Resolution of Severe Sleep-Disordered Breathing with a Nasopharyngeal Obturator in 2 Cases of Nasopharyngeal Stenosis Complicating Uvulopalatopharyngoplasty

DeAngelo, Alan J.; Mysliwiec, Vincent

doi:10.1007/s11325-004-0049-8

Cited by 8 publications

(10 citation statements)

References 17 publications

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“…17 The first patient (a 31-year-old man with a BMI of 26.6 kg/m 2 ) showed a post-treatment decrease in AHI from 46 to 5.7 episodes per hour. 17 The second patient (a 32-year-old man with a BMI of 27.2 kg/m 2 ) showed a decrease in AHI from 57 to 4.7 episodes per hour. 17 Both patients had improvement in snoring and daytime somnolence.…”

Section: Nasopharyngeal Obturatorsmentioning

confidence: 96%

“…16,17 This article aimed to systematically review outcomes in adult OSA patients who are treated with nasopharyngeal airway stenting devices (i.e. nasal trumpets and modified mandibular advancement devices).…”

Section: Introductionmentioning

confidence: 99%

“…Nasopharyngeal obturators, which are modified mandibular advancement devices, have also been utilised to move the soft palate forward and stent open the nasopharyngeal airway 16 , 17 …”

Section: Introductionmentioning

confidence: 99%

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Nasopharyngeal airway stenting devices for obstructive sleep apnoea: A systematic review and meta-analysis

et al. 2014

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Objective: To systematically review outcomes of adults with obstructive sleep apnoea treated with nasopharyngeal airway stenting devices.Methods: Medline, Scopus, Web of Science and the Cochrane Library databases were searched, and data on device use and tolerability, sleepiness, oxygen saturation, apnoea index, apnoea-hypopnoea index, and sleep quality were collected.Results: Of 573 potential studies, 29 were retrieved for detailed evaluation and 16 met the study criteria. Polysomnography data for patients treated with nasal trumpets as an isolated therapy were pooled for metaanalysis. The mean apnoea index ± standard deviation, for 53 patients, decreased from 32.4 ± 15.9 to 9.0 ± 7.2 episodes per hour ( p < 0.00001). The mean apnoea-hypopnoea index, for 193 patients, decreased from 44.1 ± 18.9 to 22.7 ± 19.3 episodes per hour ( p < 0.00001). The mean lowest oxygen saturation, for 193 patients, increased from 66.5 ± 14.2 to 75.5 ± 13.9 per cent ( p < 0.00001).Conclusion: Some studies have demonstrated limited effectiveness and low tolerability of nasopharyngeal airway stenting devices, while other studies have shown a significant benefit in treating obstructive sleep apnoea, with a high level of patient acceptance. Nasal trumpets have been successful in decreasing airway obstruction in the short term.

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Section: Nasopharyngeal Obturatorsmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

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Nasopharyngeal airway stenting devices for obstructive sleep apnoea: A systematic review and meta-analysis

et al. 2014

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“…According to Haavisto et al [22], hemorrhages can occur postoperatively in up to 14% of the patients. Stenoses in the nasopharyngeal region are described as complications to be feared after UPPP [23]. In our series, stenoses did not occur in any of the patients treated by means of our modified UPPP technique with preservation of the mucosal fold between uvula and the upper pole of the tonsils.…”

Section: Discussionmentioning

confidence: 45%

Long-term results and complications following uvulopalatopharyngoplasty in 116 consecutive patients

Röösli

Schneider

Häusler

2006

Eur Arch Otorhinolaryngol

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A modified uvulopalatopharyngoplasty (UPPP) was carried out between January 1992 and December 2003 at the ENT Department of the Inselspital in Bern in 146 patients with habitual or complicated rhonchopathy. The operation consisted of a classical tonsillectomy or residual tonsil resection and additional shortening of the uvula. The natural mucosal fold between the uvula and the upper pole of the tonsils was carefully preserved. A wide opening to the rhinopharynx was created by asymmetric suturing of the glossopalantine and pharyngopalatine arches. A retrospective questionnaire with regard to rhonchopathy, phases of apnea, daytime drowsiness, obstruction of nasal breathing, long-term complications and patient satisfaction was used to evaluate the short-term and longterm effectiveness of the modified UPPP as well as the incidence of adverse side effects. Complete postoperative courses were evaluated in 116 patients. Surgical complications were restricted to one case with postoperative hemorrhage. A velum insufficiency or postoperative rhinopharyngeal stenosis did not occur. Eighty-three patients (72%) confirmed a persistent suppression or substantial improvement of the rhonchopathy. Disappearance or decrease of sleep apnea was confirmed in 12 (63%) out of 19 postoperative polysomnographic follow-up investigations. Long-term complications occurred in a total of 27 (23%) of 116 patients. They were confined to minor problems such as dryness of the mouth (n = 12), slight difficulty in swallowing (n = 7), discrete speech disturbances (n = 1), and slight pharyngeal dysesthesias (n = 7) with feeling of a lump in the throat and compulsive clearing of the throat. Eightyfive patients (73%) reported that they were satisfied with the postoperative result even several years after the operation. Looking back, 31 patients (27%) would no longer have the operation performed. The inadequate result of the rhonchopathy was specified as the reason by 21 patients. Ten patients had unpleasant memories of the operation because of intensive postoperative pain. Snoring and apneic phases are suppressed or improved by non-traumatic UPPP in the majority of patients. This effect persisted even years after the operation.

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“…They considered that olfactory loss after UPPP seemed hard to explain by air flow changes only. Nasopharyngeal stenosis is a rare complication of UPPP [ 15 ]. It might change air flow through choanae and impair olfactory function, but nasopharyngeal stenosis was not observed in both of our cases by nasal endoscopy.…”

Section: Discussionmentioning

confidence: 99%

Olfactory Loss after Uvulopalatopharyngoplasty: A Report of Two Cases with Review of the Literature

Jiang

Chang

2014

Case Reports in Otolaryngology

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Uvulopalatopharyngoplasty (UPPP) has been a popular surgical method for treating obstructive sleep apnea syndrome since it was introduced in the early 1980s. Olfactory loss has been reported as a rare side effect in several cases. However, the olfactory test results and the prognosis were not mentioned in these cases. We present two patients who complained of loss of olfactory function after UPPP. Their olfactory function was evaluated by the phenyl ethyl alcohol odor detection threshold test and the University of Pennsylvania Smell Identification Test. After treatment with steroid and zinc salt, their olfactory function was improved but not recovered completely.

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Resolution of Severe Sleep-Disordered Breathing with a Nasopharyngeal Obturator in 2 Cases of Nasopharyngeal Stenosis Complicating Uvulopalatopharyngoplasty

Cited by 8 publications

References 17 publications

Nasopharyngeal airway stenting devices for obstructive sleep apnoea: A systematic review and meta-analysis

Nasopharyngeal airway stenting devices for obstructive sleep apnoea: A systematic review and meta-analysis

Long-term results and complications following uvulopalatopharyngoplasty in 116 consecutive patients

Olfactory Loss after Uvulopalatopharyngoplasty: A Report of Two Cases with Review of the Literature

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