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Query: UMLS:C0037315 (sleep apnea)
 8,000 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aim of the study was to evaluate if RME (Rapid Maxillary Expansion) therapy could improve both the patency of the nasal airways and the Obstructive Sleep Apnoea Syndrome (OSAS). 42 children with a case history of oral breathing, snoring and night time apnoeas were studied. Selection criteria were: no adenotonsillar hypertrophy, Body Mass Index (BMI) below 24 and a malocclusion characterised by a narrow upper jaw, determined by postero-anterior cephalometric evaluation. Patients underwent an ENT visit with auditory and respiratory tests including daytime a sleepiness questionnaire, a 19-channel polysomnography, and an orthognatodontic examination; finally the patient underwent X-rays investigations. All the investigations were carried out before orthodontic therapy (T0), after one month (T1) with the device still on, and 4 months after the end of the orthodontic treatment which lasted for about 6-12 months (T2). All the changes induced by RME on the upper jaw and nasal septum were analysed by postero-anterior cephalometric evaluation in T0, T1 and T2. In all treated cases, the authors obtained an opening of the midpalatal suture; this was confirmed both by intraoral occlusal X-rays and postero-anterior cephalograms. The results reported by the 42 patients studied show that the R.M.E. therapy widens the nasal fossa and releases the septum thus restoring a normal nasal airflow with disappearance of obstructive sleep disordered breathing. Changing the anatomic structure, RME brought a significant functional improvement. Therefore the orthodontist can play an important role in the interdisciplinary treatment of OSAS patients.
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PMID:Obstructive Sleep Apnoea Syndrome (OSAS) and rhino-tubaric disfunction in children: therapeutic effects of RME therapy. 1589 84

Tonsillectomy and adenoidectomy are probably the commonest surgeries performed in the ENT field as well as the most controversial ones. There are very few consensus documents available for these two surgeries. In 1997 a document written by the two mentioned Societies was published, in order to update such document regarding tonsillectomy and adenoidectomy procedures we have met this year representatives from both scientific societies and a new document has been elaborated. We describe the diagnostic criteria of pharyngo-tonsillitis and adenoiditis as well as of obstructive sleep apnoea syndrome, with the aim of a better comprehension of these processes when a decision needs to be made regarding surgery. Indications and contraindications of tonsillectomy and adenoidectomy are here described.
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PMID:[Indications for tonsillectomy and adenoidectomy: consensus document by the Spanish Society of ORL and the Spanish Society of Pediatrics]. 1655 Aug 58

Role of Helicobacter Pylori and nasopharyngeal bacteries in the pathogenesis of otitis media. Interest of Tonsillectomy in MRSA positive patients. Sleep apnea syndrome increases sudden death during night. Prevalence of Acoustic Neuroma, and surgical difficulties in case of conservative treatment failures. Role of CRP in the sinus treatment's decision. Is sinusitis influenced by anatomical factors? Do we have to treat with antibiotics? Role of mycosis? Are the sprays for snorers efficient? Is the facial nerve now radiologically visible? Are systematic punctures of thyroid nodules mandatory and with what frequency? Cetuximab is a promessing treatment in ENT.
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PMID:[Questions in Ent]. 1661 28

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 long-term 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. Eighty-five 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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PMID:Long-term results and complications following uvulopalatopharyngoplasty in 116 consecutive patients. 1671 2

Tonsillectomy in children is performed on a regular basis in ENT. The indications are chronic tonsillitis, sleep apnea to deeper structures. The natural history of tonsillar hyperplasia is regression when a child is six years beyond. In children with bilateral tonsillar hyperplasia we studied the use of laser as an alternative procedure to reduce the bulk of the tonsillar mass. Children with symptoms of bilateral tonsillar hyperplasia underwent laser tonsillotomy. The tonsils were dissected using carbon dioxide (CO2) laser. The tonsillar bed was left untouched. Intraoperative and postoperative conditions were noted.
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PMID:Laser tonsillotomy in children with tonsillar hyperplasia. 1724 May 97

Primary snoring is mainly the bed partner's problem and not that of the snorer. The request for treatment arises from how annoying the snoring is and how sensitive the bed partner is to noise. In addition to a thorough medical history and an ENT examination, a polysomnography should be always performed to differentiate between primary snoring, upper airway resistance and obstructive sleep apnoea syndromes. Primarily weight loss and avoidance of alcohol in the evening as well as devices and surgery are used in the treatment of snoring.
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PMID:[Snoring: therapeutic options]. 1798 43

Adenoidectomy is a common ENT procedure performed in hospitals in Malaysia. Adenoidectomy is indicated in patients with recurrent adenoiditis, nasal obstruction or sleep apnoea secondary to adenoid hypertrophy when conservative management has failed. Over the years, there are advances in the techniques of adenoidectomy, from the conventional transoral to endoscopic transnasal/transoral adenoidectomy. The purpose of this article is to describe the technique and emphasize the advantages of this procedure to that of the conventional technique.
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PMID:Transoral endoscopic adenoidectomy: initial experience. 1893 47

