Advances in Box Surgery for Obstructive Sleep Apnea: Genioglossus Advancement, Hyoid Suspension, and Maxillomandibular Advancement.
Advances in Box Surgery for Obstructive Sleep Apnea: Genioglossus Advancement, Hyoid Suspension, and Maxillomandibular Advancement. Adv Otorhinolaryngol. 2017;80:99-108 Authors: Goh YH, Tan W, Abdullah VJ, Kim SW Abstract Box surgery for obstructive sleep apnea (OSA) patients consists of mandibular surgery, including genioglossus advancement, hyoid suspension, and maxillomandibular advancement, as an airway reconstruction. This surgery was developed in the early 1980s. Thereafter, techniques were modified in each surgery for the enhancement of outcome and prevention of complications. However, the indication for surgery remains poorly defined due to the dynamicity of the upper airway, variability of the phenotype in OSA patients, and absence of a representative method for the obstruction site in the upper airway. As a result, box surgery is performed restrictively. On the development of an evaluation method including radiologic and endoscopic examination during sleep, the indications and surgical outcomes of each box surgery should be standardized and reevaluated. In this review, the development and limitations of box surgery will be discussed for the positive future of this surgery. PMID: 28738365 [PubMed - in process]
This study is the first to compare the most optimal mandibular protrusive position according to three titration procedures, as well as to compare the therapeutic efficacy of these titration methods.Trial registrationClinicalTrials.gov,NCT03716648. Registered on 23 October 2018.
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 ...
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...
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]
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.
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]
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
Conclusions:Three baseline DISE phenotypes identified during drug-induced sleep were significantly related to MAD treatment outcome: one beneficial, tongue base collapse, and two adverse, complete concentric collapse at the level of the palate and complete laterolateral oropharyngeal collapse. If confirmed in future prospective studies, these results could guide patient selection for MAD outcome.Clinical Trial Registration:This prospective clinical trial (PROMAD) was registered onClinicaltrials.gov with identifier: NCT01532050.Citation:Op de Beeck S, Dieltjens M, Verbruggen AE, Vroegop AV, Wouters K, Hamans E, Willemen M, ...
This article focuses specifically on medical history and physical examination.MethodsA multidisciplinary work-group drew up a first version of the guidelines, graded according to level of evidence following the GRADE grading system. The final version was obtained by including the suggestions and comments from the editorial group.ResultsAt the end of the process, guidelines were established and graded regarding the following points: interview and analysis of the various interview scores recommended in the literature; clinical examination with awake upper-airway endoscopy; and indications for referral to non-ENT specialists.
CONCLUSIONS: According 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 EVIDENCE: III. Retrospective comparative study. PMID: 31115738 [PubMed - as supplied by publisher]