scholarly journals Effect of radiofrequency vs other surgeries in the management of obstructive sleep apnoea

2019 ◽  
Vol 5 (4) ◽  
pp. 893
Author(s):  
Atul M. Bage ◽  
Lakshman Bhaskar Muthuvel ◽  
Pradheep Kalatharan
Keyword(s):  
Upper Airway ◽  
Cost Effective ◽  
Sleep Apnoea ◽  
Age Group ◽  
Voice Change ◽  
Radiofrequency Surgery ◽  
Airway Collapse ◽  
Upper Airway Collapse ◽  
Post Operative Pain ◽  
Obstructive Sleep

<p class="abstract"><strong>Background:</strong> Snoring is an important social problem seen in both men and women. Snoring occurs as a result of soft tissue vibration caused by a partial upper airway collapse during sleep. The aim of the study was to analyse the morbidity and efficacy of radiofrequency thermal ablation of upper airway in patients suffering from OSA.</p><p class="abstract"><strong>Methods:</strong> In the Department of ENT, Pondicherry, 40 patients between the age group of 20 to 60 years who were diagnosed to have OSA were operated according to the site of obstruction including RFVTR. Various parameters including ESS, partner scores, post-op pain, bleeding, pharyngeal dryness voice change were measured accordingly on the 1st day, 45th day, 90th day and 180th day postoperatively for the efficacy of treatment and also for assessing the morbidity of treatment provided.  </p><p class="abstract"><strong>Results:</strong> There is a statistically significant reduction in ESS scores and partner scores between pre-operative period and post operatively on the 45th day, 90th day and 180th day. Post-operative pain assessment also showed that patients who underwent RFVTR had lesser pain when compared to other surgeries like zetaplasty, LAUP, etc.</p><p class="abstract"><strong>Conclusions:</strong> Radiofrequency surgery should be considered as the treatment of choice for mild OSA and hypopneic snorers. The important advantage of these procedures is technically simple and minimally invasive. RFTA of the soft palate leaves the mucosa intact contrary to LAUP, hence the pain comparably less. Relatively cost effective when compared to LASER and Coblator.</p>

scholarly journals A comparative study of adult and pediatric polysomnography

2018 ◽  
Vol 4 (3) ◽  
pp. 630
Author(s):  
Athiyaman K. ◽  
Gowri Shankar M. ◽  
Suji G. ◽  
Prabhu D.
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Pediatric Population ◽  
Upper Airway ◽  
Age Group ◽  
Gender Distribution ◽  
Airway Collapse ◽  
Upper Airway Collapse ◽  
Obstructive Sleep ◽  
Significant Difference

<p class="abstract"><strong>Background:</strong> Obstructive sleep apnea (OSA) also referred to as obstructive sleep apnea-hypopnea-is a sleep disorder that involves cessation or significant decrease in airflow in the presence of breathing effort. It is the most common type of sleep-disordered breathing and is characterized by recurrent episodes of upper airway collapse during sleep. Pediatric obstructive sleep apnea syndrome (OSAS), like adult OSAS, is characterized by intermittent upper airway collapse during sleep and is associated with anatomic and neuromuscular factors. However, the clinical manifestations, diagnostic criteria, and polysomnographic findings of OSAS in children are likely to be different from those in adults. Adult OSA and pediatric OSA though the pathogenesis is more or less same, the evaluation gives a significant difference in outcome.</p><p class="abstract"><strong>Methods:</strong> 60 patients who meet the inclusion criteria were subjected to clinical evaluation and level 1 sleep study was done.  </p><p class="abstract"><strong>Results:</strong> Mean age group in adults was 39.86±8.42 yrs the most common cause in adults being obesity and the mean age group in pediatric was 7.63±1.71 yrs with adenotonsillar hypertrophy being the commonest cause. The gender distribution among affected is predominantly being male both in adults and in the pediatric population. The lowest mean desaturation was 81% in adults as compared to 73.23% in children.</p><p class="abstract"><strong>Conclusions:</strong> Significant PSG findings were noted in gender distribution and in Mean desaturation, AHI in both adults and pediatric population.</p>

scholarly journals A systematic review of anaesthetic agents used in Drug Induced Sedation Endoscopy (DISE) and a description of a new DISE technique

2021 ◽  
Author(s):  
Oliver Sanders ◽  
Bhik Kotecha ◽  
Vik Veer
Keyword(s):  
Meta Analysis ◽  
Upper Airway ◽  
Sleep Apnoea ◽  
Limited Information ◽  
Drug Induced ◽  
Anaesthetic Agents ◽  
Industry Standard ◽  
Airway Collapse ◽  
Upper Airway Collapse ◽  
Obstructive Sleep

AbstractObjectivesDrug induced sleep endoscopy (DISE) is a standardly used investigation for surgical planning in obstructive sleep apnoea management once conservative treatments have proven inadequate. There are a variety of anaesthetic agents used to obtain sedation necessary for DISE. These agents may have different effect on the upper airway and other parameters important in the diagnosis of the site of collapse during sleep. We aimed to review the commonly agents and evaluate the significance of their impact on the the diagnosis.MethodsA search was conducted through PubMed looking for studies on commonly used anaesthetic agents and their effect on the upper airway and cardiopulmonary parameters. Results: Of the 109 studies yielded by the search, 19 were deemed relevant to the review and met all inclusion criteria. The agents reviewed were: propofol, dexmedetomidine, remifentanil, isoflurane, sevoflurane, midazolam and topical lidocaine. A meta-analysis was not conducted due to the limited number of relevant studies and the heterogeneity of outcomes measured. All agents examined gave some element of airway collapse and impact on cardiopulmonary measures. Most of these effects were shown to be dose-dependent. Of the agents considered dexmedetomidine and propofol gave the most consistently reliable and physiologically safe representations of upper airway collapse seen in OSA patients.ConclusionThere is limited information and no industry standard for the sedative regimen used for DISE. Of the agents reviewed those that caused least cardiopulmonary instability, respiratory depression and exaggerated upper airway collapse were deemed the most appropriate for DISE. The agent that best meet these criteria is dexmedetomidine followed by propofol.

scholarly journals Much Ado about Sleep: Current Concepts on Mechanisms and Predisposition to Pediatric Obstructive Sleep Apnea

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 1032
Author(s):  
Ashley L. Saint-Fleur ◽  
Alexa Christophides ◽  
Prabhavathi Gummalla ◽  
Catherine Kier
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Upper Airway ◽  
Biomechanical Properties ◽  
Primary Role ◽  
Airway Narrowing ◽  
Airway Collapse ◽  
Upper Airway Collapse ◽  
Obstructive Sleep ◽  
Review Current

Obstructive Sleep Apnea (OSA) is a form of sleep-disordered breathing characterized by upper airway collapse during sleep resulting in recurring arousals and desaturations. However, many aspects of this syndrome in children remain unclear. Understanding underlying pathogenic mechanisms of OSA is critical for the development of therapeutic strategies. In this article, we review current concepts surrounding the mechanism, pathogenesis, and predisposing factors of pediatric OSA. Specifically, we discuss the biomechanical properties of the upper airway that contribute to its primary role in OSA pathogenesis and examine the anatomical and neuromuscular factors that predispose to upper airway narrowing and collapsibility.

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