Changes in Quality of Life and Respiratory Disturbance After Extended Uvulopalatal Flap Surgery in Patients With Obstructive Sleep Apnea

Li, Hsueh‐Yu; Chen, Ning‐Hung; Shu, Y. C.; Wang, Pa-Chun

doi:10.1001/archotol.130.2.195

Cited by 45 publications

(24 citation statements)

References 18 publications

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“…Both UPPP and the flap showed comparable results with regard to effectiveness for OSA, amount of tissue removed and complications. Six papers investigated the effect of an isolated uvulopalatal flap without any other surgeries at the same time [241,[244][245][246][247][248]. The AHI decreased significantly from 45 to 14 within 6-12 months after surgery.…”

Section: Overview Of the Evidencementioning

confidence: 99%

Non-CPAP therapies in obstructive sleep apnoea

Randerath

Verbraecken²,

Andreas³

et al. 2011

Eur Respir J

311

179

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In view of the high prevalence and the relevant impairment of patients with obstructive sleep apnoea syndrome (OSAS) lots of methods are offered which promise definitive cures for or relevant improvement of OSAS.This report summarises the efficacy of alternative treatment options in OSAS.An interdisciplinary European Respiratory Society task force evaluated the scientific literature according to the standards of evidence-based medicine.Evidence supports the use of mandibular advancement devices in mild to moderate OSAS. Maxillomandibular osteotomy seems to be as efficient as continuous positive airway pressure (CPAP) in patients who refuse conservative treatment. Distraction osteogenesis is usefully applied in congenital micrognathia or midface hypoplasia. There is a trend towards improvment after weight reduction. Positional therapy is clearly inferior to CPAP and long-term compliance is poor. Drugs, nasal dilators and apnoea triggered muscle stimulation cannot be recommended as effective treatments of OSAS at the moment. Nasal surgery, radiofrequency tonsil reduction, tongue base surgery, uvulopalatal flap, laser midline glossectomy, tongue suspension and genioglossus advancement cannot be recommended as single interventions. Uvulopalatopharyngoplasty, pillar implants and hyoid suspension should only be considered in selected patients and potential benefits should be weighed against the risk of long-term side-effects. Multilevel surgery is only a salvage procedure for OSA patients.

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Section: Overview Of the Evidencementioning

confidence: 99%

Non-CPAP therapies in obstructive sleep apnoea

Randerath

Verbraecken²,

Andreas³

et al. 2011

Eur Respir J

311

179

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“…Briefly, animals were housed in Plexiglas boxes with free access to food and water and exposed 7 h/day for 14 days to either E-IH (20 brief exposures/h to 5% O 2-5% CO2) or air-air cycling (sham, constant stream of room air). We have demonstrated that this protocol lowers PO2 to ϳ35 mmHg with no change in PCO2 (37), simulating moderate to severe sleep apnea where O2 saturation falls as low as 70% (22,23). Body weight, systolic blood pressure (SBP), and heart rate were recorded on days 0 and 14 before the start of the daily E-IH or air-air exposure using a standard tail-cuff apparatus (IITC).…”

Section: Animalsmentioning

confidence: 99%

Eucapnic intermittent hypoxia augments endothelin-1 vasoconstriction in rats: role of PKCδ

Allahdadi

Duling²,

Walker³

et al. 2008

American Journal of Physiology-Heart and Circulatory Physiology

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We reported previously that simulating sleep apnea by exposing rats to eucapnic intermittent hypoxia (E-IH) causes endothelin-dependent hypertension and increases constrictor sensitivity to endothelin-1 (ET-1). In addition, augmented ET-1-induced constriction in small mesenteric arteries (sMA) is mediated by increased Ca(2+) sensitization independent of Rho-associated kinase. We hypothesized that exposing rats to E-IH augments ET-1-mediated vasoconstriction by increasing protein kinase C (PKC)-dependent Ca(2+) sensitization. In sMA, the nonselective PKC inhibitor GF-109203x (3 microM) significantly inhibited ET-1-stimulated constriction in E-IH arteries but did not affect ET-1-stimulated constriction in sham arteries. Phospholipase C inhibitor U-73122 (1 microM) also inhibited constriction by ET-1 in E-IH but not sham sMA. In contrast, the classical PKC (cPKC) inhibitor Gö-6976 (1 microM) had no effect on ET-1-mediated vasoconstriction in either group, but a PKCdelta-selective inhibitor (rottlerin, 3 microM) significantly decreased ET-1-mediated constriction in E-IH but not in sham sMA. ET-1 increased PKCdelta phosphorylation in E-IH but not sham sMA. In contrast, ET-1 constriction in thoracic aorta from both sham and E-IH rats was inhibited by Gö-6976 but not by rottlerin. These observations support our hypothesis that E-IH exposure significantly increases ET-1-mediated constriction of sMA through PKCdelta activation and modestly augments ET-1 contraction in thoracic aorta through activation of one or more cPKC isoforms. Therefore, upregulation of a PKC pathway may contribute to elevated ET-1-dependent vascular resistance in this model of hypertension.

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“…It reduces the risk of nasopharyngeal incompetence and is associated with less postoperative pain. It is however contraindicated in patients with excessively long or bulky soft palate 51,52 . UPPP lowers the positive airway pressure requirements, thus improving CPAP compliance in selected patients 53 .…”

Section: Uvulopalatopharynoplasty (Uppp)mentioning

confidence: 99%

Diagnosis and Management of Obstructive Sleep Apnea

Mehta¹,

Ariga²

2014

J Biol Sci Opin

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Sleep is defined as a naturally recurring state characterized by altered consciousness, relatively inhibited sensory activity and inhibition of nearly all voluntary muscles. Poor sleep quality results in excessive daytime sleepiness, impaired health status, depressive symptoms and poor quality of life. Upper airway sleep disorders (UASD) are becoming commonly recognized by medical and dental communities. Snoring is a mild form of these disorders. Obstructive Sleep Apnea (OSA) is a severe yet under-diagnosed sleep related breathing disorder. It is characterized by repetitive complete or partial occlusion of the upper airway, resulting in apnea, hypopnea, oxygen desaturation and sleep fragmentation. OSA can lead to a series of systemic, dental and psychological problems if left untreated. Efforts have been made to pin-point the symptoms to effectively evaluate this disorder and to efficiently treat it. This review gives a brief description on the evaluation criteria, associated systemic complications and series of invasive and non invasive treatment options for management and improvement of individuals affected with OSA.

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Changes in Quality of Life and Respiratory Disturbance After Extended Uvulopalatal Flap Surgery in Patients With Obstructive Sleep Apnea

Abstract: To evaluate the subjective and objective outcomes of extended uvulopalatal flap (EUPF) surgery in patients with obstructive sleep apnea.

Cited by 45 publications

References 18 publications

Non-CPAP therapies in obstructive sleep apnoea

Non-CPAP therapies in obstructive sleep apnoea

Eucapnic intermittent hypoxia augments endothelin-1 vasoconstriction in rats: role of PKCδ

Diagnosis and Management of Obstructive Sleep Apnea

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