scholarly journals Effect of Cooling Irrigating Saline in Tongue Base Ablation in Obstructive Sleep Apnea

OTO Open ◽  
2021 ◽  
Vol 5 (1) ◽  
pp. 2473974X2198959
Author(s):  
Ahmed Yassin Bahgat
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Controlled Trial ◽  
Tongue Base ◽  
Control Group ◽  
University Hospitals ◽  
Energy Field ◽  
Obstructive Sleep ◽  
Prospective Randomized Controlled Trial ◽  
Significant Difference

Objective Plasma is formed by creating a high-density energy field within an electrically conductive fluid such as saline. Sometimes ablated bits of tissue get stuck between the electrodes of the wand, obstructing the suction channel. The purpose of this study is to investigate the effect of cooling the irrigating saline during ablation of the hypertrophied tongue base in patients with obstructive sleep apnea. Study Design Prospective randomized controlled trial. Setting An otorhinolaryngology department in Main University hospitals. Methods Sixty adult patients with obstructive sleep apnea and tongue base hypertrophy underwent tongue base ablation surgery. Patients were randomly divided into 2 groups of 30 patients each: cooled saline and room temperature saline. The Coblation wand used was the EVac 70 Xtra HP (Smith & Nephew). Results In this study, a significant difference in operative time (mean ± SD) was seen between groups: 21.2 ± 5.5 minutes in the cold group and 47 ± 9.5 minutes in the control group ( P = .001). The wands in the cold group did not obstruct, while all the wands in the control group were obstructed by tissue clogs with variable degrees, hence wasting more time to clean the wands’ tips. Conclusion Cooling the irrigating saline overcame the problem of wand clogs, and the wand tip did not occlude at all during the procedures, thus saving time lost in wand cleaning and demonstrating a faster and safer surgical procedure. Further studies are needed to identify the hemostatic effect of the cooled saline over the regular one.

scholarly journals The Effect of Vitamin C Therapy Towards Malondialdehyde Plasma Content on Chronic Tonsillitis Patients With Risk of Obstructive Sleep Apnea Syndrome

2018 ◽  
Vol 10 (9) ◽  
pp. 97
Author(s):  
Sutji Pratiwi Rahardjo Hiro ◽  
Hiro Salomo Mangape ◽  
Abdul Qadar Punagi ◽  
Andi Nilawati Usman
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Vitamin C ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Chronic Tonsillitis ◽  
Control Group ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Apnea Syndrome

INTRODUCTION: Sleep Apnea Syndrome is a syndrome with an episode of apnea or hypopnea during sleep. The objective of this study was to investigate the effect of the vitamin C therapy to plasma Malondialdehyde (MDA) level in patients with chronic tonsillitis who have a risk factor of Obstructive Sleep Apnea Syndrome (OSAS), measured pre and post-therapy.METHODS: The design of this study was a clinical trial with pre-test and post-test control group. This study was conducted in Dr. Wahidin Sudirohusodo Hospital and Hasanuddin University Teaching Hospital in Makassar and 30 subjects was enrolled (20 subjects were patients with chronic tonsillitis and OSAS, and 10 subjects were control). The measurement of plasma MDA level was obtained using ELISA method. The data were analyzed using the Mann-Whitney test and Chi-square test.RESULTS: The results of this study showed a decreasing level of plasma MDA in patients with chronic tonsillitis and OSAS after the vitamin C therapy. However, there was no significant difference between patients who had not received vitamin C therapy.CONCLUSION: The intervention of vitamin C in chronic tonsillitis patients and can reduce levels of plasma MDA.

scholarly journals Creatinine Clearance in Patients with Obstructive Sleep Apnea

2021 ◽  
Vol 7 (1) ◽  
pp. 59
Author(s):  
Seda Beyhan Sagmen ◽  
Nesrin Kiral ◽  
Ali Fidan ◽  
Elif Torun Parmaksiz ◽  
Coskun Dogan ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Endothelial Dysfunction ◽  
Creatinine Clearance ◽  
Control Group ◽  
Apnea Hypopnea Index ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

During an apnea, hemodynamic complications such as hypoxemia, a rise in systemic and pulmonary arterial pressure, and changes in heart rate occur in patients with obstructive sleep apnea (OSA). Potential mechanisms of OSA-associated renal dysfunction include renal hypoxia, hypertension, endothelial dysfunction. Hypertension is common in patients with OSA. This study aims to assess OSA patients' renal functions and investigate the creatinine clearance (CC) values across OSA patients with and without hypertension. The study included 530 individuals with OSA and 60 individuals with an apnea-hypopnea index (AHI) of <5. CC calculated with the Cockcroft-Gault Equation. Patients with OSA divide into two groups as the group of patients with hypertension (HT) (group 1) and without HT (group 2). The study included 339 (64%) male and 191 (36%) female patients. It found that 32.4% of OSA patients had HT (Group 1). There was a significant difference in CC and urea levels between groups 1 and 2 (p<0.001; p=0.005). While CC was low in the OSA group, CC values were not statistically significantly different between the OSA patients and the control group (p>0.05). A statistically significant difference was detected in urea and creatinine levels between the OSA and control groups (p=0.005; p=0.012). Creatinine clearance decreases in patients with OSA in the presence of HT. Patients with OSA often experience cardiovascular disorders, and glomerular endothelial dysfunction occurs in OSA patients.

scholarly journals Comparing Cognitive Performance in Patients with Obstructive Sleep Apnea and healthy Subjects

