Ultrasonic Measurement of Lingual Artery and Its Application for Midline Glossectomy

2020 ◽  
Vol 129 (9) ◽  
pp. 856-862
Author(s):  
Chun Liu ◽  
Jie Qin ◽  
Dengxiang Xing ◽  
Haibo Lu ◽  
Ruiyi Yue ◽  
...  
Keyword(s):  
Body Mass Index ◽  
High Sensitivity ◽  
Ultrasonic Measurement ◽  
Lingual Artery ◽  
Control Group ◽  
Apnea Hypopnea Index ◽  
Tube Insertion ◽  
Obstructive Sleep ◽  
Operative Planning ◽  
Tongue Position

Objective: To explore the application of lingual artery ultrasound (US) for midline glossectomy in patients with obstructive sleep apnea (OSA). Methods: Lingual artery US was performed in 57 OSA patients (OSA group) and 20 normal persons (control group). The differences in the depths of the lingual arteries and the distances between the bilateral lingual arteries were compared between two groups. The correlations between apnea-hypopnea index (AHI), AHI after the nasopharyngeal tube insertion (NPT-AHI), Friedman tongue position (FTP) and all the parameters of lingual arteries were analyzed. Results: Both the depths of the lingual arteries and the distances between the bilateral lingual arteries in the OSA group were larger than those in the control group ( P < .01). All the parameters of the lingual arteries in OSA patients were positively correlated with AHI, NPT-AHI and FTP ( P < .05). While controlling for body mass index (BMI), all the parameters of the lingual arteries in OSA patients were still correlated with NPT-AHI positively ( P ≤ .01). Conclusion: Pre-operative US can show the course of the lingual artery clearly for pre-operative planning. The depth and width of the lingual artery in OSA patients were different from controls. NPT-AHI has high sensitivity in predicting all the parameters of the lingual arteries. FTP is closely correlated with the depth of the lingual arteries.

scholarly journals Explorating the Involvement of Plasma Sestrin2 in Obstructive Sleep Apnea

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Rong Jiang ◽  
Qiru Wang ◽  
Huifen Zhai ◽  
Xiaohua Du ◽  
Shibo Sun ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Body Mass Index ◽  
Coronary Heart Disease ◽  
Obstructive Sleep Apnea ◽  
Heart Disease ◽  
Sleep Apnea ◽  
Body Mass ◽  
Control Group ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep

Obstructive sleep apnea (OSA) can lead to serious complications such as coronary heart disease and hypertension due to oxidative stress. Sestrin2 expression is upregulated under conditions of oxidative stress. This study aimed to explore whether Sestrin2 was involved in OSA. OSA and healthy control subjects were recruited and matched with age, gender, and body mass index (BMI). Plasma Sestrin2 levels were measured and compared. A multivariate stepwise regression model was used to detect the relationship between Sestrin2 and other variable factors. The Sestrin2 levels were compared between before and after four weeks treatment by nasal continuous positive airway pressure (nCPAP) in severe OSA patients. Fifty-seven subjects were divided into two groups: control group (39.33 ± 9.40 years, n = 21) and OSA group (38.81 ± 7.84 years, n = 36). Plasma Sestrin2 levels increased in the OSA group (control group 2.06 ± 1.76 ng/mL, OSA group 4.16 ± 2.37 ng/mL; P=0.001). Sestrin2 levels decreased after four-week nCPAP treatment (pre-nCPAP 5.21 ± 2.32 ng/mL, post-nCPAP 4.01 ± 1.54 ng/mL; P=0.004). Sestrin2 was positively correlated with apnea/hypopnea index (AHI) oxygen desaturation index, while negatively correlated with mean oxygen saturation. Moreover, these correlations remained unchanged after adjusting for gender, age, waist-to-hip ratio, and body mass index. Multiple regression analysis showed that there was an association between Sestrin2 and AHI. Our findings suggest that Sestrin2 is involved in OSA. The increase of plasma Sestrin2 is directly related to the severity of OSA. To some extent, Sestrin2 may be useful for determining the severity of OSA and monitoring the effect of CPAP. In addition, since some complications of OSA such as coronary heart disease and diabetes are usually related with oxidative stress, the role of Sestrin2 in those OSA complications needs further study.

scholarly journals STOP Questionnaire

2008 ◽  
Vol 108 (5) ◽  
pp. 812-821 ◽  
Author(s):  
Frances Chung ◽  
Balaji Yegneswaran ◽  
Pu Liao ◽  
Sharon A. Chung ◽  
Santhira Vairavanathan ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Screening Tool ◽  
High Sensitivity ◽  
Surgical Patients ◽  
Apnea Hypopnea Index ◽  
Neck Size ◽  
Obstructive Sleep ◽  
And Gender ◽  
Stop Questionnaire

