scholarly journals INCREASING THE UPPER AIRWAY SPACE USING ORAL APPLIANCES IN PATIENTS WITH MILD SLEEP APNOEA CAUSED BY STOMATOGNATHIC DYSFUNCTIONS

2016 ◽  
Vol 60 (2) ◽  
Author(s):  
Halina Ey-Chmielewska ◽  
Iwona Teul ◽  
Jacek Lorkowski
Keyword(s):  
Upper Airway ◽  
Anatomical Variations ◽  
Sleep Apnoea ◽  
Oral Appliances ◽  
Upper Respiratory Tract ◽  
Upper Airways ◽  
Stomatognathic System ◽  
Different Types ◽  
Abnormal Breathing ◽  
Upper Respiratory

Introduction: Abnormal breathing can be caused by developmental malformations or anatomical variations in the upper airways. Stomatognathic diseases may significantly impair the patency of the upper respiratory tract. Treatment of advanced stomatognathic dysfunctions is difficult due to their multifactorial aetiology, and often involves many phases. Sleep apnoea is one of the most bothersome complications. The mainstay therapeutic strategy relies on modifying the position of the mandible against the maxilla, achieved by using different types of oral appliances.Material and methods: The study was carried out in 2006–2010 on 92 patients (mean age 42.5 years) with diagnosed advanced dysfunction of the stomatognathic system. The treatment relied on the use of an orthodontic appliance (54 patients) or combined multi­‍‑phase therapy with splints used in the first phase (22 patients). Two different appliances were used (one of them was modified by the authors). Parameters assessed in the study included time to resolution of pain, reduction in the incidence of sleep apnoea, and improvement in nasal breathing.Results: Change in the protrusion of the mandible not only relieved problems with the stomatognathic system, but also improved breathing in patients. The use of modified oral appliances reduced treatment duration and improved patients’ comfort. Therefore, it may be useful in the treatment of patients with mild sleep apnoea.

Sensory mechanisms in the upper respiratory tract affect the inhalation of cigarette smoke in man

1986 ◽  
Vol 71 (1) ◽  
pp. 117-119 ◽  
Author(s):  
S. G. N. Grant ◽  
G. Woodman ◽  
S. P. Newman ◽  
D. Pavia ◽  
S. W. Clarke
Keyword(s):  
Cigarette Smoke ◽  
Upper Airway ◽  
Sensory Receptors ◽  
Topical Anaesthesia ◽  
Upper Respiratory Tract ◽  
Upper Airways ◽  
The Mean ◽  
Upper Respiratory ◽  
Sensory Mechanisms ◽  
Stimulation Of

1. Cigarette puffing parameters (puff volume, puff duration, number of puffs, total smoking time) and inhaled smoke volume (by a radiotracer techique) have been measured in a group of 11 asymptomatic smokers, once after topical anaesthesia of the upper airways and once without anaesthesia. 2. Topical anaesthesia significantly reduced the mean inhaled smoke volume per puff for the group from 41.1 ml to 30.6 ml (P < 0.05) and the total inhaled smoke volume from 575 ml to 528 ml (P = 0.05), but cigarette puffing parameters were unchanged. 3. It is concluded that stimulation of upper airway sensory receptors, probably sensitive to nicotine, may be an important mechanism in determining the amount of cigarette smoke inhaled by smokers.

Recurrent upper airway infections and bacterial biofilms

2006 ◽  
Vol 121 (4) ◽  
pp. 341-344 ◽  
Author(s):  
J Galli ◽  
F Ardito ◽  
L Calò ◽  
L Mancinelli ◽  
M Imperiali ◽  
...  
Keyword(s):  
Biofilm Formation ◽  
Upper Airway ◽  
Bacterial Biofilms ◽  
Repeated Treatment ◽  
Upper Respiratory Tract ◽  
Upper Airways ◽  
Airway Infections ◽  
Upper Respiratory ◽  
Tissue Specimens

Background: Bacterial biofilms identified in various medical devices used in otorhinolaryngology, including tympanostomy tubes, voice prostheses, and cochlear implants, can directly colonise mucosal tissues. The upper airways seem to be at high risk for this type of colonisation. Chronic and/or recurrent upper airway infections may be related to the complex structural and biochemical (quorum sensing) organisation of the biofilm which interferes with the activity of antibiotics (including those with proven in vitro efficacy), thus promoting the establishment of a chronic infection eradicable only by surgical treatment. Biofilm formation plays a role in upper respiratory infections: it not only explains the resistance of these infections to antibiotic therapy but it also represents an important element that contributes to the maintenance of a chronic inflammatory reaction.Objectives: To document the presence of biofilms in surgical tissue specimens from patients with recurrent infection diseases, and identify their possible role in the chronicity of these infectious processes.Method: We examined 32 surgical specimens from the upper respiratory tract (tonsils, adenoids, mucosa from the ethmoid and maxillary sinuses) of 28 patients (20 adults, eight children) with upper airway infections that had persisted despite repeated treatment with anti-inflammatory agents and antibiotics with demonstrated in vitro efficacy. Tissues were cultured using conventional methods and subjected to scanning electron microscopy for detection of biofilm formation.Results: Over 80 per cent (26/32; 81.3 per cent) of the tissue specimens were culture-positive. Bacterial biofilms (associated in most cases with coccoid bacteria) were observed in 65.6 per cent of the tissue samples.

Effect of sulfur baths on the upper respiratory tract and hearing organ

1927 ◽  
Vol 23 (8) ◽  
pp. 856-856
Author(s):  
N. Bobrovsky
Keyword(s):  
Respiratory Tract ◽  
Upper Respiratory Tract ◽  
Upper Airways ◽  
Hearing Organ ◽  
Upper Respiratory

The question of the effect of H2S on the mucosa of the upper respiratory tract and the hearing organ is currently not yet sufficiently developed. Observations of Dr. Mogilnitsky on patients with sulfur baths suggest that H2S acts directly on the mucosa of the upper airways, causing its hyperaemia, increased secretion and reduction of atrophic phenomena; long-term action of H2S, on the contrary, increases atrophic phenomena.

Stridor

2018 ◽  
pp. 63-66
Author(s):  
Sean Donovan ◽  
Heidi Cordi
Keyword(s):  
Respiratory Distress ◽  
Symptom Control ◽  
Upper Airway ◽  
Upper Respiratory Tract ◽  
Short Time Period ◽  
Time Period ◽  
Mucosal Edema ◽  
Upper Respiratory ◽  
Nebulized Epinephrine ◽  
Short Time

This case illustrates acute respiratory distress in pediatric patient populations. More specifically, it highlights signs of upper airway obstruction, including stridor. This type of presentation most frequently occurs with croup, also known as laryngotracheobronchitis, but can also occur in other pathologic conditions, which are briefly discussed. Croup is a viral infection that causes upper respiratory tract symptoms, including a harsh “seal-like” barking cough, secondary to mucosal edema in the upper airway. Significant swelling can cause respiratory distress with development of stridor, prompting treatment with nebulized epinephrine. In addition, steroid medication is often administered for longer term symptom control. Most children recover well in a relatively short time period.

scholarly journals Bacterial Phosphorylcholine Decreases Susceptibility to the Antimicrobial Peptide LL-37/hCAP18 Expressed in the Upper Respiratory Tract

2000 ◽  
Vol 68 (3) ◽  
pp. 1664-1671 ◽  
Author(s):  
Elena S. Lysenko ◽  
Jane Gould ◽  
Robert Bals ◽  
James M. Wilson ◽  
Jeffrey N. Weiser
Keyword(s):  
Cell Surface ◽  
Respiratory Tract ◽  
Antimicrobial Peptide ◽  
Membrane Lipids ◽  
Upper Airway ◽  
Phase Variable ◽  
Upper Respiratory Tract ◽  
Epithelial Surface ◽  
Host Membrane ◽  
Upper Respiratory

