<p><strong>Introdução</strong>: a síndrome da apneia obstrutiva do sono (SAOS) caracteriza-se por episódios recorrentes de obstrução parcial ou total da via aérea superior, normalmente acompanhada por roncos. É de etiologia multifatorial, e o diagnóstico leva em consideração os atores de risco e as comorbidades. <strong>Objetivo</strong>: estudar os fatores de risco da SAOS, devido às comorbidades e às consequências graves que podem estar relacionadas à patologia, visando a atuar em sua prevenção e tratamento. <strong>Revisão de literatura</strong>: os principais fatores<br />de risco encontrados foram: obesidade, circunferência cervical maior que 40 cm, IMC aumentado, histórico familiar, sexo masculino, meia-idade, Classe III e IV de Mallampati modificada e alterações nas vias aéreas superiores como desvio de septo nasal, palato ole rebaixado e posteriorizado e alterações craniofaciais. <strong>Metodologia</strong>: realizou-se uma revisão de literatura sobre os fatores de<br />risco da SAOS, utilizando-se as bases de dados Pubmed, Scielo e Medline e os descritores de busca de acordo com os DECs ou Mesh.<strong>Conclusão</strong>: o estudo dos fatores de risco associados à presença de SAOS demonstra a necessidade da abordagem interdisciplinar ssa patologia junto ao médico otorrinolaringologista, por ser ela multifatorial.</p>
45% of patients did not come back for chemodenervation. Treatment cost can be a reason for the high dropout rate (Fig. 1).Other treatment options for unilateral lower lip palsy include selective neurectomy of the healthy contralateral side. Another reconstructive option is reconstruction of the lower lip depressor activity with digastric muscle transfer.Patients with CULLP have high level of concern regarding their mouth symmetry during speech and smiling. Chemodenervation treatment resulted with higher patient satisfaction with speech in comparison to smiling. One possible reason can be the anatomy of the smile as explained by Rubin et al in 1974. 10 There are there 3 types of smile, namely ''Mona Lisa,'' canine and full denture smile. The only smile affected by lower lip palsy is the full denture smile, therefore it can be speculated patients that have the other smile patterns are not affected as much. Whereas unilateral lower lip palsy almost always causes serious asymmetry during speech, especially while pronouncing sounds that incorporate i and e.Although this study was carried out in CULLP patients only, results are also applicable to other DLI related asymmetries. Contralateral DLI chemodenervation is also a very valid option for patients with acquired unilateral lower lip palsy such as Bell palsy, iatrogenic marginal mandibular palsy. CONCLUSIONMost CULLP patients are concerned regarding their asymmetric appearance while smiling or speaking. Chemodenervation of the contralateral DLI muscle reduces concern levels and has high patient satisfaction. Chemodenervation of the contralateral healthy DLI muscle is a valid, practical treatment option.
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