Obstructive sleep apnea (OSA) is considered the silent killer pathology of the new millennium. This is due to increased risk factors such as obesity. Healthcare systems face an increasing burden from severe cases of OSA. We performed a study on a group of 152 Romanian patients with OSA recording data obtained through polysomnography and cephalometric variables, recorded in lateral plain X-rays. The results confirmed some of the data available from previous studies worldwide, but some of the variables presented a positive statistical correlation specific to our study group. For example, the apnea-hypopnea index (AHI) correlated with the uvula length but surprisingly did not correlate with body mass index (BMI) because obesity tends to become endemic in Romania. To our knowledge, this is one of the first studies focusing on cephalometric data in Romanian OSA patients. The results obtained through this study will be further analyzed in research on larger groups of Romanian OSA patients.
BACKGROUND. Smell disorders may be classified in quantitative and qualitative. The literature shows that the main causes of odour disorders, both qualitative and quantitative, are due to aging, viral infections and tumors of the upper respiratory tract, craniocerebral trauma, neurodegenerative diseases of the nervous system, drug use or exposure to various toxic substances. Total laryngectomy and oncologic treatment causes smell disorders.OBJECTIVE. The aim of this study is to evaluate the aspects related to the patient’s smell disorders after total laryngectomy, during the oncological treatment represented by radiotherapy.MATERIAL AND METHODS. A prospective observational study was performed on a group of 52 patients, over a period of one year (2016-2017), who benefited from total laryngectomy and who underwent oncological treatment, represented by radiotherapy. Patients were evaluated before starting radiotherapy and during radiotherapy sessions. All patients underwent quantitative and qualitative smell assessment.RESULTS. At the end of week 7 of radiotherapy, none of the patients was considered normosmic, 10 patients were considered to be suffering from hyposmia and 42 from anosmia. Statistically significant changes in the quantitative determination of odour occurred in the fourth week, respectively at the radiation dose of 40Gy. Qualitative odour assessment in this study showed a statistically significant decrease starting with the fifth week of radiotherapy, respectively with a radiation dose of 50Gy.CONCLUSION. Radiation therapy has a major impact on the quality of life of patients with laryngeal cancer, which has the lowest scores at the beginning and end of the treatment.
BACKGORUND. Obstructive sleep apnea syndrome (OSAS) is a major health problem. The complications of this condition decrease the quality of life. Patients with OSAS present an increased risk of cardiovascular diseases: arterial hypertension, heart failure, myocardial ischemia, myocardial infarction, stroke. MATERIAL AND METHODS. The patients included in the study were divided into 4 groups, depending on the value of the apnea-hypopnea index (AHI): Control Group A with AHI<5; Group B – mild apnea, 5<AHI<15; Group C – moderate apnea, 16<AHI<30; Group D – severe apnea, AHI >30. AHI and heart rate at different sleep stages were correlated. RESULTS. 133 patients were analyzed. The average age was 47 years±15 years, and the gender distribution shows women 21.1% and men 78.9%. The average value of oxygen saturation was 90.45±4.99%. The average value of heart rate during sleep was 104±67.7 beats/minute. The heart rate was variable depending on the sleep stage, with p = 0.0089 regardless of the sleep stage. CONCLUSION. It can be argued that sleep apnea is a factor that interferes with the adaptive mechanisms of heart rate during sleep. Polysomnographic evaluation of sleep stages and clinical examination of patients with OSAS allow the initiation of treatments to prevent the occurrence of cardiovascular diseases.
OBJECTIVE. This study examines the association between the severity of obstructive sleep apnea and the pharyngeal parameters using the ultrasound of the submental region. MATERIAL AND METHODS. For this study, data obtained from 40 patients, who had undergone investigations in the Galenus Medical Centre in order to diagnose sleep apnea, was analyzed. The following parameters were compared: the transverse diameter of the retrolingual region, the transverse diameter of the retropalatal region and the tongue base thickness. These regions were measured at different moments of respiration such as: during forced expiration, during forced inspiration and while the patients performed Müller’s Manoeuvre. The neck circumference, the body mass index of patients and the severity of sleep apnea obtained from polysomnography were analyzed. RESULTS. The evaluation of the results revealed: severe obstructive sleep apnea in 16 patients, respectively moderate severity in 10 patients, mild apnea in 4 patients, and no obstructive sleep apnea in 10 patients. Statistically significant results (p<0.05) were found after comparing the parameters obtained in patients with severe apnea versus the parameters in patients without apnea, with mild or respectively moderate apnea. CONCLUSION. Based on the results obtained, we consider that cervical ultrasound is useful in the diagnosis of severe obstructive apnea, identifying the pathological changes of the anatomical structures that basically cause this category of disease. Due to the fact that in our country ultrasound is a relatively inexpensive method, being also a non-irradiating, repeatable and accessible method, it should be more widely applied also in the field of otorhinolaryngology in order to view structures accessible to this type of imaging.
BACKGORUND. Sleep is a complex biological process and represents a reversible state of unconsciousness in which metabolism and motor activity are reduced. Sleep disorders are a group of conditions that disrupt a person’s normal sleep patterns. Sleep disorders are one of the most common clinical problems encountered. Inadequate or non-restorative sleep can interfere with normal physical, mental, social and emotional functioning. Sleep pathology is a frequent condition, but often underdiagnosed. MATERIAL AND METHODS. In this retrospective study, we aimed to investigate patients with suspected obstructive sleep apnea syndrome based on the response to the Berlin Questionnaire, which suggests the presence of an increased or decreased risk of sleep disorders. We conducted a study in patients with cardiovascular, metabolic, pulmonary antecedents, which were associated with risk factors, such as: age, body mass index, neck circumference, abdominal circumference, history of snoring. RESULTS AND CONCLUSIONS. The Berlin Questionnaire is a useful tool for detecting mild, moderate and severe apnea syndrome, being used for its early diagnosis, especially in cases where polysomnography is more difficult to perform, in order to select patients for the continuation of the examination protocols. This questionnaire is a reliable tool for the exclusion of obstructive sleep apnea and can be a particularly important tool in the allocation of diagnostic resources in patients suspected of having a breathing disorder during sleep.
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