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Drug-induced acute upper airway obstruction
Published in Philippe Camus, Edward C Rosenow, Drug-induced and Iatrogenic Respiratory Disease, 2010
Michael Lippmann, Ganesan Murali
Patients with OSA have a structurally smaller pharyngeal airway than non-apnoeic patients. The genioglossus is of great importance in the pathophysiology of sleep apnoea as it contracts during inspiration and increased phasic activity of the genioglossus is seen during the awake state in patients with OSA. The phasic activity of genioglossus and tensor veli palatini decreases with sleep onset. Sleep deprivation and use of alcohol, sedatives and anaesthetic agents such as propofol also reduce the activity of the genioglossus.75–79 The loss of genioglossus muscle activity is associated with a decrease in airway patency and collapse of the pharyngeal airway. Hypoglossal nerve stimulation contracts the genioglossus and has been studied for maintaining upper airway patency in OSA.80 Continuous positive airway pressure (CPAP) acts as a pneumatic splint of the upper airway and is used for the management of OSA.
A computational model of upper airway respiratory function with muscular coupling
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2022
Olusegun J. Ilegbusi, Don Nadun S. Kuruppumullage, Matthew Schiefer, Kingman P. Strohl
The basic issues are the degree to which muscle activation vs. mechanical properties contribute to the disorder. Previous studies have shown that upper airway dilator muscle activation, particularly the genioglossus, will maintain upper airway patency during sleep (Fogel et al. 2004). The genioglossus is an extrinsic muscle of the tongue located at the tongue base. This pathway has been exploited to treat OSA. Unilateral hypoglossal nerve stimulation producing a protrusion force on the tongue is a treatment technique for OSA (Strollo et al. 2014). This empiric demonstration underscores how little we know about the relative contribution of muscle activation to airway patency.