Background Obstructive sleep apnea (OSA) is a major risk factor for perioperative adverse events. However, no screening tool for OSA has been validated in surgical patients. This study was conducted to develop and validate a concise and easy-to-use questionnaire for OSA screening in surgical patients. Methods After hospital ethics approval, preoperative patients aged 18 yr or older and without previously diagnosed OSA were recruited. After a factor analysis, reliability check, and pilot study; four yes/no questions were used to develop this screening tool. The four questions were respectively related to snoring, tiredness during daytime, observed apnea, and high blood pressure (STOP). For validation, the score from the STOP questionnaire was evaluated versus the apnea-hypopnea index from monitored polysomnography. Results The STOP questionnaire was given to 2,467 patients, 27.5% classified as being at high risk of OSA. Two hundred eleven patients underwent polysomnography, 34 for the pilot test and 177 for validation. In the validation group, the apnea-hypopnea index was 20 +/- 6. The sensitivities of the STOP questionnaire with apnea-hypopnea index greater than 5, greater than 15, and greater than 30 as cutoffs were 65.6, 74.3, and 79.5%, respectively. When incorporating body mass index, age, neck circumference, and gender into the STOP questionnaire, sensitivities were increased to 83.6, 92.9, and 100% with the same apnea-hypopnea index cutoffs. Conclusions The STOP questionnaire is a concise and easy-to-use screening tool for OSA. It has been developed and validated in surgical patients at preoperative clinics. Combined with body mass index, age, neck size, and gender, it had a high sensitivity, especially for patients with moderate to severe OSA.

Weight Loss Ameliorates Markers of Systemic Inflammation and Endothelial Dysfunction in Obstructive Sleep Apnea Obese Patients

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Shehab M Abd El-Kader
Keyword(s):  
Body Mass Index ◽  
Weight Loss ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Weight Reduction ◽  
Control Group ◽  
Apnea Hypopnea Index ◽  
Obese Patients ◽  
Obstructive Sleep ◽  
Adhesive Molecules

Background: Obstructive sleep apnea (OSA) is the most common sleep disorder in clinical practice. Its growing worldwide prevalence may be due to the rising incidence of obesity in the public. OSA has been increasingly recognized as a major public health issue, as it has a significant influence on the incidence and prognosis of cardiovascular diseases. Although, these abnormalities could be modulated with weight reduction, there is limitation in clinical studies have addressed the beneficial effects of weight reduction in modulating biomarkers of endothelial dysfunction and cytokines for obesity associated with OSA. Objective: This study was designed to detect the effects of weight loss on the inflammatory cytokines and adhesive molecules in obese patients with obstructive sleep apnea. Methods: Seventy obese patients with moderate to severe OSA (the apnea-hypopnea index (AHI)>15 events/hour), their age ranged from 36- 50 years and their body mass index ranged from 26-31kg/m2 were equally assigned into two groups: the weight reduction group received aerobic exercises, diet regimen, where the control group received no intervention for 12 weeks. Results: The mean values of body mass index (BMI), apnea-hypopnea index (AHI), tumor necrosis factor –alpha (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP), inter-cellular adhesion molecule (ICAM-1), vascular cell adhesion molecule (VCAM-1) and E-selectin were significantly decreased in the training group, however the results of the control group were not significant. In addition, there were significant differences between both groups at the end of the study. Conclusion: Weight loss ameliorates inflammatory cytokines and adhesive molecules among obese patients with obstructive sleep apnea.

Anterior Palatoplasty for the Treatment of OSA

2009 ◽  
Vol 141 (2) ◽  
pp. 253-256 ◽  
Author(s):  
Kenny P. Pang ◽  
Raymond Tan ◽  
Puravi Puraviappan ◽  
David J. Terris
Keyword(s):  
Body Mass Index ◽  
Clinical Stage ◽  
Long Term Results ◽  
Apnea Hypopnea Index ◽  
Type I ◽  
Obstructive Sleep ◽  
The Mean ◽  
Anterior Palatoplasty

