Theoretical approach towards increasing effectiveness of palatal surgery in obstructive sleep apnea: role for concomitant positional therapy?
| Autor: | J. P. van Maanen, N. de Vries, Birgit I. Witte |
|---|---|
| Přispěvatelé: | Epidemiology and Data Science, Other Research |
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Neurology medicine.medical_treatment Polysomnography Treatment outcome Patient Positioning stomatognathic system Tongue Medicine Humans In patient Aged Retrospective Studies Sleep Apnea Obstructive business.industry Uvulopalatopharyngoplasty Signal Processing Computer-Assisted Middle Aged Ablation medicine.disease Combined Modality Therapy nervous system diseases respiratory tract diseases Surgery Obstructive sleep apnea Otorhinolaryngology Uvula Concomitant Pharynx Female Neurology (clinical) Palate Soft business Follow-Up Studies |
| Zdroj: | Sleep and breathing, 18(2), 341-349. Springer Verlag van Maanen, J P, Witte, B I & de Vries, N 2014, ' Theoretical approach towards increasing effectiveness of palatal surgery in obstructive sleep apnea: role for concomitant positional therapy? ', Sleep and breathing, vol. 18, no. 2, pp. 341-349 . https://doi.org/10.1007/s11325-013-0891-7 |
| ISSN: | 1520-9512 |
| Popis: | The aims of this study are to evaluate the effect of palatal surgery (uvulopalatopharyngoplasty (UPPP) or Z-palatoplasty (ZPP)) with or without (+/-) concomitant radiofrequent ablation of the base of the tongue (RFTB) on body position-specific apnea-hypopnea index (AHI) values in patients with obstructive sleep apnea (OSA) and to compare this treatment outcome to the theoretical effect of (addition of) positional therapy (PT).Retrospective analysis of pre- and posttreatment polysomnographies in 139 patients who had undergone UPPP/ZPP +/- RFTB was performed. Hypothetical evaluation of the effects of (addition of) ideal PT on AHI in positional OSA (POSA) patients was carried out.Median AHI significantly decreased from 18.0 to 11.2 (p 0.001). Median AHI in all separate positions decreased significantly as well. Sixty-eight patients suffered from POSA and showed a significant decrease in median AHI from 15.5 to 11.5 (p = 0.002). In the 71 non-positional OSA (NPOSA) patients, the significant AHI decrease was more outspoken, from 23.0 to 11.0 (p 0.001). Our hypothetical model to treat POSA patients with an ideal PT (as monotherapy or in addition to surgery) resulted in a significant median AHI decrease from 18.0 to 4.5 (p 0.0001).UPPP/ZPP +/- RFTB significantly reduces AHI and all body position-specific AHI values. This reduction is significantly higher in NPOSA than in POSA patients. When considering UPPP/ZPP +/- RFTB, the effect of body position needs to be taken into account. PT, either as monotherapy or in addition to surgery, theoretically has shown to improve treatment results dramatically in POSA patients. Prospective, controlled trials focusing on the effects of this combination of treatments should further evaluate this hypothetical conclusion. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink