scholarly journals RAPID MAXILLARY EXPANSION AS THE DEFINITIVE OPTION FOR THE TREATMENT OF SLEEP APNEA / HYPOAPNEA SYNDROME IN CHILDREN. LITERATURE REVIEW

2021 ◽  
pp. 156-158
Author(s):  
Monserrat Valenzuela Yáñez ◽  
Javiera Rojas Donaire ◽  
María Jesús Zárate Piffardi ◽  
Sergio Toro Canales ◽  
Rodrigo Caracuel Barría
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Literature Review ◽  
Sleep Disorder ◽  
Upper Airway ◽  
Maxillary Expansion ◽  
Obstructive Sleep ◽  
Normal Sleep ◽  
Normal Ventilation ◽  
Respiratory Sleep Disorder

Obstructive Sleep Apnea / Hypoapnea Syndrome (OSAHS) has been described as a respiratory sleep disorder, characterized by partial or total obstruction of the upper airway, which distorts normal ventilation during sleep and 1 normal sleep patterns .Its most frequent etiology in children 2,3,4 is adenotonsillary hypertrophy , but other causes associated with syndromes and dentomaxillary anomalies are also recognized,such as maxillary compression.

scholarly journals Treatment of Obstructive Sleep Apnea in Children: Handling the Unknown with Precision

2020 ◽  
Vol 9 (3) ◽  
pp. 888 ◽  
Author(s):  
David Gozal ◽  
Hui-Leng Tan ◽  
Leila Kheirandish-Gozal
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Treatment Options ◽  
A Priori ◽  
Upper Airway ◽  
Surgical Removal ◽  
Low Grade ◽  
Maxillary Expansion ◽  
Obstructive Sleep ◽  
Anti Inflammatory

Treatment approaches to pediatric obstructive sleep apnea (OSA) have remarkably evolved over the last two decades. From an a priori assumption that surgical removal of enlarged upper airway lymphadenoid tissues (T&A) was curative in the vast majority of patients as the recommended first-line treatment for pediatric OSA, residual respiratory abnormalities are frequent. Children likely to manifest persistent OSA after T&A include those with severe OSA, obese or older children, those with concurrent asthma or allergic rhinitis, children with predisposing oropharyngeal or maxillomandibular factors, and patients with underlying medical conditions. Furthermore, selection anti-inflammatory therapy or orthodontic interventions may be preferable in milder cases. The treatment options for residual OSA after T&A encompass a large spectrum of approaches, which may be complementary, and clearly require multidisciplinary cooperation. Among these, continuous positive airway pressure (CPAP), combined anti-inflammatory agents, rapid maxillary expansion, and myofunctional therapy are all part of the armamentarium, albeit with currently low-grade evidence supporting their efficacy. In this context, there is urgent need for prospective evidence that will readily identify the correct candidate for a specific intervention, and thus enable some degree of scientifically based precision in the current one approach fits all model of pediatric OSA medical care.

scholarly journals Obstructive sleep apnea syndrome (OSA) in adolescents: therapeutic management

2018 ◽  
Vol 21 (1) ◽  
pp. 107
Author(s):  
A. Amaddeo ◽  
L. Griffon ◽  
B. Thierry ◽  
V. Couloigner ◽  
A. Joly ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Positive Airway Pressure ◽  
Sleep Apnea Syndrome ◽  
Upper Airway ◽  
Maxillary Expansion ◽  
Obstructive Sleep ◽  
Osa Treatment ◽  
Type 3

Obstructive sleep apnea (OSA) in adolescents is characterized by a predominance of OSA type 2 which is associated with overweight/obesity. The treatment of OSA in adolescents depends on the cause of OSA and its risk and / or precipitating factors. Adenotonsillectomy is the cornerstone of OSA treatment in case of hypertrophy of the adenoids and/or tonsils. An anti-inflammatory treatment has proven its efficacy in mild to moderate or mild residual OSA after adenotonsillectomy. Orthodontic treatments such as rapid maxillary expansion or jaw positioning are indicated in case of dentofacial disharmonies. Continuous positive airway pressure (CPAP), is mainly indicated in type-3 OSA, which is associated with craniofacial or upper airway malformations or anomalies and should be performed by a pediatric multidisciplinary team having an expertise in sleep and OSA. Finally, maxillofacial or craniofacial surgery may be indicated in adolescents with type-3 OSA. In conclusion, the treatment of OSA in adolescents is based on the type of OSA, its severity and the medical characteristics of each patient.

