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PubMed1996

OA for OSA.

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Humans↗
PubMed2001

[Changes of microarousal in OSAS patients during CPAP].

OBJECTIVE: To study the mechanism of microarousal, its clinical meaning and value in the diagnosis and treatment of sleep apnea-hypopnea syndrome (SAHS). METHODS: 270 snorers (218 men, 58 women) mean aged 48 years underwent standard polysomnography (PSG), from which AHI, sleep latency (SL), number of oxygen desaturation >/= 4% per hour (ODI(4)) and microarousal index (MAI) were calculated. The overnight PSG recordings were also repeated during nCPAP in 28 patients, who have filled in the Epworth Sleep Score (ESS) before and after the treatment to evaluate the improvement of daytime sleepiness. RESULTS: Of the 270 snorers, there were 247 SAHS patients. Their AHI, ODI(4), MAI and SL were (43 +/- 27)/h, (44 +/- 23)/h, (29 +/- 16)/h and (12 +/- 17) min, respectively. AHI and MAI, ODI(4) and MAI were both positively correlated (r = 0.38, both P < 0.001). MAI and SL were negatively correlated (r = -0.15, P = 0.02), while AHI and SL, ODI(4) and SL were not correlated (r = -0.09, -0.02, P > 0.1). Of the 28 patients after CPAP, ODI(4) decreased from (48 +/- 25)/h to (4 +/- 9)/h, MAI decreased from (27 +/- 18)/h to (15 +/- 9)/h. The ESS and SL indicated that subjective and objective sleepiness improved. CONCLUSIONS: Microarousals with at least 3 seconds EEG changes can be scored by computerized EEG analysis. MAI can reflect the severity of daytime sleepiness. MAI is complementary to AHI in the diagnosis and treatment of SAHS. After nCPAP, the patients' MAIs decreased and daytime sleepiness improved.

Adult↗
PubMed2002

[Some differential considerations of OSAS in adults and children].

Some respiratory troubles on childhood keep, comparatively with the same adult's pathology, certain peculiarities worth to know. This is the case of obstructive sleep apnea syndrome, which can suffer both children and adults, but with important etiopathogenical differences: clinical, and therapeutical between the two ages groups, which we must have in mind. Report of differential considerations between the 2 age-groups that we consider more relevants in this syndrome, that every time is more and more seen in clinical practice.

Adult↗
PubMed2004

Tongue base reduction with hyoepiglottoplasty for the treatment of severe OSA.

Surgical treatment for retro-lingual obstruction in patients suffering from obstructive sleep apnea syndrome remains a problem for which there is no simple solution. The techniques most in use (tongue suspension, genioglossal advancement with hyoid suspension) are effective primarily as stabilization methods modifying neither tongue position, nor volume and only produce appreciable results when performed on non-overweight patients with respiratory disturbance index <40. For patients suffering from severe obstructive sleep apnoea syndrome in whom the most obvious morphological alteration is the presence of hypo-pharyngeal obstruction due to tongue base hypertrophy, who are overweight or suffering from moderate obesity, a surgical procedure aimed at reducing tongue volume and at repositioning the hyoid bone, even if invasive, leads to a favourable outcome. Herein, personal experience is described in a group of 8 patients presenting severe obstructive sleep apnoea syndrome incompatible with normal quality of life and normal life expectancy (mean respiratory disturbance index = 55.1) who underwent surgical resection of the tongue base with hyoepiglottoplasty. This technique, first described by Chabolle, differs radically from others inasmuch as it guarantees enlargement of the hypo-pharyngeal lumen and remodelling of the hyolingual complex. Using a suprahyoid cervical approach, it is possible to effect ample reduction of the tongue base with amplification of the hypo-pharyngeal airway without inducing problems as far as concerns either swallowing or speech.

Adult↗
PubMed1991

Surgical treatment of obstructive sleep apnea syndrome (OSAS)

Obstructive sleep apnea syndrome patients usually present with multiple areas of anatomic disproportions. The site or sites of obstruction must be accurately diagnosed preoperatively by a systematic means of examining the patient. This includes nasopharyngoscopy with Muller maneuver and sometimes cephalometrics. The surgical treatment is individualized to the site or sites of obstruction and can include tracheostomy, septoplasty, UPPP, geniohyoid advancement and suspension of the hyoid. For extreme cases advancement of the maxilla, mandible and hyoid bone are sometimes necessary.

Combined Modality Therapy↗