Inferior Partial Turbinectomy: An Effective Procedure for Chronic Rhinitis

1994 ◽  
Vol 73 (6) ◽  
pp. 405-407 ◽  
Author(s):  
Steven Mucci ◽  
Aristides Sismanis
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Local Anesthesia ◽  
Nasal Obstruction ◽  
Effective Procedure ◽  
Safe Procedure ◽  
Success Rates ◽  
Chronic Rhinitis ◽  
Obstructive Sleep

The safety and effectiveness of inferior partial turbinectomy (IPT) as a treatment for refractory chronic rhinitis was studied. Fifty-five patients, 34 males and 21 females, underwent IPT for chronic rhinitis, the majority under local anesthesia and in conjunction with septoplasty. Relief of nasal obstruction, rhinorrhea, snoring, headache, and obstructive sleep apnea was subjectively measured after an average follow-up of 18 months. We noted particularly high success rates - 92.3% and 85.5% - for nasal obstruction and rhinorrhea, respectively. Complications, in the form of post-op bleeding, were low at 3.7%. We conclude that IPT is an effective and safe procedure when properly performed. This work should help otolaryngologists become more comfortable in performing this old but controversial technique for treating chronic rhinitis.

Improvement in Obstructive Sleep Apnea (OSA) in Super Morbidly Obese Patients After Bariatric Surgery

2020 ◽  
Vol 103 (8) ◽  
pp. 725-728
Keyword(s):  
Bariatric Surgery ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Lifestyle Modification ◽  
Apnea Hypopnea Index ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Obstructive Sleep ◽  
Objective Evidence

Background: Lifestyle modification is the mainstay therapy for obese patients with obstructive sleep apnea (OSA). However, most of these patients are unable to lose the necessary weight, and bariatric surgery (BS) has been proven to be an effective modality in selected cases. Objective: To provide objective evidence that BS can improve OSA severity. Materials and Methods: A prospective study was conducted in super morbidly obese patients (body mass index [BMI] greater than 40 kg/m² or BMI greater than 35 kg/m² with uncontrolled comorbidities) scheduled for BS. Polysomnography (PSG) was performed for preoperative assessment and OSA was treated accordingly. After successful surgery, patients were invited to perform follow-up PSG at 3, 6, and 12 months. Results: Twenty-four patients with a mean age of 35.0±14.0 years were enrolled. After a mean follow-up period of 7.8±3.4 months, the mean BMI, Epworth sleepiness scale (ESS), and apnea-hypopnea index (AHI) significantly decreased from 51.6±8.7 to 38.2±6.8 kg/m² (p<0.001), from 8.7±5.9 to 4.7±3.5 (p=0.003), and from 87.6±38.9 to 28.5±21.5 events/hour (p<0.001), respectively. Conclusion: BS was shown to dramatically improve clinical and sleep parameters in super morbidly obese patients. Keywords: Morbid obesity, Bariatric surgery, Obstructive sleep apnea (OSA)

Aerodynamics Analysis of the Impact of Nasal Surgery on Patients with Obstructive Sleep Apnea and Nasal Obstruction

ORL ◽  
2021 ◽  
pp. 1-8
Author(s):  
Lifeng Li ◽  
Demin Han ◽  
Hongrui Zang ◽  
Nyall R. London
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Nasal Obstruction ◽  
Upper Airway ◽  
Apnea Hypopnea Index ◽  
Nasal Surgery ◽  
Subjective Sleep Quality ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
The Impact