ABSTRACT A number of pathogens of the upper respiratory tract express an unusual prokaryotic structure, phosphorylcholine (ChoP), on their cell surface. We tested the hypothesis that ChoP, also found on host membrane lipids in the form of phosphatidylcholine, acts so as to decrease killing by antimicrobial peptides that target differences between bacterial and host membranes. In Haemophilus influenzae, ChoP is a phase-variable structure on the oligosaccharide portion of the lipopolysaccharide (LPS). There was a bactericidal effect of the peptide LL-37/hCAP18 on a nontypeableH. influenzae strain, with an increasing selection for the ChoP+ phase as the concentration of the peptide was raised from 0 to 10 μg/ml. Moreover, constitutive ChoP-expressing mutants of unrelated strains showed up to 1,000-fold-greater survival compared to mutants without ChoP. The effect of ChoP on resistance to killing by LL-37/hCAP18 was dependent on the salt concentration and was observed only when bacteria were grown in the presence of environmental choline, a requirement for the expression of ChoP on the LPS. Further studies established that there is transcription of the LL-37/hCAP18 gene on the epithelial surface of the human nasopharynx in situ and inducible transcription in epithelial cells derived from the upper airway. The presence of highly variable amounts of LL-37/hCAP18 in normal nasal secretions (<1.2 to >80 μg/ml) was demonstrated with an antibody against this peptide. It was concluded that ChoP alters the bacterial cell surface so as mimic host membrane lipids and decrease killing by LL-37/hCAP18, an antimicrobial peptide that may be expressed on the mucosal surface of the nasopharynx in bactericidal concentrations.

Upper airway resistances in fetal sheep: the influence of breathing activity

1986 ◽  
Vol 60 (1) ◽  
pp. 160-165 ◽  
Author(s):  
R. Harding ◽  
A. D. Bocking ◽  
J. N. Sigger
Keyword(s):  
Respiratory Muscles ◽  
Upper Airway ◽  
Late Gestation ◽  
Liquid Volume ◽  
Upper Respiratory Tract ◽  
Fetal Sheep ◽  
Lower Trachea ◽  
Upper Respiratory ◽  
Lung Liquid ◽  
Laryngeal Resistance

Fetal breathing movements (FBM) and lung liquid volume are known to affect lung development, but little is known about mechanisms controlling movement of liquid through the upper respiratory tract (URT). Therefore we measured resistances of the URT in 8 unanesthetized fetal sheep during late gestation while FBM were monitored from pressures in the lower trachea or from electromyogram of respiratory muscles. URT resistance to liquid flow toward the amniotic sac increased from 3.5 +/- 1.9 Torr X ml-1 X min during episodes of FBM to 21.1 +/- 5.7 Torr X ml-1 X min during apnea. Laryngeal resistance during apnea was greater (P less than 0.001) than supralaryngeal resistance in each of six fetuses in which URT resistance was partitioned. Fetal paralysis abolished the increase in laryngeal resistance to efflux that was previously related to the high-voltage electrocortical state and apnea. We were unable to quantify URT resistance to fluid movement toward the lungs because the larynx acted as a valve, permitting flow toward the lungs only in the presence of FBM. The supralaryngeal portion of the URT also apparently acts as a valve, normally preventing the entry of amniotic fluid into the pharynx. These findings help to explain our earlier observations that efflux of liquid from the fetal lungs is greater during episodes of FBM than during apnea.

scholarly journals Upper Airway Findings and Markers of Lung Disease Progression in Patients with Cystic Fibrosis

2020 ◽  
Vol 24 (04) ◽  
pp. e434-e437
Author(s):  
Luciane Mazzini Steffen ◽  
Luise Sgarabotto Pezzin ◽  
Natassia Sulis ◽  
Nedio Steffen ◽  
Leonardo Araujo Pinto
Keyword(s):  
Cystic Fibrosis ◽  
Lung Disease ◽  
Disease Progression ◽  
Nasal Polyps ◽  
Nasal Swab ◽  
Statistical Significance ◽  
Upper Airway ◽  
Forced Expiratory Volume ◽  
Upper Respiratory Tract ◽  
Upper Airways

Abstract Introduction Cystic fibrosis (CF) is a genetic disease that limits the quality of life mainly due to respiratory symptoms. The relationship between findings of the upper airways and CF lung disease is not yet completely understood. Objective The aim of the present study is to describe the most frequent nasal findings and pathogens in patients with CF and investigate the association between the findings of the upper respiratory tract and markers of lung disease progression. Methods Retrospective study in patients with CF from the Pediatric Pulmonology Department who underwent otorhinolaryngological evaluation between 2015 and 2017. Nasal endoscopy and nasal swab collection were part of the evaluation. The severity markers used were: percentage of predicted forced expiratory volume in the first second (FEV1%), body mass index (BMI) and the Shwachman-Kulczycki (SK) clinical score. Results A total of 48 patients with CF were included. The mean of the predicted percentage of FEV1% was 83.36 ± 30.04. The average 14 and SK score 89.11 ± 10.50. The bacteriology of the nasal swab was positive in 27 (54.1%) patients. Staphylococcus aureus was positive in 18 patients, Pseudomonas aeruginosa in 5, Pseudomonas cepacea in 3 and Stenotrophomonas maltophila in 1 patient. Nasal polyps were found in nine participants. Nasal polyps were found in nine participants and were associated with lower SK score. Conclusion The pathogens found in the upper airway were, in order: S. aureus, P. aeruginosa, P. cepacea e S. maltophila. The presence of polyps in the nasal cavity showed statistical significance and appears to have association with the prognostic factor measured by the SK score.

