Surgical planning after sleep versus awake techniques in patients with obstructive sleep apnea

Objective/Hypothesis This study examined correlations between surgical recommendations based on either drug-induced sleep endoscopy (DISE) or common awake examination methods in patients with obstructive sleep apnea syndrome (OSAS). Study Design Prospective, blinded, clinical trial at a university hospital. Methods An otorhinolaryngologist designed surgical plans for patients with OSAS after clinical examination, lateral cephalometry, the Muller maneuver, and Friedman staging. A second otorhinolaryngologist blinded to the previous plans made surgical recommendations after DISE. A third person tested agreement between the two sets of plans using Cohen's kappa statistic and the chi-squared te…

Randomized study comparing two tongue base surgeries for moderate to severe obstructive sleep apnea syndrome

To compare the effectiveness and morbidity of the tongue base radiofrequency and tongue base suspension techniques combined with uvulopalatopharyngoplasty for moderate to severe obstructive sleep apnea.Prospective and randomized surgical trial at a university hospital.In total, 57 patients received either tongue base radiofrequency reduction (n = 29) or tongue base suspension (n = 28). Apnea-hypopnea index, lowest oxygen saturation (polysomnography), Epworth score, and side effects were assessed. Success was defined as aor =50 percent reduction and final apneahypopnea index15/h, and an Epworth score11.The success rates of the two procedures were 57.1 percent and 51.7 percent, respectively (…

Documento de consenso del síndrome de apneas-hipopneas durante el sueño en niños (versión completa)

Dimensional analysis of the upper airway in obstructive sleep apnoea syndrome patients treated with mandibular advancement device: A bi‐ and three‐dimensional evaluation

BACKGROUND The efficiency of the mandibular advancement device (MAD) in patients with obstructive sleep apnoea syndrome (OSAS) has been demonstrated. Nevertheless, the behaviour of the upper airway once MAD is placed and titrated, and its correlation with the apnoea-hypopnoea index (AHI) is still under discussion. OBJECTIVES To analyse the morphological changes of the upper airway through a bi- and three-dimensional study and correlate it with the polysomnographic variable, AHI. METHODS Patients were recruited from two different hospitals for the treatment of OSAS with a custom-made MAD. A cone-beam computer tomography and a polysomnography were performed at baseline and once the MAD was ti…

Impact of an oral appliance on obstructive sleep apnea severity, quality of life, and biomarkers

OBJECTIVE/HYPOTHESIS To investigate outcomes including efficacy, quality of life, and levels of inflammatory markers of a mandibular advancement device (MAD) for moderate-to-severe obstructive sleep apnea (OSA). STUDY DESIGN Case-control study. METHODS Patients with apnea-hypopnea index (AHI) ≥ 15/hr who only accepted MAD therapy (study group) or who refused any treatment (control group) were recruited. At baseline and at 6 months, polysomnography, Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire (FOSQ), C-reactive protein (CRP), interleukin 1β, interleukin 6, and tumor necrosis factor α (TNF-α) were assessed in both groups. RESULTS At baseline, the study group (n …

[Double second branchial cleft anomaly].

Second branchial cleft anomalies are the most common of this type of neck masses. They can be classified in four types (Bailey/Proctor classification) according to their location. Type II is the most common, and related to vital neck structures such as the carotid artery and jugular vein. Cysts are the most frequent among them. Management consists of surgical excision of the cyst and tract by cervicotomy to avoid recurrence. We present an extremely rare case of a 32-year-old male who presented a sudden appearance of a right lateral neck mass that was identified by an image study as a double branchial cleft cyst. A review of simultaneous branchial cleft cyst in the literature is also made.

Doble anomalía de la segunda hendidura branquial

Las anomalias de la segunda hendidura branquial son las mas comunes. Hay 4 tipos (clasificacion de Bailey/Proctor) segun su localizacion. El tipo II, que es el mas comun, esta en contacto con los grandes vasos. Su forma de presentacion es diversa, aunque la mas frecuente es la quistica. El tratamiento es quirurgico con extirpacion completa por cervicotomia para evitar recidivas. Presentamos el caso clinico extremadamente raro de un varon de 32 anos con debut brusco de tumoracion laterocervical derecha, con estudio de imagen que demuestra la presencia de doble quiste branquial. Revisamos en la literatura casos de simultaneidad de quistes branquiales.