OBJECTIVE: Review long-term results of the modified cautery-assisted palatoplasty (mod CAPSO)/anterior palatoplasty for the treatment of mild-moderate obstructive sleep apnea (OSA). STUDY DESIGN: Prospective series of 77 patients. All patients were >18 years old, type I Fujita, body mass index (BMI) < 33, Friedman clinical stage II, with apnea-hypopnea index (AHI) from 1.0 to 30.0. The mean follow-up time was 33.5 months. The procedure involved an anterior soft palatal advancement technique with or without removal of the tonsils. The procedure was done under general or local anesthesia. RESULTS: There were 69 men and eight women; the mean age was 39.3 years old; and mean BMI was 24.9 (range 20.7–26.8). There were 38 snorers and 39 OSA patients. The AHI improved in patients with OSA, 25.3 ± 12.6 to 11.0 ± 9.9 ( P < 0.05). The overall success rate for this OSA group was 71.8 percent (at mean 33.5 months). The mean snore scores (visual analog score) improved from 8.4 to 2.5 (for all 77 patients). Lowest oxygen saturation also improved in all OSA patients. Subjectively, all patients felt less tired. CONCLUSION: This technique has been shown to be effective in the management of patients with snoring and mild-moderate OSA.

scholarly journals Endothelial Function and Arterial Stiffness Should Be Measured to Comprehensively Assess Obstructive Sleep Apnea in Clinical Practice

2021 ◽  
Vol 8 ◽  
Author(s):  
Jinmei Luo ◽  
Xiaona Wang ◽  
Zijian Guo ◽  
Yi Xiao ◽  
Wenhao Cao ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Arterial Stiffness ◽  
Endothelial Function ◽  
Augmentation Index ◽  
Reactive Hyperemia ◽  
Control Group ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
Tnf Α

Objective: An effective clinical tool to assess endothelial function and arterial stiffness in patients with obstructive sleep apnea (OSA) is lacking. This study evaluated the clinical significance of subclinical markers for OSA management in males without serious complications.Patients/Methods: Males without serious complications were consecutively recruited. Clinical data, biomarker tests, reactive hyperemia index (RHI), and augmentation index at 75 beats/min (AIx75) measured by peripheral arterial tonometry were collected. An apnea hypopnea index (AHI) cutoff of ≥15 events/h divided the patients into two groups.Results: Of the 75 subjects, 42 had an AHI ≥15 events/h. Patients with an AHI ≥15 events/h had higher high-sensitivity C-reactive protein, tumor necrosis factor-alpha (TNF-α), vascular endothelial growth factor, and AIx75 values than the control group but no statistical difference in RHI was observed. After controlling for confounders, TNF-α was negatively correlated with the average oxygen saturation (r = −0.258, P = 0.043). RHI was correlated with the rapid eye movement (REM) stage percentage (r = 0.306, P = 0.016) but not with AHI (P &gt; 0.05). AIx75 was positively correlated with the arousal index (r = 0.289, P = 0.023) but not with AHI (r = 0.248, P = 0.052).Conclusions: In males with OSA without severe complications, TNF-α and AIx75 are independently related to OSA. The role of RHI in OSA management requires further elucidation. These markers combined can comprehensively evaluate OSA patients to provide more evidence for the primary prevention of coronary heart disease and treatment response assessment.

scholarly journals Effect of ventilation therapy on mortality rate among obesity hypoventilation syndrome and obstructive sleep apnoea patients

2020 ◽  
Vol 6 (2) ◽  
pp. 00101-2019 ◽  
Author(s):  
Hanna-Riikka Kreivi ◽  
Tuomas Itäluoma ◽  
Adel Bachour
Keyword(s):  
Body Mass Index ◽  
Mortality Rate ◽  
Body Mass ◽  
Obstructive Sleep Apnoea ◽  
Sleep Apnoea ◽  
Control Group ◽  
Obesity Hypoventilation Syndrome ◽  
Obstructive Sleep ◽  
Hypoventilation Syndrome ◽  
Obesity Hypoventilation

