of Simulator Upper Airway Anatomic Fidelity

Otolaryngology ◽

10.1177/0194599816674658 ◽

2016 ◽

Vol 156 (6) ◽

pp. 1154-1157 ◽

Cited By ~ 3

Author(s):

Jennifer A. Woo ◽

Sonya Malekzadeh ◽

Kelly M. Malloy ◽

Ellen S. Deutsch

Keyword(s):

Pilot Study ◽

Oral Cavity ◽

Nasal Cavity ◽

Upper Airway ◽

Flexible Endoscopy ◽

Aerodigestive Tract ◽

Passive State ◽

Point Scale ◽

Anatomic Site ◽

Radar Chart

This study evaluates the anatomic fidelity of several commercially available pediatric and adult manikins, including airway task trainers, which could be used in aerodigestive procedure training. Twenty-three experienced otolaryngologists assessed the aerodigestive anatomy of 5 adult and 5 pediatric manikins in a passive state, using rigid and flexible endoscopy. Anatomic fidelity was rated on a 5-point scale for the following: nasal cavity, nasopharynx, oral cavity, oropharynx, larynx, trachea, esophagus, and neck. Mean scores and standard deviations were tabulated for each manikin at each anatomic site. Ratings by survey participants demonstrated variation in the anatomic fidelity of the aerodigestive tract in a range of manikins. Radar chart display of the results allows comparison of manikin fidelity by anatomic site. Differences in scores may allow instructors to select manikins with the best anatomic fidelity for specific educational purposes, and they may contribute to recommendations to improve future manikin design.

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Perceptual Accuracy of Upper Airway Compromise in Children: Clinical Relevance and Future Directions for Research

Allergy & Rhinology ◽

10.2500/ar.2013.4.0060 ◽

2013 ◽

Vol 4 (2) ◽

pp. ar.2013.4.0060 ◽

Cited By ~ 3

Author(s):

Daphne Koinis-Mitchell ◽

Cynthia Esteban ◽

Sheryl J. Kopel ◽

Barbara Jandasek ◽

Katie Dansereau ◽

...

Keyword(s):

Pilot Study ◽

Respir Crit ◽

Persistent Asthma ◽

Upper Airway ◽

High Risk Group ◽

Preliminary Evaluation ◽

Symptom Perception ◽

Perceptual Accuracy ◽

Asthma Morbidity ◽

Clinical Tools

Approximately 80% of children with asthma have coexisting allergic rhinitis. The accurate recognition and assessment of asthma and rhinitis symptoms is an integral component of guideline-based treatment for both conditions. This article describes the development and preliminary evaluation of a novel paradigm for testing the accuracy of children's assessment of their upper airway (rhinitis) symptoms. This work is guided by our previous research showing the clinical efficacy of tools to evaluate children's perceptual accuracy of asthma symptoms and linking accurate asthma symptom perception to decreased asthma morbidity (Fritz G, et al., Ethnic differences in perception of lung function: A factor in pediatric asthma disparities? Am J Respir Crit Care Med 182:12–18, 2010; Klein RB, et al., The Asthma Risk Grid: Clinical interpretation of symptom perception, Allergy Asthma Proc 251–256, 2004). The pilot study tests a paradigm that allows for the examination of the correspondence of children's assessment of their upper airway functioning with actual values of upper airway flow through the use of a portable, handheld nasal peak flowmeter. Nine children with persistent asthma were evaluated over a 4-week period. The article describes the rhinitis perceptual accuracy paradigm and reviews the results of a pilot study, showing a large proportion of inaccurate rhinitis symptoms “guesses” by the sample of children with persistent asthma. Patterns of inaccuracy, rhinitis control, and asthma morbidity are also described. Directions for future work are reviewed. The development of clinical tools to evaluate children's accuracy of rhinitis symptoms are needed, given the central role of the self-assessment of symptoms in guideline-based care. Accurate perception of the severity of rhinitis symptoms may enhance rhinitis control, lessen the burden of asthma, and prevent unnecessary emergency use among this high-risk group of children.

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Inspiratory flow limitation in obstructive sleep apnoea patients

Clinical Science ◽

10.1042/cs20040024 ◽

2004 ◽

Vol 106 (6) ◽

pp. 563-565 ◽

Cited By ~ 3

Author(s):

Ramon FARRÉ

Keyword(s):

Pilot Study ◽

Airway Obstruction ◽

Sleep Disorder ◽

Obstructive Sleep Apnoea ◽

Upper Airway ◽

Sleep Apnoea ◽

Obstructive Sleep Apnoea Syndrome ◽

Bench Test ◽

Flow Limitation ◽

Obstructive Sleep

Patients suffering from the obstructive sleep apnoea syndrome (OSAS) experience nocturnal episodes of upper airway obstruction resulting in recurrent oxygen desaturations and arousals. Methods to quantify the nocturnal obstructive events are of interest for characterizing this prevalent sleep disorder. In a study published in this issue of Clinical Science, Bloch and co-workers propose the computation of a new index for objectively quantifying the degree of flow limitation in patients with OSAS. The results obtained in a bench test and in a pilot study in patients suggest that the flow limitation index proposed may help to better characterize the disturbed breathing events undergone by patients with OSAS.

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