Lateral pharyngoplasty techniques for obstructive sleep apnea syndrome: a comparative experimental stress test of two different techniques

Iannella, Giannicola; Magliulo, Giuseppe; Luca, Milena Di; Vito, Andrea De; Meccariello, Giuseppe; Cammaroto, Giovanni; Pelucchi, Stefano; Bonsembiante, Anna; Vicini, Claudio

doi:10.1007/s00405-020-05883-2

Cited by 29 publications

(17 citation statements)

References 19 publications

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“…MMA is one of the many surgical procedures that are currently available for treating OSA [ 7 ]. MMA was part of a phase 2 algorithm where it followed phase 1 (nasal, palate, tongue base procedures, hyoid advancement) [ 8 , 9 ]. If phase 1 incompletely treated, then phase 2 was appropriate [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

A preoperative predictive study of advantages of airway changes after maxillomandibular advancement surgery using computational fluid dynamics analysis

et al. 2021

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The purpose of this study was to develop a simulation approach for predicting maxillomandibular advancement-induced airway changes using computational fluid dynamics. Eight patients with jaw deformities who underwent maxillomandibular advancement and genioglossus advancement surgery were included in this study. Computed tomography scans and rhinomanometric readings were performed both preoperatively and postoperatively. Computational fluid dynamics models were created, and airflow simulations were performed using computational fluid dynamics software; the preferable number of computational mesh points was at least 10 million cells. The results for the right and left nares, including simulation and postoperative measurements, were qualitatively consistent, and surgery reduced airflow pressure loss. Geometry prediction simulation results were qualitatively consistent with the postoperative stereolithography data and postoperative simulation results. Simulations were performed with either the right or left naris blocked, and the predicted values were similar to those found clinically. In addition, geometry prediction simulation results were qualitatively consistent with the postoperative stereolithography data and postoperative simulation results. These findings suggest that geometry prediction simulation facilitates the preoperative prediction of the postoperative structural outcome.

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Section: Introductionmentioning

confidence: 99%

A preoperative predictive study of advantages of airway changes after maxillomandibular advancement surgery using computational fluid dynamics analysis

et al. 2021

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“…Surgical intervention should be considered in patients who are noncompliant with the above treatments or in whom they fail [ 5 ]. Barbed suture pharyngoplasty, one of the updated surgical technique, has been shown to be effective in OSA patients in controlling the autonomic function of the heart, demonstrating a decrease in sympathetic activity after surgery significantly associated with surgical success and a decrease in AHI ( p = 0.033 and p = 0.001, respectively) [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Elevated Monocytic Interleukin-8 Expression under Intermittent Hypoxia Condition and in Obstructive Sleep Apnea Patients

Chuang

Lee

et al. 2021

IJMS

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Obstructive sleep apnea (OSA) is a disease with great cardiovascular risk. Interleukin-8 (IL-8), an important chemokine for monocyte chemotactic migration, was studied under intermittent hypoxia condition and in OSA patients. Monocytic THP-1 cells were used to investigate the effect of intermittent hypoxia on the regulation of IL-8 by an intermittent hypoxic culture system. The secreted protein and mRNA levels were studied by means of enzyme-linked immunosorbent assay and RT/real-time PCR. The chemotactic migration of monocytes toward a conditioned medium containing IL-8 was performed by means of the transwell filter migration assay. Peripheral venous blood was collected from 31 adult OSA patients and RNA was extracted from the monocytes for the analysis of IL-8 expression. The result revealed that intermittent hypoxia enhanced the monocytic THP-1 cells to actively express IL-8 at both the secreted protein and mRNA levels, which subsequently increased the migration ability of monocytes toward IL-8. The ERK, PI3K and PKC pathways were demonstrated to contribute to the activation of IL-8 expression by intermittent hypoxia. In addition, increased monocytic IL-8 expression was found in OSA patients, with disease severity dependence and diurnal changes. This study concluded the monocytic IL-8 gene expression can be activated by intermittent hypoxia and increased in OSA patients.

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“…In the last few years, many authors have begun to demonstrate the capacity of functional endoscopy of the upper airway to discriminate responder and non-responder patients. In 2014, Sasao [2] affirmed that functional endoscopy may have significant clinical utility in predicting the success of oral appliance treatment. In 2016 and 2019, Hokuno [25,26] affirmed that functional endoscopy is an optimal predictor of responder patients with a high level of predictive accuracy (a sensitivity of 85.7%, specificity of 80.8%, and positive predictive value of 85.7%) and has negative predictive value for maximum mandibular protrusion.…”

Section: Discussionmentioning

confidence: 99%

“…Several treatment options are available for the effective management of obstructive sleep apnea (OSA). Surgery plays an important role and various authors have described many techniques with good results [1][2][3][4][5]. In addition to surgical therapy, there are other therapeutic options aimed at improving the symptoms and quality of life of patients, among these the use of mandibular advancement devices (MAD) in the treatment of obstructive sleep apnea (OSA) is a consolidated therapy [6].…”

Section: Introductionmentioning

confidence: 99%

Functional Upper Airway Space Endoscopy: A Prognostic Indicator in Obstructive Sleep Apnea Treatment with Mandibular Advancement Devices

Gasparini

Saponaro

Todaro

et al. 2021

IJERPH

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Purpose: The use of a mandibular advancement device (MAD) in the treatment of obstructive sleep apnea (OSA) is a consolidated therapy. This study aimed to evaluate the predictive value of awake upper airways (UA) functional endoscopy in identifying the outcome of MAD therapy. Methods: This observational prospective study included 30 adult OSA patients, all patients underwent pre-treatment awake UA functional endoscopy, during the exam subjects were instructed to advance their mandible maximally, and they were divided into three different groups according to the response of the soft tissue, group A (expansion), group B (stretch), group C (unchanged). The results of this test were used in combination with other noninvasive indexes to predict the treatment outcome in terms of apnea-hypopnea index (AHI) reduction. Results: We found that a substantial AHI reduction occurred in group A and group B while e slight AHI reduction was measured in group C. Conclusion: Based on our experience the awake UA endoscopy is a valid prognostic exam for discriminating responder and non-responder patients; in addition our results indicate the possibility of predicting a range of post-treatment AHI index values.

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Lateral pharyngoplasty techniques for obstructive sleep apnea syndrome: a comparative experimental stress test of two different techniques

Cited by 29 publications

References 19 publications

A preoperative predictive study of advantages of airway changes after maxillomandibular advancement surgery using computational fluid dynamics analysis

A preoperative predictive study of advantages of airway changes after maxillomandibular advancement surgery using computational fluid dynamics analysis

Elevated Monocytic Interleukin-8 Expression under Intermittent Hypoxia Condition and in Obstructive Sleep Apnea Patients

Functional Upper Airway Space Endoscopy: A Prognostic Indicator in Obstructive Sleep Apnea Treatment with Mandibular Advancement Devices

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