IntroductionThe prevalence of obesity is continually increasing worldwide, which increases the incidence of obesity hypoventilation syndrome (OHS) and its consequent mortality.MethodsWe reviewed the therapy mode, comorbidity and mortality of all OHS patients treated at our hospital between 2005 and 2016. The control group consisted of randomly selected patients with obstructive sleep apnoea (OSA) treated during the same period.ResultsWe studied 206 OHS patients and 236 OSA patients. The OHS patients were older (56.3 versus 52.3 years, p<0.001) and heavier (body mass index 46.1 versus 32.2 kg·m−2, p<0.001), and the percentage of women was higher (41.2% versus 24.2%, p<0.001), respectively. The OHS patients had more hypertension (83% versus 61%, p<0.001) and diabetes (62% versus 31%, p<0.001) than the OSA patients, but no higher stroke (4% versus 8%, p=0.058) or ischaemic heart disease (14% versus 15%, p=0.437) incidence. The 5- and 10-year, unadjusted survival rates were lower among the OHS patients than among the OSA patients (83% versus 96% and 74% versus 91%, respectively; p<0.001). Differences in mortality rates were not related to age, sex or body mass index; covariates such as Charlson Comorbidity Index and ventilation therapy predicted survival. The mortality rate decreased significantly (p<0.001) both in OHS and OSA patients even after adjusting for covariates.ConclusionsThe mortality rate in OHS was significantly higher than that in OSA patients even after adjusting for covariates. Ventilation therapy by continuous positive airway pressure or noninvasive ventilation have reduced mortality significantly in all patients.

scholarly journals 0894 A Two Item Questionnaire Reflecting Parental Concern As An Indicator Of The Severity Of Obstructive Sleep Apnea In Children

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A340-A341
Author(s):  
R Tauman ◽  
M Lavi ◽  
M Greenfeld ◽  
G Fishman ◽  
O Wasserzug ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Apnea Hypopnea Index ◽  
Prospective Analysis ◽  
Z Score ◽  
Parental Concern ◽  
Item Questionnaire ◽  
Obstructive Sleep ◽  
The Mean ◽  
Sleep Related Breathing Disorder ◽  
Pediatric Sleep Questionnaire

Abstract Introduction The currently available questionnaires based on parental reporting of OSA symptoms include large number of items and are not sufficient to the diagnosis and assessment of OSA severity. We aimed to evaluate a simple 2-item questionnaire regarding parental concern as a predictor of the severity of OSA in children as measured by polysomnography. Methods Prospective analysis of parental concern regarding their children referred for PSG due to suspected OSA. Parents of all study children completed the brief Parental Concern Scale (PCS) questionnaire and the validated Pediatric Sleep Questionnaire-Sleep-Related Breathing Disorder questionnaire (PSQ-SRBD). The PCS consisted of 1 question on the need for surgery and 1 question on concerns about the child’s breathing. Results Ninety-five children (mean age 4.2 ± 2.5 years, 52% males, mean body mass index z score 0.45 ± 1.8) were recruited. Twenty-three children (24%) had moderate-severe OSA and were referred for adenotonsillectomy. Significant correlations were found between the need for surgery score and the apnea-hypopnea index (r=0.22, P = .029), as well as the mean SpO2 levels (r=-0.24, P = .02). The likelihood for the diagnosis of moderate-severe OSA by PSG increased as parental ranking for the need for surgery increased (P = .003). The need for surgery score and the child’s age were the only predictors for moderate-severe OSA (P = .01 and P = .043, respectively). Conclusion Querying parents on their perception of their child’s need for surgery is a sensitive, practical, and easy-to-use tool that can help the clinician in prioritizing referral to PSG. Support  

scholarly journals Olfactory Bulb Volume and Olfactory Sulcus Depth in Patients With OSA: An MRI Evaluation

2019 ◽  
Vol 99 (7) ◽  
pp. 442-447
Author(s):  
Adil Doğan ◽  
Nuray Bayar Muluk ◽  
Hamza Şahin
Keyword(s):  
Olfactory Bulb ◽  
Upper Airway ◽  
Magnetic Resonance Images ◽  
Control Group ◽  
Apnea Hypopnea Index ◽  
Female Patients ◽  
Proinflammatory Mediators ◽  
Obstructive Sleep ◽  
Picture Archiving And Communication ◽  
The Right

Objectives: We evaluated olfactory functions in patients with obstructive sleep apnea (OSA). Methods: The cranial magnetic resonance images of 58 adult patients (36 males and 22 females) aged 27 to 79 years were retrieved from the hospital picture archiving and communication system (PACS) system. There were 29 patients with OSA (17 males and 12 females), diagnosed according to the polysomnography results. A control group consisted of 29 healthy patients without OSA. Olfactory bulb (OB) volume and olfactory sulcus (OS) depth measurements were performed. Nasal septal deviation (SD) was also evaluated and recorded as no SD, deviation to the right, and deviation to the left in all groups. Results: Olfactory bulb volumes of the OSA group were significantly lower than those of the control group ( P < .05), whereas OS depth values were not different ( P > .05). There was a positive correlation between the right and left OB volumes and right and left OS depth values ( P < .05). In older patients with OSA and in female patients with OSA, OB volumes decreased bilaterally ( P < .05). Olfactory sulcus depth of the right side was lower in the female patients with OSA compared to the male patients with OSA ( P < .05). There were no significant correlations between apnea–hypopnea index and OB volumes and OS depth values in the OSA group ( P > .05) Conclusion: In patients with OSA, OB volumes decreased bilaterally. It may be related to intermittent nocturnal hypoxia/reoxygenation episodes, which may be a trigger for upper airway inflammation; and proinflammatory mediators maybe harmful on olfactory neuroepithelium and olfactory impairment may occur.

