Comparison of Obstructive Sleep Apnea Syndrome in Children with Cleft Palate following Furlow Palatoplasty or Pharyngeal Flap for Velopharyngeal Insufficiency

2004 ◽  
Vol 41 (2) ◽  
pp. 152-156 ◽  
Author(s):  
Yu-Fang Liao ◽  
M. Samuel Noordhoff ◽  
Chiung-Shing Huang ◽  
Philip K. T. Chen ◽  
Ning-Hung Chen ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Cleft Palate ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Velopharyngeal Insufficiency ◽  
Obstructive Sleep ◽  
The Mean ◽  
Pharyngeal Flap ◽  
Apnea Syndrome

Objective To evaluate the incidence and severity of obstructive sleep apnea syndrome (OSAS) in patients with cleft palate having a Furlow palatoplasty or pharyngeal flap for correction of velopharyngeal insufficiency (VPI). Patients A total of 48 nonsyndromic children with repaired cleft palate with VPI were enrolled in the study. Twenty of the children had a Furlow palatoplasty (F group) and 28 children had a pharyngeal flap (P group) for correction of VPI. Interventions An overnight polysomnography evaluation was done to evaluate the incidence and severity of OSAS 6 months or more postoperatively. Main Outcome Measures Symptoms of OSAS, respiratory disturbance index (RDI), oxyhemoglobin desaturation index (DI), and sleep stages were measured. Results In the P group, the mean percentage of stage 2 sleep was lower than the F group (p < .05). The mean RDI and DI were larger in the P group, compared with the F group (p < .001). The incidence and severity of OSAS were higher in the P group, compared with the F group (p < .001 and p = 0.05, respectively). Conclusions A Furlow palatoplasty should be used in deference to a pharyngeal flap whenever possible on the basis of the preoperative evaluation of VPI because of the decreased incidence and severity of OSAS.

Obstructive Sleep Apnea Secondary to Surgery for Velopharyngeal Insufficiency

1993 ◽  
Vol 30 (4) ◽  
pp. 387-390 ◽  
Author(s):  
Antonio Ysunza ◽  
Manuel Garcia-Velasco ◽  
Miguel Garcia-Garcia ◽  
Reyes Haro ◽  
Matilde Valencia
Keyword(s):  
Obstructive Sleep Apnea ◽  
Surgical Treatment ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Velopharyngeal Insufficiency ◽  
Flap Surgery ◽  
Obstructive Sleep ◽  
Pharyngeal Flap ◽  
Apnea Syndrome

The files of 585 patients who had had pharyngeal flap surgery for the correction of velopharyngeal insufficiency were reviewed. Eighteen patients, ranging in age from 6 to 16 years, showed clinical symptoms of obstructive sleep apnea syndrome. All of these cases had a Polysomnographic evaluation and videonasopharyngoscopy. Fifteen cases met the criteria for the diagnosis of obstructive sleep apnea syndrome and eventually underwent surgical treatment. A modified uvulopalatopharyngoplasty was done in 14 of the 15 cases. One patient had a prominent uvula flipping into the port of a Jackson's type pharyngoplasty, so a partial resection of the uvula was performed. Surgical treatment was successful in 14 of 15 cases, including the case with the partial uvular resection. In one case, severe sleep apnea persisted after surgery and a complete section of the flap was performed to correct the obstruction. Sizeable tonsils were found in 13 out of 15 cases, whereas flap width appeared unrelated to obstruction. Preoperative assessment of tonsillar tissue is of vital importance before pharyngeal flap surgery.

scholarly journals The Association of Obstructive Sleep Apnea Syndrome and Accident Risk in Heavy Equipment Operators

Medicina ◽  
2019 ◽  
Vol 55 (9) ◽  
pp. 599 ◽  
Author(s):  
Hakan Celikhisar ◽  
Gulay Dasdemir Ilkhan
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
High Risk ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Upper Respiratory Tract ◽  
Heavy Equipment ◽  
Obstructive Sleep ◽  
The Mean ◽  
Apnea Syndrome

