Updated Friedman Staging System for Obstructive Sleep Apnea.

Updated Friedman Staging System for Obstructive Sleep Apnea. Adv Otorhinolaryngol. 2017;80:41-48 Authors: Friedman M, Salapatas AM, Bonzelaar LB Abstract In the practice of sleep medicine, the first step is identification of those patients at high risk for sleep apnea. Nearly every physician and every hospital has preferred methods of screening. Many patient questionnaires or surveys as well as some objective physical measurements have been suggested to predict the presence of sleep apnea. Screening is well established, and laboratory and home testing are widely available. An early assessment with a physical examination can help direct treatment planning. The Friedman tongue position, lingual tonsil hypertrophy grading, and the effects of oral positioning on the hypopharynx should be used in early assessment for treatment planning, and as screening tools to assess the sight of obstruction. Although these screening tools are not substitutes for drug-induced sleep endoscopy (DISE), they are crucial in early assessment as many patients do not require surgery or DISE early in the evaluation. PMID: 28738388 [PubMed - in process]
Source: Advances in Oto-Rhino-Laryngology - Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research

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Authors: Elkalla RS, El Mourad MB Abstract BACKGROUND: Drug induced sleep endoscopy (DISE) has emerged as a promising tool for customizing the adequate surgical approach to relieve airway obstruction in sleep apnea patients. We aimed to compare propofol, dexmedetomidine or ketofol with regards their efficacy and safety for sedation in patients with obstructive sleep apnea (OSA) undergoing DISE procedure. METHODS: Sixty adult OSA patients scheduled for DISE procedure were randomly allocated into three equal groups to receive either propofol (group P), dexmedetomidine (group D), or ketofol (group K). Incidence of oxygen desaturation
Source: Minerva Anestesiologica - Category: Anesthesiology Tags: Minerva Anestesiol Source Type: research
AbstractPerioperative complications related to obstructive sleep apnea still occur despite the use of partial pressure end-tidal CO2\(\left( {{{\text{P}}_{{\text{ETC}}{{\text{O}}_2}}}} \right)\) and pulse oximetry. Airway obstruction can complicate propofol sedation and a novel monitor combining mandibular movement analysis with capnography may facilitate its detection. Patients scheduled for sleep endoscopy were recruited and monitored with standard monitoring,\({{\text{P}}_{{\text{ETC}}{{\text{O}}_2}}},\) and Jaw Activity (JAWAC) mandibular movement sensors. A post hoc analysis investigated airway obstruction prediction ...
Source: Journal of Clinical Monitoring and Computing - Category: Information Technology Source Type: research
The amount of mandibular protrusion is a key factor in optimizing the efficacy of mandibular advancement device (MAD) therapy in an individual patient diagnosed with obstructive sleep apnea. This process is ca...
Source: Trials - Category: General Medicine Authors: Tags: Study protocol Source Type: research
Abstract This project aimed to develop and implement a nasal ventilation mask (NVM) guideline to reduce the incidence of airway obstruction in outpatients undergoing endoscopy procedures. An observational design was used to evaluate implementation of an NVM guideline as the oxygen delivery method for this patient population. An evidence-based guideline for NVM use was developed for patients with obstructive sleep apnea (OSA) and/or an elevated body mass index (BMI) above 35 kg/m² undergoing esophagogastroduodenoscopy and/or colonoscopy procedures at an outpatient endoscopy clinic. Patients receiving moderate ...
Source: AANA Journal - Category: Anesthesiology Authors: Tags: AANA J Source Type: research
Abstract OBJECTIVE: The aim of the present study was to review the literature on ENT disorders associated with craniosynostosis (CS), focusing on symptoms, diagnostic work-up, treatment and outcome. METHODS: Publications were retrieved by consulting the PubMed® free search engine of the US National Library of Medicine. The term "craniosynostosis" was combined with the following key-words: ENT, apneas, OSAS, sleep-disordered breathing, tonsillectomy, deafness, hearing loss. RESULTS: The main ENT disorders associated with CS are upper airway obstruction, chronic otitis and hearing loss. Obstr...
Source: Neuro-Chirurgie - Category: Neurosurgery Authors: Tags: Neurochirurgie Source Type: research
CONCLUSION: Medicare patients undergoing UAS have shorter waiting periods, fewer insurance-related treatment delays and may experience fewer procedure cancellations when compared to patients with private insurance. The investigational status of UAS by private insurance companies delays care for patients with OSA. LEVEL OF EVIDENCE: 4. PMID: 31544468 [PubMed - as supplied by publisher]
Source: The Annals of Otology, Rhinology, and Laryngology - Category: ENT & OMF Authors: Tags: Ann Otol Rhinol Laryngol Source Type: research
ConclusionDISE induced significant revision of the location and change in treatment of obstruction sites in children with OSAHS. Systematic implementation, especially in type-I OSAHS, would allow more precise pre-therapeutic classification and treatment adapted to actual airway obstruction.
Source: European Annals of Otorhinolaryngology, Head and Neck Diseases - Category: ENT & OMF Source Type: research
ConclusionsThe German multi-center long-term outcomes compare favorably with previously published studies. Respiratory and sleepiness efficacy outcomes were sustained over 2 and 3  years, with a favorable safety profile, supporting the safety and efficacy of a chronic implantable therapy.
Source: Sleep and Breathing - Category: Respiratory Medicine Source Type: research
CONCLUSIONS: The German multi-center long-term outcomes compare favorably with previously published studies. Respiratory and sleepiness efficacy outcomes were sustained over 2 and 3 years, with a favorable safety profile, supporting the safety and efficacy of a chronic implantable therapy. PMID: 31485853 [PubMed - as supplied by publisher]
Source: Sleep and Breathing - Category: Sleep Medicine Authors: Tags: Sleep Breath Source Type: research
ConclusionsAccording to this study, in our institution, in cases of major tonsillar hypertrophy, simultaneous soft palate surgery had no significant impact on the success rate, regardless of soft palate length. Associating soft palate surgery with palatine tonsillectomy does not seem mandatory to increase the success rate.Level of evidenceIII. Retrospective comparative study
Source: Sleep and Breathing - Category: Respiratory Medicine Source Type: research
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