ENT-specific therapy of obstructive sleep apnoea in adults

Verse, T.; Dreher, A.; Heiser, Clemens; Herzog, Michael; Maurer, Joachim T.; Pirsig, W; Rohde, Kerstin; Rothmeier, N.; Sauter, Alexander; Steffen, Armin; Wenzel, Stefan; Stuck, Boris A.

doi:10.1007/s11325-016-1353-9

Cited by 25 publications

(11 citation statements)

References 70 publications

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“…6 Otolaryngology Department, Clinica Universitaria de Navarra, Pamplona, Spain. 7 Otolaryngology Department, Ospedale Morgagni-Pierantoni, Forli, Italy. 8 Department of Otolaryngology -Head and Neck Surgery, Rabin Medical Center, Petach Tikva, Israel.…”

Section: Fundingmentioning

confidence: 99%

“…There is a need to review each particular case in detail to define these features. In recent years, there has been an improvement in selecting patients susceptible to surgery and other treatment therapies by sleep surgeons [7]. The use of drug-induced sleep endoscopy (DISE) [8,9] has allowed a more precise understanding of airway collapse including different shapes and degrees of severity.…”

Section: Introductionmentioning

confidence: 99%

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Barbed suture pharyngoplasty in velopharyngeal complete concentric collapse: a multicentric study

Castillo-Farias

Carrasco-Llatas

Bosco

et al. 2022

Egypt J Otolaryngol

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Background Studies have shown that complete concentric circular collapse (CCC) at the velum is a frequent finding in drug-induced sleep endoscopy, implying a worse prognosis for surgical outcomes in the treatment of obstructive sleep apnea syndrome (OSAS). Our group evaluated the results of pharyngoplasties with barbed sutures for this indication. We selected 48 patients with OSAS and CCC who underwent pharyngoplasty with barbed sutures in 8 tertiary centers. The outcome results were measured by polygraphy or polysomnography and Epworth Symptoms Scale (ESS) at least 6 months after surgery. Results Apnea Hypopnea Index (AHI) improved from 34.9/h [21.2] to 12.7/h [10.6]. The success rate according to Sher’s criteria was 86.7%, the cure rate was 23.9%, and an AHI < 10 occurred in 42.2% of the cases. The oxygen desaturation index improved from 32.5/h [29.9] to 12.5/h SD [11.6], and the ESS improved from 10.2 [5.2] to 6 [3.5]. Conclusions Pharyngoplasty with barbed sutures seems to be a good alternative for patients with OSAS and CCC findings in drug-induced sleep endoscopy.

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Section: Fundingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Barbed suture pharyngoplasty in velopharyngeal complete concentric collapse: a multicentric study

Castillo-Farias

Carrasco-Llatas

Bosco

et al. 2022

Egypt J Otolaryngol

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“…Verse et al [26] recommended that, isolated hyoid suspension can be used as a surgical treatment of OSA in patients with suspected hypoglossal obstruction.…”

Section: Disucssionmentioning

confidence: 99%

Efficacy of Modified Hyoid Bone Suspension Technique Compared to Midline Glossectomy in Management of Hypopharyngeal Obstruction in Obstructive Sleep Apnea Patients

Refaat

2020

International Journal of Medical Arts

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Background: Obstructive sleep apnea (OSA) is a common and challenging health problem, especially in adults, as it is the second most common disease related to sleep. Surgical treatment plays an important role in management of OSA. However, the optimal procedure is not yet determined. Aim of the work: To compare between modified hyoid bone suspension and midline glossectomy in management of OSA due to hypopharyngeal obstruction. Patients and Methods: 40 patients with OSA due to hypopharyngeal obstruction were randomly assigned to either modified hyoid bone suspension (group A; 20 patients) or midline glossectomy (group B; 20 patients). All had been assessed by full history, clinical examination and Lab investigations and underwent pre-assigned surgical intervention. Indicators of OSA such as minimal oxygen saturation, Apnea hypopnea Index [AHI] and Epworth Sleepiness Scale [ESS] had been measured preoperatively and 6 months after surgery. Results: The studied groups were comparable as patient characteristics and preoperative data. However, hyoid suspension was associated with significant decrease of AHI [16.67±6.06 vs 20.72±4.41] and ESS [9.10±2.42 vs 11.20±2.33]. Also, minimal oxygen saturation improved significantly in group A than group B. The percentage of responders increased significantly in group A (75.0% vs 40.0% respectively). Conclusion: Modified hyoid suspension is superior than the midline glossectomy, as a safer and more effective procedure for treatment of OSA due to hypopharyngeal obstruction.