This 2008 selection of a few ENT publications is voluntary directed to the general practitionner. In otology, the interest of tympanic drainage is presented, as well as the presence of biofilms in chronic otitis media. Several publications on various treatments of tinnitus are presented, including acupuncture. Large meta-analysis of rhinosinusitis evaluation and treatment are also presented, and an original paper on efficacy of intranasal botox in allergy. Interesting studies evaluating quality of life after tonsillectomy are also presented in adults and infants, analysing not only sleep apnea syndrome and recurrent infections, but also in upper airway resistance syndrome. An interesting study showing a possible link between laryngeal cancer and helicobacter is also presented.
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PMID:[ORL news in 2008]. 1926 56

During 2008, ENT-UK received a number of professional enquiries from colleagues about the management of children with upper airway obstruction and uncomplicated obstructive sleep apnoea (OSA). These children with sleep-related breathing disorders (SRBDs) are usually referred to paediatricians and ENT surgeons. In some district general hospitals, (DGHs) where paediatric intensive care (PICU) facilities to ventilate children were not available, paediatrician and anaesthetist colleagues were expressing concern about children with a clinical diagnosis of OSA having routine tonsillectomy, with or without adenoidectomy. As BAPO President, I was asked by the ENT-UK President, Professor Richard Ramsden, to investigate the issues and rapidly develop a working consensus statement to support safe but local treatment of these children. The Royal Colleges of Anaesthetists and Paediatrics and Child Health and the Association of Paediatric Anaesthetists nominated expert members from both secondary and tertiary care to contribute and develop a consensus statement based on the limited evidence base available. Our terms of reference were to produce a statement that was brief, with a limited number of references, to inform decision-making at the present time. With patient safety as the first priority, the working party wished to support practice that facilitated referral to a tertiary centre of those children who could be expected, on clinical assessment alone, potentially to require PICU facilities. In contrast, the majority of children who could be safely managed in a secondary care setting should be managed closer to home in a DGH. BAPO, ENT-UK, APA, RCS-CSF and RCoA have endorsed the consensus statement; the RCPCH has no mechanism for endorsing consensus statements, but the RCPCH Clinical Effectiveness Committee reviewed the statement, concluding it was a 'concise, accurate and helpful document'. The consensus statement is an interim working tool, based on level-five evidence. It is intended as the starting point to catalyze further development towards a fully structured, evidence-based guideline; to this end, feedback and comment are welcomed. This and the constructive feedback from APA and RCPCH will be incorporated into a future guideline proposal.
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PMID:Tonsillectomy and adenoidectomy in children with sleep-related breathing disorders: consensus statement of a UK multidisciplinary working party. 1962 57

Obstructive sleep apnoea syndrome in a child is characterized by prolonged episodes of obstructive hypopnoea and/or apnoea of upper airway leading to morbidity. The most common risk factor is adeno-tonsillar hypertrophy. Obstructive sleep apnoea syndrome diagnosis is based on clinical ENT evaluation and an instrumental approach, such as pulse oximetry or the gold standard overnight polysomnography. The aim is to establish, in a population of children with suspected obstructive sleep apnoea syndrome, the frequency of this disorder, the effect of adenotonsillectomy and the risk of post-operative complications. A total of 481 patients (297 male, 184 female) with suspected obstructive sleep apnoea syndrome (aged 2-14 years) were evaluated between March 2007 and April 2010 and divided into 3 morphological phenotypes: classic, adult and congenital. All patients underwent ENT assessment and a pulse oximetry with 4 channels cardiopulmonary monitoring. The examination following the Brouillette criteria was defined as negative, positive or inconclusive; when positive, adenotonsillectomy was the first therapeutic approach. At 6 months after surgery, all patients underwent check-up pulse oximetry. Of the overall sample, 96% of the patients had a classical phenotype, 3% an adult type and 1% a congenital type. The monitoring resulted pathological in 19% (17% of them were at increased post-operative risk), negative in 61% and inconclusive in 20%. All 5 patients with congenital phenotype were positive. Of the positive patients, 86% underwent adenotonsillectomy and a control pulse oximetry 6 months thereafter, 96% resulted negative. Pulse oximetry was efficient in order to avoid incorrect surgery indications, improving appropriateness and safety of adenotonsillectomy in children with obstructive sleep apnoea syndrome. Adenotonsillectomy showed a success rate of 96% and there were no episodes of post-surgery complications in particular in those patients at increased risk.
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PMID:Diagnostic and therapeutic iter in paediatric OSAS: personal experience. 2205 92


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