Evaluation of morphological relations between lower craniofacial skeletal structures and dimensions of upper respiratory tract in skeletal Classes I and III

2016 ◽  
Vol 69 (6) ◽  
pp. 647-658
Author(s):  
Karolina Stelmańska ◽  
Zbigniew Paluch ◽  
Marta Twardokęs ◽  
Katarzyna Ura-Sabat ◽  
Hanna Frelich ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Respiratory Tract ◽  
Orthodontic Treatment ◽  
Upper Respiratory Tract ◽  
Facial Skeleton ◽  
Upper Airways ◽  
Skeletal Class ◽  
The Face ◽  
Upper Respiratory ◽  
Cephalometric Measurements

Introduction. Review of the literature indicates the relationship between upper airways patency and lower jaw morphology. Aim of the study. To design multidimensional models to describe morphological relations of the linear and angular dimensions of hard tissues of the lower facial skeleton and the cervical spine (independent variables) with the linear dimensions of the upper respiratory tract (dependent variables). The obtained models took into consideration the age, gender and the skeletal Class I and III of the evaluated individuals. Material and method. The patients represented two skeletal classes: I (n = 97; 42.4%) and III (n = 53; 23.1%). Prior to orthodontic treatment, lateral cephalometric radiography (LCR) was performed in all patients. The obtained cephalometric measurements were evaluated statistically. Results. The statistical analysis pointed to significant differences between variables of the URT and dimensions of the facial skeleton and the cervical spine. It also revealed significant differences between variables of the URT and dimensions of the facial skeleton and the cervical spine. The independent variable Co-Gn emerged as an important predictor in regression of the nasopharynx. The anteroinferior height of the face and mandibular inclination were the factors relevant for oropharynx. Variables of the cervical spine were significant predictors in laryngopharyngeal models. Conclusions. The results illustrating morphological interrelations between the lower face and dimensions of the URT air space may prove helpful in planning orthodontic treatment, with or without teeth extraction, as well as orthognathic surgeries.

scholarly journals Rhinoscleroma with Pharyngolaryngeal Involvement Caused byKlebsiella ozaenae

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
J. Gonzales Zamora ◽  
A. R. Murali
Keyword(s):  
United States ◽  
Klebsiella Pneumoniae ◽  
Central America ◽  
United States Of America ◽  
Upper Airway ◽  
The United States ◽  
Upper Respiratory Tract ◽  
The Usa ◽  
Upper Respiratory ◽  
Histopathology Examination

Rhinoscleroma is a chronic, slowly progressive granulomatous bacterial infection that is endemic to the tropical world, namely, Central America and Africa. It is occasionally seen in the United States of America (USA). It predominately affects the nasal mucosa but can also involve the rest of the upper respiratory tract. The well-known causative agent for rhinoscleroma is the bacteriumKlebsiella rhinoscleromatis, a subspecies ofKlebsiella pneumoniae. However,Klebsiella ozaenaecan also, albeit very rarely, cause rhinoscleroma. The diagnosis is confirmed by histopathology examination that shows the characteristic Mikulicz cells, considered pathognomonic for this infection. We report a patient with histologically proven rhinoscleroma with pharyngolaryngeal involvement in whom cultures yieldedKlebsiella ozaenae. To the best of our knowledge, only two cases of rhinoscleroma due toKlebsiella ozaenaehave been reported in the literature to date. Our case illustrates the importance of recognizing this infection in a nonendemic setting such as the USA. A lack of awareness and a delay in the diagnosis of this disease can lead to complications including upper airway obstruction, physical deformity, and, rarely, sepsis. In addition, it must be remembered that the treatment of rhinoscleroma is challenging and requires a prolonged course of antibiotics to achieve a definite cure and avoid relapses.

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