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“…The Wisconsin Sleep Cohort Study, established over two decades ago, demonstrated a relationship between OSA and obesity, thus, as obesity increases globally, the incidence of OSA is expected to increase as well [3]. The standard treatment for OSA is continuous positive airway pressure (CPAP), which is effective but fraught with challenges of maintaining adherence [4]. Other treatment options include mandibular advancement devices (MAD), weight loss, behavior modifications, and surgical options [4,5].…”

Section: Introductionmentioning

confidence: 99%

“…The standard treatment for OSA is continuous positive airway pressure (CPAP), which is effective but fraught with challenges of maintaining adherence [4]. Other treatment options include mandibular advancement devices (MAD), weight loss, behavior modifications, and surgical options [4,5].…”

Section: Introductionmentioning

confidence: 99%

Effect of Upper Airway Stimulation in Patients with Obstructive Sleep Apnea (EFFECT): A Randomized Controlled Crossover Trial

Heiser

Steffen

Hofauer

et al. 2021

JCM

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Background: Several single-arm prospective studies have demonstrated the safety and effectiveness of upper airway stimulation (UAS) for obstructive sleep apnea. There is limited evidence from randomized, controlled trials of the therapy benefit in terms of OSA burden and its symptoms. Methods: We conducted a multicenter, double-blinded, randomized, sham-controlled, crossover trial to examine the effect of therapeutic stimulation (Stim) versus sham stimulation (Sham) on the apnea-hypopnea index (AHI) and the Epworth Sleepiness Scale (ESS). We also examined the Functional Outcomes of Sleep Questionnaire (FOSQ) on sleep architecture. We analyzed crossover outcome measures after two weeks using repeated measures models controlling for treatment order. Results: The study randomized 89 participants 1:1 to Stim (45) versus Sham (44). After one week, the AHI response rate was 76.7% with Stim and 29.5% with Sham, a difference of 47.2% (95% CI: 24.4 to 64.9, p < 0.001) between the two groups. Similarly, ESS was 7.5 ± 4.9 with Stim and 12.0 ± 4.3 with Sham, with a significant difference of 4.6 (95% CI: 3.1 to 6.1) between the two groups. The crossover phase showed no carryover effect. Among 86 participants who completed both phases, the treatment difference between Stim vs. Sham for AHI was −15.5 (95% CI −18.3 to −12.8), for ESS it was −3.3 (95% CI −4.4 to −2.2), and for FOSQ it was 2.1 (95% CI 1.4 to 2.8). UAS effectively treated both REM and NREM sleep disordered breathing. Conclusions: In comparison with sham stimulation, therapeutic UAS reduced OSA severity, sleepiness symptoms, and improved quality of life among participants with moderate-to-severe OSA.

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ENT-specific therapy of obstructive sleep apnoea in adults

Cited by 25 publications

References 70 publications

Barbed suture pharyngoplasty in velopharyngeal complete concentric collapse: a multicentric study

Barbed suture pharyngoplasty in velopharyngeal complete concentric collapse: a multicentric study

Efficacy of Modified Hyoid Bone Suspension Technique Compared to Midline Glossectomy in Management of Hypopharyngeal Obstruction in Obstructive Sleep Apnea Patients

Effect of Upper Airway Stimulation in Patients with Obstructive Sleep Apnea (EFFECT): A Randomized Controlled Crossover Trial

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