Palatal anatomy for sleep apnea surgery

Olszewska, Ewa; Woodson, B. Tucker

doi:10.1002/lio2.238

Cited by 39 publications

(36 citation statements)

References 30 publications

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“…In this case, the shape of the collapse pattern is circular and, consequently, more favorable to palatal surgery. Conversely, an acute alpha angle is related to an anteroposterior collapse pattern, which is less favorable to palatal surgery [ 38 , 39 ].…”

Section: Ua Endoscopic Examinationmentioning

confidence: 99%

OSA Upper Airways Surgery: A Targeted Approach

et al. 2021

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Obstructive sleep apnea syndrome (OSA) is a multi-factorial disorder, with quite complex endotypes, consisting of anatomical and non-anatomical pathophysiological factors. Continuous positive airway pressure (CPAP) is recognized as the first-line standard treatment for OSA, whereas upper airway (UA) surgery is often recommended for treating OSA patients who have refused or cannot tolerate CPAP. The main results achievable by the surgery are UA expansion, and/or stabilization, and/or removal of the obstructive tissue to different UA levels. The site and pattern of UA collapse identification is of upmost importance in selecting the customized surgical procedure to perform, as well as the identification of the relation between anatomical and non-anatomical factors in each patient. Medical history, sleep studies, clinical examination, UA endoscopy in awake and drug-induced sedation, and imaging help the otorhinolaryngologist in selecting the surgical candidate, identifying OSA patients with mild UA collapsibility or tissue UA obstruction, which allow achievement of the best surgical outcomes. Literature data reported that the latest palatal surgical procedures, such as expansion sphincter palatoplasty or barbed reposition palatoplasty, which achieve soft palatal and lateral pharyngeal wall remodeling and stiffening, improved the Apnea Hypopnea Index, but the outcome analyses are still limited by methodological bias and the limited number of patients’ in each study. Otherwise, the latest literature data have also demonstrated the role of UA surgery in the improvement of non-anatomical factors, confirming that a multidisciplinary and multimodality diagnostic and therapeutical approach to OSA patients could allow the best selection of customized treatment options and outcomes.

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Section: Ua Endoscopic Examinationmentioning

confidence: 99%

OSA Upper Airways Surgery: A Targeted Approach

et al. 2021

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“…Obstructive sleep apnea (OSA) is a nocturnal disorder characterized by recurrent episodes of upper airway obstruction during sleep resulting in oxygen desaturation and sleep fragmentation. Various treatment and diagnosis methods of OSA are available [ 1 , 2 , 3 , 4 , 5 ]. It is an increasingly prevalent condition that has a great impact on public health.…”

Section: Introductionmentioning

confidence: 99%

Is the Oxidative Stress in Obstructive Sleep Apnea Associated with Cardiovascular Complications?—Systematic Review

Fiedorczuk

Stróżyński

Olszewska

2020

JCM

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Obstructive sleep apnea (OSA) is a prevalent, underdiagnosed disease and is considered an independent risk factor for cardiovascular disease. The exact mechanism of cardiovascular complications (CVC) development as a complication of OSA is not entirely understood. Oxidative stress is suspected to be the essential factor in initiating various comorbidities in OSA. Biomarkers of nonenzymatic lipid and protein peroxidation, DNA repair and antioxidant capabilities measured in serum, plasma and urine are frequently used to assess the presence of oxidative stress. We conducted a systematic review and quality assessment of available observational analytic studies to determine whether there is an association between oxidative stress and OSA in patients with prevalent CV disease compared to (a) patients with prevalent CV disease but no OSA, (b) patients with prevalent CV disease and less severe OSA and (c) patients with OSA and no overt CV disease. This systematic review demonstrated that, while oxidative stress is associated with OSA, there was no clear difference in the severity of oxidative stress between OSA patients with or without cardiovascular complications.

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“…Several studies demonstrate new treatment protocols for primary snoring and OSAS patients including nonsurgical and surgical procedures [ 1 , 21 , 22 ]. A variety of different devices, such as oral appliances, vests, positional therapy, and positive airway pressure therapy, may be ineffective with poor compliance, as well as cause back pain and discomfort during sleep.…”

Section: Discussionmentioning

confidence: 99%

“…Sleep-disordered breathing (SDB) is a series of disorders including snoring and obstructive sleep apneas. Obstructive sleep apnea syndrome (OSAS) is a nocturnal disorder characterized by recurrent episodes of upper airway obstruction during sleep, associated with oxygen desaturation and sleep fragmentation [ 1 , 2 ]. The severity of OSAS is measured by the apnea–hypopnea index (AHI), which is defined by the number of apneas and hypopneas events per hour of sleep.…”

Section: Introductionmentioning

confidence: 99%

The Association of Oxidative Stress in the Uvular Mucosa with Obstructive Sleep Apnea Syndrome: A Clinical Study

Olszewska

Rogalska

Brzóska

2021

JCM

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The hypothesis that individuals with obstructive sleep apnea syndrome (OSAS) demonstrate oxidative stress in the uvular mucosa that correlates with OSAS occurrence was investigated. A total of 128 participants (mean age 45.8, mean body mass index 30.7, female–male ratio 1:20) were divided into the non-OSAS group (apnea–hypopnea index—AHI ˂ 5) and OSAS-group (AHI ≥ 5), in which mild (5 ≤ AHI ˂ 15), moderate (15 ≤ AHI ˂ 30), and severe (AHI ≥ 30) sub-groups were distinguished. Laryngological examination, Epworth Sleep Scale questionnaire, and home sleep study were performed to obtain AHI, mean oxygen saturation, and lowest oxygen saturation. Total oxidative status (TOS) and total antioxidative status (TAS) were assayed in the uvular mucosa taken during palatoplasty or palatopharyngoplasty. The severity of oxidative stress was expressed as oxidative stress index (OSI). Oxidative/reductive imbalance was noted in the mucosa of the uvula of OSAS individuals, and TAS of the uvular mucosa negatively correlated with the severity of this syndrome. TOS and OSI in the mild, moderate, and severe OSAS were higher than in the non-OSAS group, whereas TAS of the uvular mucosa in the OSAS group was lower compared to the non-OSAS group. In conclusion, oxidative stress in the uvular mucosa is associated with the occurrence of OSAS.

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Palatal anatomy for sleep apnea surgery

Cited by 39 publications

References 30 publications

OSA Upper Airways Surgery: A Targeted Approach

OSA Upper Airways Surgery: A Targeted Approach

Is the Oxidative Stress in Obstructive Sleep Apnea Associated with Cardiovascular Complications?—Systematic Review

The Association of Oxidative Stress in the Uvular Mucosa with Obstructive Sleep Apnea Syndrome: A Clinical Study

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