Background and Objectives: Obstructive sleep apnea syndrome (OSAS) is the most frequent sleep disorder, characterized by the repeated collapse of the upper respiratory tract during sleep. In this study, we aimed to determine the prevalence of OSAS in heavy equipment operators and to determine the relationship between the work accidents that these operators were involved in and the OSAS symptoms and severity. In doing this, we aimed to emphasize the association of OSAS, which is a treatable disease, and these accidents, which cause loss of manpower, financial hampering, and even death. Materials and Methods: STOP BANG questionnaire was provided to 965 heavy equipment operators and polysomnography (PSG) was performed, in Izmir Esrefpasa Municipality Hospital, to the operators at high risk for OSAS. Demographic data, health status, and accidents of these operators were recorded. Results: All operators who participated in the study were male. The ages of the cases ranged from 35 to 58 and the mean age was 45.07 ± 5.54 years. The mean STOP BANG questionnaire results were 4.36 ± 3.82. In total, 142 operators were identified with high risk for OSAS and PSG could be performed on 110 of these 142 operators. According to the PSG results of the operators, 41 (37.3%) patients had normal findings, while 35 (31.8%) had mild, 20 (18.2%) had moderate, and 14 (12.7%) had severe OSAS. Among those 110 patients, 71 (64.5%) of the cases had no history of any accidents, 25 (22.8%) were almost involved in an accident due to sleepiness, and 14 (12.7%) were actually involved in an accident. There was a statistically significant relationship between the accident rate and OSAS severity (p: 0.009). Conclusion: Based on the data acquired in the present study, a positive correlation was determined between the accident statuses of drivers with OSAS severity. We want to attract attention to the necessity of evaluating the OSAS symptoms in professional heavy equipment operators during the certification period and at various intervals afterwards, and to carry out OSAS evaluations by PSG for those having a certain risk.

The impact of adenotonsillectomy on monosymptomatic primary nocturnal enuresis in children with obstructive sleep apnea syndrome

2020 ◽  
pp. 205141582097426
Author(s):  
Mazen A Ghanem ◽  
Ali I Swaid ◽  
Essa A Adawi ◽  
Rim M Ghanem ◽  
Ahmed M Ghanem ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Family History ◽  
Obstructive Sleep Apnea Syndrome ◽  
Nocturnal Enuresis ◽  
Sleep Apnea Syndrome ◽  
Primary Nocturnal Enuresis ◽  
Obstructive Sleep ◽  
The Mean ◽  
Apnea Syndrome

Objectives: To analyze the outcome of monosymptomatic primary nocturnal enuresis (MPNE) after adenotonsillectomy in children with obstructive sleep apnea syndrome (OSAS). Methods: The study included 74 MPNE children with OSAS qualified for an adenotonsillectomy procedure. MPNE was assessed prior to surgical procedure as well as 3 and 6 months after surgery. In addition to polysomnographic parameters, serum antidiuretic hormone (ADH) and brain natriuretic peptide (BNP) levels were measured preoperatively and 3 months postoperatively. Results: The mean age was 9.8 years and the mean number of nocturnal wetting weekly was 4.1. Thirty-eight percent of patients had family history of MPNE. All the patients underwent a successful adenotonsillectomy. Nocturnal enuresis was still reported in 18% of children 6 months after adenotonsillectomy. An increased risk of MPNE was significantly demonstrated in children with high obstructive apnea-hypopnea index (O-AHI), high oxygen desaturation index (ODI), high frequent nocturnal enuresis and family history. After surgery, ADH levels were significantly lower, whereas BNP levels were significantly higher in non-resolution children. Univariate analysis showed that higher O-AHI, higher ODI, severe enuresis, low serum ADH and higher serum BNP levels were indicative of persistent nocturnal enuresis. Multivariate analysis showed that higher ODI and higher BNP levels are independent prognostic markers for MPNE. Conclusions: Adenotonsillectomy in MPNE children with OSAS is an effective treatment for resolution of MPNE. Also, higher ODI caused by apnea and elevated serum BNP levels are the most important factors affecting the outcome of MPNE patients. Level of evidence: Not applicable for this multicentre audit.

