Non-CPAP therapies in obstructive sleep apnoea
| Autor: | Bernd Sanner, Winfried Randerath, Evert Hamans, Joachim T. Maurer, Jean-Louis Pépin, Ingo Fietze, S. Andreas, An Boudewyns, Marie Marklund, Georges Bettega, J R Paoli, Thomas Verse, F Jalbert, L Lacassagne, Ian Smith, Johan Verbraecken, A Valipour, Boris A. Stuck |
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| Přispěvatelé: | European Respiratory Society Task Force |
| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Adolescent medicine.medical_treatment Osteogenesis Distraction Nose Severity of Illness Index Young Adult Tongue stomatognathic system medicine Humans Continuous positive airway pressure Child Aged Hyoid suspension Aged 80 and over Salvage Therapy Sleep Apnea Obstructive Continuous Positive Airway Pressure Palate business.industry Uvulopalatopharyngoplasty Hyoid Bone Midline glossectomy Sleep apnea Middle Aged Genioglossus advancement medicine.disease nervous system diseases respiratory tract diseases Surgery medicine.anatomical_structure Child Preschool Anesthesia Pharynx Distraction osteogenesis Female Human medicine business Mandibular Advancement |
| Zdroj: | The European respiratory journal |
| ISSN: | 1399-3003 0903-1936 |
| DOI: | 10.1183/09031936.00099710 |
| Popis: | In view of the high prevalence and the relevant impairment of patients with obstructive sleep apnoea syndrome (OSAS) lots of methods are offered which promise definitive cures for or relevant improvement of OSAS. This report summarises the efficacy of alternative treatment options in OSAS. An interdisciplinary European Respiratory Society task force evaluated the scientific literature according to the standards of evidence-based medicine. Evidence supports the use of mandibular advancement devices in mild to moderate OSAS. Maxillomandibular osteotomy seems to be as efficient as continuous positive airway pressure (CPAP) in patients who refuse conservative treatment. Distraction osteogenesis is usefully applied in congenital micrognathia or midface hypoplasia. There is a trend towards improvment after weight reduction. Positional therapy is clearly inferior to CPAP and long-term compliance is poor. Drugs, nasal dilators and apnoea triggered muscle stimulation cannot be recommended as effective treatments of OSAS at the moment. Nasal surgery, radiofrequency tonsil reduction, tongue base surgery, uvulopalatal flap, laser midline glossectomy, tongue suspension and genioglossus advancement cannot be recommended as single interventions. Uvulopalatopharyngoplasty, pillar implants and hyoid suspension should only be considered in selected patients and potential benefits should be weighed against the risk of long-term side-effects. Multilevel surgery is only a salvage procedure for OSA patients. |
| Databáze: | OpenAIRE |
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