Histopathologic changes in snoring and obstructive sleep apnea syndrome

Woodson, B. Tucker; Garancis, John C.; Toohill, Robert J.

doi:10.1002/lary.5541011211

Cited by 185 publications

(147 citation statements)

References 9 publications

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“…14,15 On the other hand, morphological abnormalities of the palatopharyngeus muscle have been found by Friberg et al 16 in SAHS compared to snorers and normal non-snorers, with an increased proportion of atrophic and hypertrophic ®bers, an increased number of angulated atrophic ®bers, and a high number of muscle ®bers exhibiting similar myosin ATPase characteristics and located within a narrow region (a phenotype commonly described as ®ber type grouping). These results are consistent with those of Woodson et al, 17 who found frequent focal degeneration of myelinated nerve ®bers in SAHS.…”

Section: Introductionsupporting

confidence: 93%

“…18 However, only a small number of the patients included in the two above-mentioned studies 16,17 had conventional sleep evaluation to document and con®rm their abnormal nocturnal breathing status, as in the Friberg study patients were classi®ed according to unconventional scoring of nocturnal breathing abnormalities (percentage of periodic obstructive breathing using a sleep apnea mattress). Furthermore, Woodson et al did not compare muscle characteristics of SAHS with those of non-apneic snorers, Therefore, the respective effects of UA trauma consecutive to UA collapse and the consequences of snoring and UA¯uttering en morphological characteristics of UA muscle remained to be determined.…”

Section: Introductionmentioning

confidence: 99%

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Muscle fiber area distribution of musculus uvulae in obstructive sleep apnea and non-apneic snorers

2000

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OBJECTIVE: To determine whether differences exist in the morphology of upper airway muscles between apneic and non-apneic snorers DESIGN: Muscle characteristic analysis in patients undergoing upper airway surgery in a tertiary sleep center. SUBJECTS: 10 non-apneic snorers and 10 sleep apnea hypopnea syndrome (SAHS). MEASUREMENTS: Frequency distribution of musculus uvulae (MU) muscle ®ber area determined from 475 AE 207 (mean AE s.d.) and 697 AE 165 type IIA ®bers and 92 AE 32 and 68 AE 45 type I ®bers in snorers and SAHS, respectively. RESULTS: Histochemical analyses of MU revealed as expected that type IIA ®bers occupied a signi®cantly larger area within that muscle in SAHS compared to Snorers (89.4 AE 5.8% and 76.1 AE 15.1% respectively, P 0.01). No difference was found in the frequency distribution of type I and type IIA ®ber areas between the two groups comparing the between-groups and within-group variance of individual area distributions found in snorers and SAHS. CONCLUSION: There is no difference in muscle ®ber area frequency distribution between non-apneic snorers and SAHS patients. This suggests that musculus uvulae of these groups of patients does not have a speci®c prevalence of atrophic or hypertrophic muscle ®bers.

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Section: Introductionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Muscle fiber area distribution of musculus uvulae in obstructive sleep apnea and non-apneic snorers

2000

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“…These changes surprisingly affected all dogs in brachycephalic group classified as Grade I BAOS patients. Similar microscopical findings characterize the soft palate in human patients with obstructive sleep apnea syndrome (OSAS) (Woodson et al, 1991;Hamans et al, 2000;Berger et al, 2002).…”

Section: Discussionmentioning

confidence: 65%

“…Since palatine gland hyperplasia was present in all the brachycephalic dogs considered in this study, diet factors are less likely responsible for this feature. Vibrations and friction of soft palate during inspiratory efforts and snoring could represent valid causes for palatine gland hyperplasia to occur as defensive mechanism (Woodson et al, 1991).…”

Section: Discussionmentioning

confidence: 99%

The Anatomy of the Dog Soft Palate. II. Histological Evaluation of the Caudal Soft Palate in Brachycephalic Breeds With Grade I Brachycephalic Airway Obstructive Syndrome

