First-Choice Treatment in Mild to Moderate Obstructive Sleep Apnea

Ceylan, Kürşat; Emir, Hatice; Kızılkaya, Zeynep; Taştan, Eren; Yavanoğlu, Ahmet; Uzunkulaoğlu, Hakkı; Samim, Erdal; Felek, Sevim Arslan

doi:10.1001/archoto.2009.117

Cited by 22 publications

(13 citation statements)

References 20 publications

(38 reference statements)

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“…Two trials, one RCT by Woodson et al. and another non‐RCT by Ceylan et al., compared temperature‐controlled radiofrequency tissue ablation (TCRFTA) of the tongue and palate to CPAP, both finding minimal differences between the two on objective PSG parameters and subjective parameters such as the ESS 1495–1497 . Another study by Weaver et al.…”

Section: Surgical Treatment For Osamentioning

confidence: 99%

“…Two trials, one RCT by Woodson et al and another non-RCT by Ceylan et al, compared temperature-controlled radiofrequency tissue ablation (TCRFTA) of the tongue and palate to CPAP, both finding minimal differences between the two on objective PSG parameters and subjective parameters such as the ESS. [1495][1496][1497] Another study by Weaver et al compared a cohort of patients who had undergone UPPP versus prescribed CPAP treatment and found that the CPAP patients had a 31% higher mortality. 1498 Despite limitations, these data suggest that there may be a phenotype of patient who may benefit from interventions other than CPAP as the first line.…”

Section: Ixa3 Surgery As Primary Treatment For Osamentioning

confidence: 99%

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International Consensus Statement on Obstructive Sleep Apnea

Chang

Goldberg

Alt

et al. 2023

Int Forum Allergy Rhinol

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Background: Evaluation and interpretation of the literature on obstructive sleep apnea (OSA) allows for consolidation and determination of the key factors important for clinical management of the adult OSA patient. Toward this goal, an international collaborative of multidisciplinary experts in sleep apnea evaluation and treatment have produced the International Consensus statement on Obstructive Sleep Apnea (ICS:OSA). Methods: Using previously defined methodology, focal topics in OSA were assigned as literature review (LR), evidence-based review (EBR), or evidencebased review with recommendations (EBR-R) formats. Each topic incorporated the available and relevant evidence which was summarized and graded on study quality. Each topic and section underwent iterative review and the ICS:OSA was created and reviewed by all authors for consensus. Results: The ICS:OSA addresses OSA syndrome definitions, pathophysiology, epidemiology, risk factors for disease, screening methods, diagnostic testing types, multiple treatment modalities, and effects of OSA treatment on multiple OSA-associated comorbidities. Specific focus on outcomes with positive airway pressure (PAP) and surgical treatments were evaluated. Conclusion:This review of the literature consolidates the available knowledge and identifies the limitations of the current evidence on OSA. This effort aims to create a resource for OSA evidence-based practice and identify future research needs. Knowledge gaps and research opportunities include improving the metrics of OSA disease, determining the optimal OSA screening paradigms, developing strategies for PAP adherence and longitudinal care, enhancing selection of PAP alternatives and surgery, understanding health risk outcomes, and translating evidence into individualized approaches to therapy.

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Section: Surgical Treatment For Osamentioning

confidence: 99%

Section: Ixa3 Surgery As Primary Treatment For Osamentioning

confidence: 99%

International Consensus Statement on Obstructive Sleep Apnea

Chang

Goldberg

Alt

et al. 2023

Int Forum Allergy Rhinol

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“…After excluding duplicates, the title and abstract of 68 articles were examined, and 39 full‐text articles were assessed for eligibility. Eventually, six studies, including five cohort studies and one non‐randomised clinical trial study, completely met the inclusion criteria and were further enrolled for analysis 17–22 . Figure 1 shows the flowchart of the study selection process.…”

Section: Resultsmentioning

confidence: 99%

Minimally invasive, single‐stage, multilevel surgery for obstructive sleep apnoea: A systematic review and meta‐analysis

Rahavi‐Ezabadi,

Su,

Wang

et al. 2023

Clinical Otolaryngology

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ObjectivesMinimally invasive, single‐staged multilevel surgery (MISS MLS) could be an optimal treatment for selected patients with obstructive sleep apnea (OSA). We aim to systematically review the efficacy of MISS MLS for patients with OSA, as well as the clinical outcomes and possible complications in OSA patients before and after MISS MLS.Design and settingSystematic review and meta‐analysis. Six databases were searched, and the PRISMA guideline was followed.ParticipantsPatients with OSA receiving MISS MLS.Main outcome measuresThe random‐effects model was adopted for the statistical synthesis. The percentage and 95% confidence interval (CI) were adopted as the effect measurements of MISS MLS for OSA. Subgroup analyses and sensitivity analyses were also performed to identify the heterogeneity among the studies.ResultsThere were initially 154 articles for identification. Eventually, six studies with a total of 848 OSA patients completely met the inclusion criteria and were further enrolled for analysis. The pooled analysis showed statistically significant lower AHI (apnea/hypopnea index, /hr.; mean difference: −8.931, 95% CI: −11.591 to −6.271, I2 = 87.4%), ESS (mean difference: −2.947, 95% CI: −4.465 to −1.429, I2 = 94.9%), and snoring severity with 0‐10 visual analog scale after surgery (mean difference: −4.966, 95% CI: −5.804 to −4.128, I2 = 96.4%). The success rate was 46% in mild/moderate OSA; however, 18% in severe OSA. There were no major complications occurred.ConclusionsThe acceptable surgical outcomes, esp. in mild/moderate OSA, and rare complications are the major advantages of MISS MLS. The evidence of this study could aid the decision making in selecting suitable treatment programs for OSA patients.

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“…Most OSA patients have multilevel disease; hence, nasal, oropharyngeal and palatal, and hypopharyngeal treatment measures are required to improve the airway [ 7 ]. Waite et al first presented a multilevel procedure in 1989 [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Combined Surgical Approach for Obstructive Sleep Apnea Patient

Ebrahim

Alsanea

Alterki

2018

Case Reports in Otolaryngology

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Obstructive sleep apnea (OSA) is a disease that is associated with high morbidity and mortality and can significantly impact the quality of life in a patient. OSA is strongly associated with obesity, and literature showed that weight loss will lead to improvement in OSA. The gold standard treatment for OSA is continuous positive airway pressure (CPAP). However, other methods of treatment are available. One of these methods is multilevel sleep surgery (MLS). Literature showed that bariatric surgery can also improve OSA. A common question is which surgical procedure of these two should be performed first. We present a 5-year follow-up of a patient who underwent simultaneously bariatric surgery and MLS. His apnea-hypopnea index (AHI) decreased from 53 episodes per hour to 5.2 per hour within the first 18 months, which was measured via a level 3 polysomnography. Five years after the surgery, a repeat level 3 polysomnography showed an AHI of 6.8 episodes per hour, and the patient is asymptomatic. The patient maintained his weight and did not use CPAP after the combined surgery during the five-year period.

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First-Choice Treatment in Mild to Moderate Obstructive Sleep Apnea

Abstract: Similar comparison results with nasal CPAP in objective and subjective variables make single-stage, multilevel TCRFTVR a good alternative in primary treatment of mild to moderate obstructive sleep apnea.

Cited by 22 publications

References 20 publications

International Consensus Statement on Obstructive Sleep Apnea

International Consensus Statement on Obstructive Sleep Apnea

Minimally invasive, single‐stage, multilevel surgery for obstructive sleep apnoea: A systematic review and meta‐analysis

Combined Surgical Approach for Obstructive Sleep Apnea Patient

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