<b><i>Objective:</i></b> The purpose of this study was to evaluate the effects of nasal surgery on airflow characteristics in patients with obstructive sleep apnea (OSA) by comparing the alterations of airflow characteristics within the nasal and palatopharyngeal cavities. <b><i>Methods:</i></b> Thirty patients with OSA and nasal obstruction who underwent nasal surgery were enrolled. A pre- and postoperative 3-dimensional model was constructed, and alterations of airflow characteristics were assessed using the method of computational fluid dynamics. The other subjective and objective clinical indices were also assessed. <b><i>Results:</i></b> By comparison with the preoperative value, all postoperative subjective symptoms statistically improved (<i>p</i> &#x3c; 0.05), while the Apnea-Hypopnea Index (AHI) changed little (<i>p</i> = 0.492); the postoperative airflow velocity and pressure in both nasal and palatopharyngeal cavities, nasal and palatopharyngeal pressure differences, and total upper airway resistance statistically decreased (all <i>p</i> &#x3c; 0.01). A significant difference was derived for correlation between the alteration of simulation metrics with subjective improvements (<i>p</i> &#x3c; 0.05), except with the AHI (<i>p</i> &#x3e; 0.05). <b><i>Conclusion:</i></b> Nasal surgery can decrease the total resistance of the upper airway and increase the nasal airflow volume and subjective sleep quality in patients with OSA and nasal obstruction. The altered airflow characteristics might contribute to the postoperative reduction of pharyngeal collapse in a subset of OSA patients.

4-Year Follow-up of Treatment With Dental Appliance or Uvulopalatopharyngoplasty in Patients With Obstructive Sleep Apnea

CHEST Journal ◽  
2002 ◽  
Vol 121 (3) ◽  
pp. 739-746 ◽  
Author(s):  
Marie-Louise Walker-Engström ◽  
Åke Tegelberg ◽  
Bo Wilhelmsson ◽  
Ivar Ringqvist
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep ◽  
Dental Appliance

scholarly journals The Worsening of Positional Mild Obstructive Sleep Apnea over Time Is Associated with an Increase in Body Weight: Impact on Blood Pressure and Autonomic Nervous System

Respiration ◽  
2021 ◽  
pp. 1-10
Author(s):  
Wei-Hsiu Chang ◽  
Hsien-Chang Wu ◽  
Chou-Chin Lan ◽  
Yao-Kuang Wu ◽  
Mei-Chen Yang
Keyword(s):  
Blood Pressure ◽  
Obstructive Sleep Apnea ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Sleep Apnea ◽  
Obstructive Sleep ◽  
Mild Obstructive Sleep Apnea ◽  
Positional Dependency ◽  
Over Time

<b><i>Background:</i></b> Most patients with mild obstructive sleep apnea (OSA) are positional dependent. Although mild OSA worsens over time, no study has assessed the natural course of positional mild OSA. <b><i>Objectives:</i></b> The aim of this study was to evaluate the natural course of positional mild OSA, its most valuable progression predictor, and its impact on blood pressure (BP) and the autonomic nervous system (ANS). <b><i>Methods:</i></b> This retrospective observational cohort study enrolled 86 patients with positional mild OSA and 26 patients with nonpositional mild OSA, with a follow-up duration of 32.0 ± 27.6 months and 37.6 ± 27.8 months, respectively. Polysomnographic variables, BP, and ANS functions were compared between groups at baseline and after follow-up. <b><i>Results:</i></b> In patients with positional mild OSA after follow-up, the apnea/hypopnea index (AHI) increased (9.1 ± 3.3/h vs. 22.0 ± 13.2/h, <i>p</i> = 0.000), as did the morning systolic BP (126.4 ± 13.3 mm Hg vs. 130.4 ± 15.9 mm Hg, <i>p</i> = 0.011), and the sympathetic activity (49.4 ± 12.3% vs. 55.3 ± 13.1%, <i>p</i> = 0.000), while the parasympathetic activity decreased (50.6 ± 12.3% vs. 44.7 ± 13.1%, <i>p</i> = 0.000). The body mass index changes were the most important factor associated with AHI changes among patients with positional mild OSA (Beta = 0.259, adjust <i>R</i><sup>2</sup> = 0.056, <i>p</i> = 0.016, 95% confidence interval 0.425 and 3.990). The positional dependency disappeared over time in 66.3% of patients with positional mild OSA while 69.2% of patients with nonpositional mild OSA retained nonpositional. <b><i>Conclusions:</i></b> In patients with positional mild OSA, disease severity, BP, and ANS regulation worse over time. Increased weight was the best predictor for its progression and the loss of positional dependency. Better treatments addressing weight control and consistent follow-up are needed for positional mild OSA.