2018 ◽  
Author(s):  
Maryam Maghsoudipour ◽  
Shoaleh Memari ◽  
Khosro Sadeghniiat Haghighi ◽  
Pourya Rezasoltani
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cognitive Performance ◽  
Healthy Subjects ◽  
Pearson Correlation ◽  
Direct Consequence ◽  
Control Group ◽  
Case Group ◽  
Obstructive Sleep ◽  
Significant Difference

Introduction::   Daily performance deficits are inevitable results of a large group of sleep disorders. Cognition and cognitive performance might be defected as a direct consequence of sleep disorder assessed by subjective or objective measures. So, this survey was performed in order to compare cognitive performance of obstructive sleep apnea patients and healthy subjects in Baharloo hospital of Tehran.   Method:  In this case control study, the samples were chosen by  convenience sampling, from Baharloo hospital patients and were assigned to case group (apnea patients) and control group (healthy subjects), based on AHI score. Also, we used a demographic questionnaire, ESS, Berlin, and STOP BANG. Appropriate tool was used to assess cognitive performance in two groups. In order to analyze data we used SPSS (version 19).  Independent T test, Chi square, Fisher test, Kruskal-wallis Test, and Pearson correlation test were used. Results:   Results demonstrated a significant difference of sleepiness and cognitive performance between healthy subjects and OSA (Obstructive Sleep Apnea) patients.  Conclusion:   Screening and diagnosis of OSA patients, and considering the deficient cognitive performance is crucial. Also, education about the importance of OSA Syndrome and the treatment is necessary.     Keywords:  Obstructive sleep apnea, Cognitive performance, Excessive daytime sleepiness

scholarly journals P060 Hypoxia-induced overexpression of Rev-Erb-alpha and NPAS2 proteins in obstructive sleep apnea patients - possible mechanism of DM2 development

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A41-A41
Author(s):  
F Karuga ◽  
S Turkiewicz ◽  
M Ditmer ◽  
M Sochal ◽  
P Białasiewicz ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Serum Protein ◽  
Protein Level ◽  
Control Group ◽  
Apnea Hypopnea Index ◽  
Orphan Nuclear Receptor ◽  
Protein Levels ◽  
Obstructive Sleep ◽  
Significant Difference

Abstract Circadian clocks are endogenous coordinators of 24-hour behavioral and molecular rhythms, which disruption may be caused by obstructive sleep apnea (OSA). It is composed of a set of genes, function as activators (CLOCK, BMAL) or repressors (PER, CRY). Neuronal PAS Domain Protein 2 (NPAS2) can substitute CLOCK in its function. Orphan nuclear receptor (Rev-Erb-α) is another protein supporting the CLOCK-BMAL1 complex, forming the loop which helps to regulate their expression. There are studies suggesting the significant influence of circadian disruption mediated via NPAS2 and Rev-Erb-α on DM2 development. The aim of the study was to determine the role of NPAS2 and Rev-Erb-α in DM2 for OSA patients. All participants underwent polysomnography (PSG) examination. Based on apnea-hypopnea index accompanied by clinical data the recruited individuals (n=40) were assigned to one from 3 groups: OSA (severe OSA, no DM2; n=17), DM2 (severe OSA + DM2; n=7) and control group (no OSA, no DM2; n=16). Serum protein levels of Rev-Erb-α and NPAS2 were assessed with ELISA immunoassay. Analysis between the groups revealed the statistically significant difference only in NPAS2 protein level (p=0.037). Further post-hoc analysis revealed significant differences between OSA and the control group (p=0.017). Moreover, a statistically significant correlation between AHI and NPAS2 serum protein level was observed (r=-0.478, p=0.002). NPAS2 protein levels are associated with a number of apneas and hypopneas during the REM phase of sleep and might have a significant role in the development of OSA complications. However, further studies are needed to understand its role.

Postoperative monitoring of children with obstructive sleep apnea syndrome

2014 ◽  
Vol 155 (18) ◽  
pp. 703-707 ◽  
Author(s):  
Pálma Benedek ◽  
Gabriella Kiss ◽  
Eszter Csábi ◽  
Gábor Katona
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Preoperative Evaluation ◽  
Sleep Apnea Syndrome ◽  
Study Patient ◽  
Severe Obstructive Sleep Apnea ◽  
Obstructive Sleep ◽  
Significant Difference ◽  
Apnea Syndrome

Introduction: Treatment of pediatric obstructive sleep apnea syndrome is surgical. The incidence of postoperative respiratory complications in this population is 5–25%. Aim: The aim of the authors was to present the preoperative evaluation and monitoring procedure elaborated in Heim Pál Children Hospital, Budapest. Method: 142 patients were involved in the study. Patient history was obtained and physical examination was performed in all cases. Thereafter, polysomnography was carried out, the severity of the obstructive sleep apnea syndrome was determined, and the patients underwent tonsilloadenotomy. Results: 45 patients with mild, 50 patients with moderate and 47 patients with severe obstructive sleep apnea syndrome were diagnosed. There was no complication in patients with mild disease, while complications were observed in 6 patients in the moderate group and 24 patients in the severe group (desaturation, apnea, stridor, stop breathing) (p<0.000). In patients with severe obstructive sleep apnea syndrome, no significant difference was noted in preoperative apnoea-hypapnea index (p = 0.23) and in nadir oxygen saturation values (p = 0.73) between patients with and without complication. Conclusions: Patients with severe obstructive sleep apnea syndrome should be treated in hospital where pediatric intensive care unit is available. Orv. Hetil., 2014, 155(18), 703–707.

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