Pichetto

Arrighi

Roccabianca

et al. 2011

The Anatomical Record

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In brachycephalic dogs, the skull bone shortening is not paralleled by a decreased development of soft tissues. Relatively longer soft palate is one of the main factors contributing to pharyngeal narrowing during normal respiratory activity of these dog breeds, which are frequent carriers of the brachycephalic airway obstructive syndrome (BAOS), which affects most part of them during their postnatal life. No histological studies assessing the morphology and the normal tissue composition of the soft palate in brachycephalic dogs are available, neither has ever been determined whether the elongated soft palate is a primary or secondary event. Aim of this study was to describe the morphology of the caudal soft palate in brachycephalic dogs with Grade I BAOS to identify potential features possibly favoring the pathogenesis of BAOS. Specimens from brachycephalic dogs (N ¼ 11) that underwent preventive surgery were collected from surgery, processed for histology, and examined at six transversal levels. The brachycephalic soft palates showed peculiar features such as thickened superficial epithelium, extensive oedema of the connective tissue, and mucous gland hyperplasia. Several muscular alterations were evidenced in addition. The results of this investigation add to the general knowledge of the anatomy of soft palate in the canine species and establish baseline information on the morphological basis of the soft palate thickening in brachycephalic dogs. Anat Rec, 294:1267Rec, 294: -1272Rec, 294: , 2011. V V C 2011 Wiley-Liss, Inc.

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“…There is morphologic evidence to support the presence of a sensory neuropathy in the UA in obstructive sleepdisordered breathing [16][17][18] .…”

Section: Discussionmentioning

confidence: 99%

Oropharyngeal examination as a predictor of obstructive sleep apnea: pilot study of gag reflex and palatal reflex

Valbuza

Oliveira

Conti

et al. 2011

Arq. Neuro-Psiquiatr.

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Obstructive sleep apnea (OSA) has high prevalence and may cause serious comorbities. The aim of this trial was to show if simple noninvasive methods such as gag reflex and palatal reflex are prospective multivariate assessments of predictor variables for OSA. Method: We evaluate gag reflex and palatal reflex, of fifty-five adult patients, and their subsequent overnight polysomnography. Results: Forty-one participants presented obstructive sleep apnea. The most relevant findings in our study were: [1] absence of gag reflex on patients with severe obstructive apnea (p=0.001); [2] absence of palatal reflex on moderate obstructive apnea patients (p=0.02). Conclusion: Gag reflex and palatal reflex, a simple noninvasive test regularly performed in a systematic neurological examination can disclose the impact of the local neurogenic injury associated to snoring and/or obstructive sleep apnea syndrome. Key words: obstructive sleep apnea, OSA, gag reflex, palatal reflex.Avaliação orofaríngea como preditor da apneia obstrutiva do sono: estudo piloto dos reflexos nauseoso e palatal RESUMO A síndrome da apneia obstrutiva do sono (SAOS) possui alta prevalência e pode causar sérias comorbidades. O objetivo deste estudo foi mostrar se métodos não invasivos como os reflexos nauseoso e palatal podem ser avaliações prospectivas multivariadas preditoras para SAOS. Método: Avaliamos os reflexos palatal e nauseoso em 55 pacientes adultos, com exame polissonográfico subsequente. Resultados: 41 pacientes apresentaram SAOS. Os achados mais relevantes em nosso estudo foram: [1] ausência do reflexo nauseoso em pacientes com SAOS grave (p=0,001); [2] ausência do reflexo palatal em pacientes com SAOS moderada (p=0,02). Conclusão: Os reflexos nauseoso e palatal, um simples exame não invasivo, aplicado em uma avaliação neurológica rotineira, pode revelar o impacto de lesões neurogênicas locais associadas ao ronco e/ou a SAOS. Palavras-Chave: apneia obstrutiva do sono, SAOS, reflexo palatal, reflexo nauseoso.

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Histopathologic changes in snoring and obstructive sleep apnea syndrome

Cited by 185 publications

References 9 publications

Muscle fiber area distribution of musculus uvulae in obstructive sleep apnea and non-apneic snorers

Muscle fiber area distribution of musculus uvulae in obstructive sleep apnea and non-apneic snorers

The Anatomy of the Dog Soft Palate. II. Histological Evaluation of the Caudal Soft Palate in Brachycephalic Breeds With Grade I Brachycephalic Airway Obstructive Syndrome

Oropharyngeal examination as a predictor of obstructive sleep apnea: pilot study of gag reflex and palatal reflex

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