Expansion Sphincter Pharyngoplasty: A New Technique for the Treatment of Obstructive Sleep Apnea

2007 ◽  
Vol 137 (1) ◽  
pp. 110-114 ◽  
Author(s):  
Kenny P. Pang ◽  
B. Tucker Woodson
Keyword(s):  
Body Mass Index ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Body Mass ◽  
Apnea Hypopnea Index ◽  
Type I ◽  
Pharyngeal Wall ◽  
Obstructive Sleep ◽  
Expansion Sphincter Pharyngoplasty ◽  
Sphincter Pharyngoplasty

OBJECTIVE: In this study, we assessed the efficacy of a new method (expansion sphincter pharyngoplasty [ESP]) to treat obstructive sleep apnea. STUDY DESIGN: We conducted a prospective, randomized controlled trial. METHODS: Forty-five adults with small tonsils, body mass index less than 30 kg/m 2 , of Friedman stage II or III, of type I Fujita, and with lateral pharyngeal wall collapse were selected for the study. RESULTS: The mean body mass index was 28.7 kg/m 2 . The apnea-hypopnea index improved from 44.2 ± 10.2 to 12.0 ± 6.6 ( P < 0.005) following ESP and from 38.1 ± 6.46 to 19.6 ± 7.9 in the uvulopalatopharyngoplasty group ( P < 0.005). Lowest oxygen saturation improved from 78.4 ± 8.52% to 85.2 ± 5.1% in the ESP group ( P = 0.003) and from 75.1 ± 5.9% to 86.6 ± 2.2% in the uvulopalatopharyngoplasty group ( P < 0.005). Selecting a threshold of a 50% reduction in apnea-hypopnea index and apnea-hypopnea index less than 20, success was 82.6% in ESP compared with 68.1% in uvulopalatopharyngoplasty ( P < 0.05). CONCLUSION/SIGNIFICANCE: The ESP may offer benefits in a selected group of OSA patients.

scholarly journals Polysomnographic and clinical characteristics of positional obstructive sleep apnea patients

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Seda Beyhan Sagmen ◽  
Sevda Cömert
Keyword(s):  
Body Mass Index ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Body Mass ◽  
Severe Disease ◽  
Upper Airway ◽  
Neck Circumference ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
The Mean

Abstract Background Obstructive sleep apnea is a condition characterized by the complete or partial obstruction of the upper airway during sleep. This study aimed to compare the clinical and polysomnographic characteristics of our obstructive sleep apnea patients according to their positional and non-positional features. Results Two hundred eighty patients were included in the study. One hundred two patients (36.43%) were female, while 178 patients (63.57%) were male. While 88 (31.43%) of these patients were defined as positional patients, 192 (68.57%) were defined as non-positional patients. The mean age of the positional patients (46.78 ± 9.66) was lower than the mean age of the non-positional patients (50.90 ± 10.96) (p 0.001). Similarly, the mean body mass index of the positional patients (29.39 ± 3.80) was lower than the mean body mass index of the non-positional patients (33.30 ± 6.45) (p < 0.001). Neck circumference values of the positional patients (40.36 ± 2.65) were lower compared to the non-positional patients (43.32 ± 2.54) (p < 0.001). Sleep values were compared based on the presence of positional sleep apnea. In the positional patients, sleep duration, sleep efficiency (percentage), duration of stage N3, minimum, and mean saturation values were found to be higher compared to the non-positional patients, while nightlong apnea hypopnea index, apnea index, percentage of sleep time with oxygen saturation below 90%, oxygen desaturation index, mean heart rate, and periodic limb movement index values were found to be lower (p < 0.05). The rate of severe sleep apnea (7.95%) in the positional patients was lower than the non-positional patients (53.65%) (p < 0.001). Conclusion In the light of these data, positional OSA is a very important condition presented in 31.43% of OSA patients and it was determined that these patients were younger, had less body mass index, and shorter neck circumference. The rate of severe disease was found to be lower in positional OSA patients

Sign in / Sign up

Export Citation Format

Share Document