Upper airway surgery of obstructive sleep apnea in pycnodysostosis: Case report and literature review

2014 ◽  
Vol 164 (8) ◽  
pp. 2029-2035 ◽  
Author(s):  
Elisa Testani ◽  
Emanuele Scarano ◽  
Chiara Leoni ◽  
Serena Dittoni ◽  
Anna Losurdo ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Case Report ◽  
Sleep Apnea ◽  
Literature Review ◽  
Upper Airway ◽  
Upper Airway Surgery ◽  
Airway Surgery ◽  
Obstructive Sleep

scholarly journals Obstructive Sleep Apneu (OSA), Obesitas Hypoventilation Syndrome (OHS) dan Gagal Napas

2019 ◽  
Vol 1 (3) ◽  
pp. 94
Author(s):  
Mokhammad Mukhlis ◽  
Arief Bakhtiar
Keyword(s):  
Obstructive Sleep Apnea ◽  
Respiratory Failure ◽  
Sleep Apnea ◽  
Disease Management ◽  
Literature Review ◽  
Upper Airway ◽  
Obesity Hypoventilation Syndrome ◽  
Obstructive Sleep ◽  
Hypoventilation Syndrome ◽  
Obesity Hypoventilation

Background: Obstructive sleep apnea (OSA) is a state of the occurrence of upper airway obstruction periodically during sleep that causes breathing to stop intermittently, either complete (apnea) or partial (hipopnea). Obesity hypoventilation syndrome (OHS) is generally defined as a combination of obesity (BMI ≥ 30 kg / mc) with arterial hypercapnia while awake (PaCO2 > 45 mmHg) in the absence of other causes of hypoventilation. Purpose: In order for the pulomonologis can understand the pathogenesis and pathophysiology of OSA and its complications. Literature review: Several studies have been expressed about the link between OSA, OHS with respiratory failure disease. Pathophysiology of OSA, OHS in respiratory failure were difficult to detect, can cause respiratory failure disease management becomes less effective. Conclusion: A good understanding can help with the diagnosis and management of the appropriate conduct to prevent complications of respiratory failure associated with OSA.

Asthma and Obstructive Sleep Apnea

Asthma ◽  
2014 ◽  
pp. 63-79 ◽  
Author(s):  
Larry M. Ladi ◽  
Edward S. Schulman
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sleep Apnea Syndrome ◽  
Upper Airway ◽  
Asthmatic Patients ◽  
Obstructive Sleep ◽  
Smooth Muscle Function ◽  
Normal Sleep ◽  
Definition Of ◽  
Overnight Polysomnography

Obstructive sleep apnea syndrome (OSAS) results from obstruction of the upper airway with resultant brief periods of breathing cessation of at least 10 seconds (apnea) or marked reductions in flow (hypopnea) during sleep that are insufficient to meet the definition of apnea. This pattern is accompanied by oxyhemoglobin desaturation, persistent inspiratory efforts against the occluded airway, and arousal from sleep. Clinically, the condition is recognized by recurrent sleep interruptions, snoring, choking and gasping spells on awakening, and daytime drowsiness caused by loss of normal sleep. The diagnosis is confirmed and graded on overnight polysomnography criteria. If uncorrected, the disorder often can lead to hypertension, respiratory failure, and cardiac abnormalities. Data suggest that OSAS is an independent risk factor for asthma exacerbations and that OSAS symptoms are more common in asthmatic patients than in the general population, hence linking these two major diseases. Both conditions share mechanical, hormonal, and immunologic reasons for their effects. However, studies show that continuous positive airway pressure might modify airway smooth muscle function and asthma control in patients with both disorders.

The effect of adenotonsillectomy and rapid maxillary expansion on the upper airway in pediatric obstructive sleep apnea: a randomized crossover-controlled trial

SLEEP ◽  
2021 ◽  
Author(s):  
Maria Cecilia Magalhães ◽  
Carlos José Soares ◽  
Eustáquio A Araújo ◽  
Gabriela de Rezende Barbosa ◽  
Ricardo Maurício O Novaes ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Upper Airway ◽  
Rapid Maxillary Expansion ◽  
Wilcoxon Test ◽  
Apnea Hypopnea Index ◽  
Marginal Effect ◽  
Maxillary Expansion ◽  
Obstructive Sleep ◽  
Group Comparisons

Abstract Study Objectives We aimed to determine the effects of adenotonsillectomy (AT) and rapid maxillary expansion (RME) on the apnea-hypopnea index (AHI) and compare volumetric changes in the upper airway (UA) arising from AT and RME. Methods Thirty-nine children who presented with maxillary constriction and grade III/IV tonsillar hypertrophy were randomized into two groups. One group underwent AT as the first treatment, and the other group underwent RME. Polysomnography (PSG) and cone-beam computed tomography (CBCT) were conducted before (T0) and 6 months after the first treatment (T1). In a crossover design, individuals with AHI>1 received the second treatment. Six months later, they underwent PSG and CBCT (T2). The influence of age, sex, tonsil and adenoid hypertrophy, initial AHI severity, initial volume of the UA, first treatment, and maxillary expansion amount was evaluated using linear regression analysis. Intra- and inter-group comparisons for AHI and inter-group comparisons of volumetric changes in each region of the UA were performed using a paired t-test and Wilcoxon test. Results The initial AHI severity and therapeutic sequence in which AT was the first treatment explained for 95.6% of AHI improvement. AT caused significant improvements in the AHI and volumetric increases in the buccopharynx and total UA areas compared to RME. Conclusions The initial AHI severity and AT as the first treatment accounted for most of the AHI improvement. Most reductions in AHI were due to AT, which promoted more volumetric increases in UA areas than RME. RME may have a marginal effect on pediatric obstructive sleep apnea.

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.

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