Multilevel Obstructive Sleep Apnea Surgery.

Multilevel Obstructive Sleep Apnea Surgery. Adv Otorhinolaryngol. 2017;80:109-115 Authors: Lin HC, Weaver EM, Lin HS, Friedman M Abstract Continuous positive airway pressure (CPAP) is the primary treatment of obstructive sleep apnea/hypopnea syndrome (OSA). Most sleep physicians are in agreement that a certain number of OSA patients cannot or will not use CPAP. Although other conservative therapies, such as oral appliance, sleep hygiene, and sleep positioning, may help some of these patients, there are many who fail all conservative treatments. As sleep surgeons, we have the responsibility to screen patients for both symptoms and signs of OSA. As experts of upper airway diseases, we often view an airway clearly and help the patient understand the importance of assessment and treatment for OSA. Surgery for OSA is not a substitute for CPAP but is a salvage treatment for those who failed CPAP and other conservative therapies and therefore have no other options. Most early studies and reviews focused on the efficacy of uvulopalatopharyngoplasty, a single-level procedure for the treatment of OSA. Since OSA is usually caused by multilevel obstructions, the true focus on efficacy should be on multilevel surgical intervention. The purpose here is to provide an updated overview of multilevel surgery for OSA patients. PMID: 28738374 [PubMed - in process]
Source: Advances in Oto-Rhino-Laryngology - Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research

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Authors: Damaskos C, Garmpis N, Kollia P, Mitsiopoulos G, Barlampa D, Drosos A, Patsouras A, Gravvanis N, Antoniou V, Litos A, Diamantis E Abstract The globalization of the Western lifestyle has resulted in a dramatic increase of diabetes mellitus, a complex, multifactorial disease. Diabetes mellitus is a condition often associated with disorders of the cardiovascular system. It is well established that three quarters of diabetics, aged over 40, will die from cardiovascular disease and are more likely than non-diabetics to die from their first cardiovascular event. Therefore, risk stratification is necessary to ind...
Source: Current Cardiology Reviews - Category: Cardiology Tags: Curr Cardiol Rev Source Type: research
To determine whether combining acoustic pharyngometric parameters with cephalometric and clinical parameters could improve the predictive power for significant obstructive sleep apnea (OSA) in a Korean population.
Source: Auris, Nasus, Larynx - Category: ENT & OMF Authors: Source Type: research
ConclusionCPAP indication without a previous sleep study showed a low sensitivity ( ≅ 22%) but a specificity greater than 95% in patients with high pretest probability for OSA (snoring, report of frequent apneas, BMI> 25 kg/m2 and sleepiness or tiredness plus comorbidity).
Source: Sleep and Breathing - Category: Respiratory Medicine Source Type: research
AbstractPurposeTo establish the efficacy of oral antidepressants compared to placebo in improving obstructive sleep apnea (OSA) as measured on a polysomnography study. Secondary outcomes included self-reported sleepiness.MethodsAuthors identified prospective randomized placebo-controlled studies from MEDLINE through PubMed, Web of Science, the Cochrane Library and EMBASE up to February 2019 in English language. Antidepressants included tricyclic antidepressants (TCA), tetracyclic antidepressants (TeCA), selective serotonin reuptake inhibitors (SSRI), and serotonin receptor modulators (SRM). Studies were assessed for inclus...
Source: Sleep and Breathing - Category: Respiratory Medicine Source Type: research
A 40-year-old man was treated with tonsillectomy and underwent early surgical exploration because of bleeding. Postoperative bleeding complications were treated with bronchoscopy. In addition to obesity, normal thyroid function, type 2 diabetes mellitus, and current tobacco abuse with severe obstructive sleep apnea syndrome, biochemistry revealed severe hypercholesterolemia (total cholesterol 572 mg/dL) and hypertriglyceridemia (1,220 mg/dL). During the postoperative period, low doses of propofol (up to 2 mg/kg/h for 10 hours), along with remifentanil (up to 0.0016 mg/kg/h for 20 hours), midazolam, and tramadol, were neede...
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Letter to the Editor Source Type: research
Screening for depression in patients with OSA would be worthwhile because there is a high rate of comorbidity.
Source: ENTtoday - TRIO Best Practices - Category: ENT & OMF Authors: Tags: Practice Focus Sleep Medicine TRIO Best Practices depression Obstructive sleep apnea patient care Source Type: research
Effects of bone marrow‑derived mesenchymal stem cell transplantation on chronic obstructive pulmonary disease/obstructive sleep apnea overlap syndrome in rats. Mol Med Rep. 2019 Sep 30;: Authors: Chen M, Huang Z, Bi H, Pan X, He J, He L, He X, Du J, Zhou K, Wang L, Wang Q, Guo X, Jin Z Abstract Bone marrow‑derived mesenchymal stem cells (BMSCs) possess potential therapeutic properties for treating patients with chronic obstructive pulmonary disease (COPD), which is characterized by emphysema and obstructive sleep apnea (OSA). However, their effects on overlap syndrome (OS) remain unclear. We invest...
Source: Molecular Medicine Reports - Category: Molecular Biology Tags: Mol Med Rep Source Type: research
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Source: Respiratory Investigation - Category: Respiratory Medicine Source Type: research
ConclusionPreschool children with mild OSA present the following: skeletal Class II pattern with a more retrognathic mandible, increased overjet size, and more pronounced symptoms in the domains of sleep and emotion. Dental arch constriction is not a typical feature in our sample of Asian preschool children with mild OSA.
Source: Journal of Dental Sciences - Category: Dentistry Source Type: research
ConclusionsIn AF patients, there is underuse of GDT for non-AF comorbidities. The association between GDT use and outcomes was strongest in heart failure and obstructive sleep apnea patients where use of GDT was associated with lower mortality and less AF progression.
Source: American Heart Journal - Category: Cardiology Source Type: research
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