scholarly journals Insulin resistance and affecting factors in patients with obstructive sleep apnea syndrome

2017 ◽  
Vol 3 (4) ◽  
pp. 986
Author(s):  
Hatice Beyazal Polat ◽  
Metin Çeliker ◽  
Songül Özyurt ◽  
Suat Terzi ◽  
Abdülkadir Özgür
Keyword(s):  
Insulin Resistance ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Apnea Hypopnea Index ◽  
Obese Patients ◽  
Obstructive Sleep ◽  
The Mean ◽  
Apnea Syndrome

<p class="abstract"><strong>Background:</strong> Metabolic syndrome and insulin resistance are common in patients with obstructive sleep apnea syndrome (OSAS) independently of obesity. This study aims to examine and evaluate the insulin resistance and the factors affecting the insulin resistance in patients with OSAS.</p><p class="abstract"><strong>Methods:</strong> Patients admitted to the sleep disorders clinic of our hospital with snoring complaints and diagnosed with OSAS in the last 6 months were included to the study. Insulin resistance was calculated by the Homa-IR formula. &gt;2.7 was considered insulin resistance.  </p><p class="abstract"><strong>Results:</strong> The mean Homa-IR value was 3.86±4.69 and 42 (49.4%) patients were found to have insulin resistance. Mean insulin resistance was 2.68±2.2 in normal weight patients, 2.30±1.41 in overweight patients, 3.96±1.83 in obese patients, and 8.61±12.13 in morbid obese patients. The mean apnea hypopnea index of the patients was 22.95±15.20; 30 (35.2%) were with mild, 26 (30.6%) were with moderate and 29 (34.1%) were with severe OSAS. Insulin resistance was 2.35±1.36 in patients with mild AHI; 3.09±1.30 in<strong> </strong>patients with moderate AHI, and 6.11±7.35 in severe cases. In our study, the most significant relationship was found to be between insulin resistance in OSAS patients with insulin resistance and BMI and AHI.</p><p><strong>Conclusions:</strong> Insulin resistance is common in patients with OSAS independently of obesity. In our study, BMI and AHI were found to be the most important factors associated with insulin resistance in patients with OSAS.</p>

scholarly journals The value of posterior rhinomanometry in evaluating patients with snoring and obstructive sleep apnea syndrome

2016 ◽  
Vol 6 (21) ◽  
pp. 31-38
Author(s):  
Alex George Stanciu ◽  
Alexandra Cirticioiu ◽  
Adriana Neagos
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Diagnostic Methods ◽  
Sleep Related Breathing Disorders ◽  
Obstructive Sleep ◽  
The Mean ◽  
Apnea Syndrome ◽  
Nasal Pathology

Abstract BACKGROUND. Nowadays, snoring and obstructive sleep apnea are the most common sleep-related breathing disorders (SRBD) found in the medical practice and they are estimated to affect approximately 4% of men and 2% of women in the middle-aged workforce. There are some ENT pathologies that are involved in snoring, and also in obstructive sleep apnea syndrome. The nose plays an important part in both breathing and SRBD. The aim of this study was to determine the role of posterior rhinomanometry in the diagnoses of snoring and obstructive sleep apnea syndrome. MATERIAL AND METHODS. We present a retrospective observational study that took place during a three-year period, between 2009 and 2012. In this study were included 110 subjects, who have undergone polysomnographic investigations, as well as an ENT clinical examination focused on endoscopy and posterior rhinomanometry evaluation. RESULTS. The mean age was 46.09 ± 10.91 years, the mean height was 177.58 ± 10.02 cm and the mean weight was 98.45 ± 17.74 kg. Analysing these results, we found a significant correlation between them and the severity of the sleep pathology. The posterior rhinomanometry results were correlated with nasal allergic rhinitis (p = 0.06) and not correlated with other nasal pathology, such as nasal septum deviation. The changes in the size and shape of the tongue base or epiglottis proved to have an important impact upon rhinomanometric values, with a statistically significant value (p = 0.03, respectively p = 0.08). CONCLUSION. All diagnostic methods must be interpreted in connection with each other.

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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