Gustatory Function after Radiofrequency Tongue Base Reduction in Patients with Obstructive Sleep Apnea

2011 ◽  
Vol 145 (5) ◽  
pp. 853-857 ◽  
Author(s):  
Young Gyu Eun ◽  
Seung Youp Shin ◽  
Jae Yong Byun ◽  
Myung Gu Kim ◽  
Kun Hee Lee ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Surgical Treatment ◽  
Sleep Apnea ◽  
Medical Center ◽  
Tongue Base ◽  
Safe Procedure ◽  
Gustatory Function ◽  
Obstructive Sleep ◽  
Before And After ◽  
Tongue Base Reduction

Objectives. To investigate the changes in gustatory function as a complication after radiofrequency tongue base reduction (RTBR) in patients with obstructive sleep apnea (OSA). Study Design. Before-and-after study. Setting. Academic tertiary medical center. Subjects and Methods. Thirty-four patients with suspected velopharyngeal collapse only underwent uvulopalatopharyngoplasty (UPPP group). Twenty-five patients with velopharyngeal and retrolingual collapse underwent concurrent UPPP with RTBR (RTBR group). All patients were evaluated before surgery and at 1 and 4 weeks after surgical treatment. A questionnaire was given to assess symptoms of hypogeusia, dysgeusia, hyposmia, and sensation of the tongue. Electrogustometry (EGM) in 4 areas was used to determine gustatory function. Results. Postoperative values for subjective symptoms did not significantly change following surgical treatment in either group. EGM thresholds of all tested in both groups did not significantly change 1 week and 4 weeks after surgery. Conclusions. Gustatory function remained unchanged after RTBR in patients with OSA. The authors suggest that RTBR is a safe procedure in terms of taste sensation in OSA patients.

Rapid maxillary expansion in children with obstructive sleep apnea syndrome: 12-month follow-up

2007 ◽  
Vol 8 (2) ◽  
pp. 128-134 ◽  
Author(s):  
Maria Pia Villa ◽  
Caterina Malagola ◽  
Jacopo Pagani ◽  
Marilisa Montesano ◽  
Alessandra Rizzoli ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Rapid Maxillary Expansion ◽  
Maxillary Expansion ◽  
Obstructive Sleep ◽  
Apnea Syndrome

scholarly journals CPAP treatment, glycemia and diabetes risk in obstructive sleep apnea and comorbid cardiovascular disease

2020 ◽  
Author(s):  
Kelly A. Loffler ◽  
Emma Heeley ◽  
Ruth Freed ◽  
Rosie Meng ◽  
Lia R. Bittencourt ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Glycemic Control ◽  
Usual Care ◽  
Serum Glucose ◽  
Cpap Therapy ◽  
Cpap Treatment ◽  
Obstructive Sleep

Objective: Despite evidence of a relationship between obstructive sleep apnea (OSA), metabolic dysregulation and diabetes mellitus (DM), it is uncertain whether OSA treatment can improve metabolic parameters. We sought to determine effects of long-term continuous positive airway pressure (CPAP) treatment on glycemic control and DM risk in patients with cardiovascular disease (CVD) and OSA. <strong>Research Design and Methods: </strong>Blood, medical history, and personal data were collected in a <strong>substudy of 888 participants in the </strong>Sleep Apnea Cardiovascular Endpoints (SAVE) trial in which patients with OSA and stable CVD were r<strong>andomized</strong> to receive CPAP plus Usual Care, or Usual Care alone. Serum glucose and glycated hemoglobin A<sub>1c</sub> (HbA<sub>1c</sub>) were measured at baseline, and six months, two- and four years, and incident diabetes diagnoses recorded. Results: Median follow-up was 4.3 years. In those with pre-existing DM (n=274), there was no significant difference between CPAP and Usual Care groups in serum glucose, HbA<sub>1c</sub> or anti-diabetic medications during follow-up. There were also no significant between-group differences in participants with pre-diabetes (n=452), nor in new diagnoses of DM. Interaction testing suggested that women with diabetes did poorly in the Usual Care group while their counterparts on CPAP therapy remained stable. <strong>Conclusions</strong><b>:</b> Among patients with established CVD and OSA, we found no evidence that CPAP therapy over several years affected glycemic control in those with diabetes or pre-diabetes, or DM risk over standard of care treatment. The potential differential effect according to sex deserves further investigation.

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