Comprehensive review of surgeries for obstructive sleep apnea syndrome

Camacho, Macario; Certal, Victor; Capasso, Robson

doi:10.5935/1808-8694.20130139

Cited by 47 publications

(36 citation statements)

References 60 publications

(91 reference statements)

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“…Mean daily use of 4 hours a day is necessary (Marin et al, 2005). Even thou some improves, some has irritation and stomach bloating, and 46-83 % of patients, are non adherent to therapy (Camacho et al, 2013). But with technological advancements, lower than 50% achieve apnea index which is less than 10, and apnea is reduced by 50% (Olson et al, 2003).…”

Section: Conservatively It Include-mentioning

confidence: 99%

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Modalities of treatment for sleep disordered breathing

Tin¹,

Ohn²

2016

Asian J. Med. Biol. Res

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Abstract:Sleep disordered breathing is a spectrum of diseases that includes snoring, upperairway resistance syndrome and obstructive sleep apnea. It occurs more in obese males, resulting in hypertension and cardiac complications if untreated. There are various treatments, conservatively and surgically, starting from simple tonsillectomy to multi-level surgeries and multi discipline. Literature review was carried out on the pathophysiology, clinical presentation, complications, diagnosis and various treatments, using internet Google, search PubMed. Additional information was obtained by cross referencing, using text and journals in the medical libraries.

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Section: Conservatively It Include-mentioning

confidence: 99%

“…But in Frank R Miller study surgical cure rate was 20% (Miller et al, 2002).  Midline glossectomy, Lingualplasty, and submucosal minimally invasive lingual excision (SMILE) removing tissue from back of tongue and making it smaller, it is less use now (Camacho et al, 2013).  Radiofrequency ablation (RFA) Somnoplasty.…”

Section: Conservatively It Include-mentioning

confidence: 99%

Modalities of treatment for sleep disordered breathing

Tin¹,

Ohn²

2016

Asian J. Med. Biol. Res

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“…Specifically, the article by Mantovani et al [2] brings to the attention of the readers whether UPPP should be performed at all in the setting of minimally invasive surgeries (Barbed Roman Blinds Technique [2]) and newer technologies such as hypoglossal nerve stimulators [3]. We do agree that because there are several surgical treatment modalities available [4], that surgeons should not reflexively select UPPP as the treatment of choice for all obstructive sleep apnea (OSA) patients. In appropriately selected patients, however, such as those with mild OSA, a normal tongue, large tonsils, elongated and thickened uvulas with a retrodisplaced soft palate, a UPPP could be appropriate.…”

Section: Editorialmentioning

confidence: 97%

Tissue-Sparing Uvulopalatopharyngoplasty for OSA: Conservative, Compassionate and Possibly just as Effective

Camacho

Certal

Modi³

et al. 2015

Indian J Otolaryngol Head Neck Surg

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A common surgical treatment for obstructive sleep apnea (OSA) is uvulopalatopharyngoplasty (UPPP). Unfortunately, traditional UPPP can cause a foreign body sensation, chronic discomfort and in rare cases, nasopharyngeal stenosis or velopharyngeal insufficiency. Modifications to traditional UPPP have been developed over the years to help decrease side effects, while trying to maintain or improve OSA outcomes. Conservative, tissue-sparing UPPP techniques include preservation of soft palate tissues (muscle and/or mucosa), avoidance of plication or conservative plication of the uvula, partial instead of complete uvulectomy, and suture plication of the palatopharyngeussuperior pharyngeal constrictor-palatoglossus muscles with complete preservation of surrounding tissues after tonsillectomy.

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“…Sleep surgery is sought by those who have failed or have refused medical management, such as positive airway pressure, oral appliances, myofunctional therapy [3] and/or nasopharyngeal airway devices [4]. Sleep surgeries, such as skeletal surgeries [5], hypoglossal nerve stimulators [6], and several soft tissue surgeries [7] have been developed and used to treat adult OSA.…”

Section: Introductionmentioning

confidence: 99%

Transpalatal advancement pharyngoplasty for obstructive sleep apnea: a systematic review and meta-analysis

Volner

Dunn

Chang

et al. 2016

Eur Arch Otorhinolaryngol

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The objective is to determine if apnea-hypopnea index (AHI) and lowest oxygen saturation (LSAT) improve after transpalatal advancement pharyngoplasty (TPAP) with obstructive sleep apnea (OSA) in adults, using a systematic review and meta-analysis. Nine databases, including PubMed/MEDLINE, were searched through April 1, 2016. All studies that included patients who underwent TPAP alone were included in this analysis. Fifty-six studies were potentially relevant, 37 were downloaded and five studies met criteria with 199 patients (age: 42.5 ± 9.7 years and body mass index: 29.0 ± 4.0 kg/m). The grand mean (M) and standard deviation (SD) for AHI (199 patients) pre and post-TPAP decreased from 54.6 ± 23.0 [95 % CI 51.4, 57.8] to 19.2 ± 16.8 [95 % CI 16.9, 21.5] events/h (relative reduction: 64.8 %). Random effects modeling demonstrated a mean difference (MD) of -36.3 [95 % CI -48.5, -24.1], overall effect Z = 5.8 (p < 0.00001), and I = 85 % (significant inconsistency). The standardized mean difference (SMD) for TPAP demonstrated a large magnitude of effect for AHI -1.76 [95 % CI -2.4, -1.1]. For LSAT (70 patients), the pre and post-TPAP M ± SD improved from 81.9 ± 8.1 [95 % CI 80.0, 83.8] to 85.4 ± 6.9 [95 % CI 83.8, 87.0], with a MD of 3.55, overall effect Z = 1.79 (p = 0.07). Thus far, few studies have evaluated transpalatal advancement pharyngoplasty; therefore, we recommend additional studies, especially prospective studies. Research comparing TPAP to pharyngoplasty procedures without palatal advancement would help determine the optimal role for this procedure.

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Comprehensive review of surgeries for obstructive sleep apnea syndrome

Cited by 47 publications

References 60 publications

Modalities of treatment for sleep disordered breathing

Modalities of treatment for sleep disordered breathing

Tissue-Sparing Uvulopalatopharyngoplasty for OSA: Conservative, Compassionate and Possibly just as Effective

Transpalatal advancement pharyngoplasty for obstructive sleep apnea: a systematic review and meta-analysis

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