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The Surgical Management of Snoring and Obstructive Sleep Apnoea
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Bhik Kotecha, Mohamed Reda Elbadawey
A number of procedures were described in the literature aimed at dilating the hypopharynageal airway, including genioglossus advancement, tongue base suspension suture, hyoid suspension, maxillomandibular advancement and laser midline glossectomy. Most of the reports describing these procedures are pilot studies with no standardized comparison of other techniques used in the treatment of OSA. The reported success rate of some of these procedures approaches 60% in the short term. These procedures are associated with relatively high complication rates, such as swallowing problems, taste change, tongue oedema, tooth numbness and mandibular fractures. The midline laser glossectomy was associated with a high incidence of post-operative bleeding.117
Advanced Surgical Treatment of Obstructive Sleep Apnea Syndrome in the Pediatric Patient
Published in Mark A. Richardson, Norman R. Friedman, Clinician’s Guide to Pediatric Sleep Disorders, 2016
Jerome E. Hester, Nelson B. Powell, Robert R. Riley
Typically, the initial treatment is performed in the operating room. This may be performed in conjunction with palatal surgery, or even as an adjunct to the genioglossus advancement. The patient is admitted overnight for oxygen saturation monitoring. Subsequent treatments may be done in the office under local anesthetic, although once again patient compliance in the pediatric age group may limit this, thus necessitating use of intravenous sedation in the operating room.
Obstructive sleep apnea: personalizing CPAP alternative therapies to individual physiology
Published in Expert Review of Respiratory Medicine, 2022
Brandon Nokes, Jessica Cooper, Michelle Cao
Skeletal surgery includes 1) hyoid advancement 2) genioplasty/genioglossus advancement 3) maxillary expansion 4) maxillomandibular advancement 5) mandibular distraction and 6) maxillomandibular expansion. The two most common are maxillomandibular advancement (MMA) and genioglossus advancement (GGA), which are often described as tongue base surgery [91]. Predictors of success for skeletal surgery are complete concentric collapse (CCC) and lateral pharyngeal wall collapse (LPW) on DISE, or congenital dentofacial deformity on physical exam [91]. Previously, MMA was used as a salvage surgical therapy for OSA, but now has more predictable clinical outcomes through visualizing the pattern of collapse at the velum during DISE [91]. The OSA cure rate for MMA is approximately 38%, but again can be optimized through careful patient selection [92].
Comparison of radiofrequency and transoral robotic surgery in obstructive sleep apnea syndrome treatment
Published in Acta Oto-Laryngologica, 2018
Engin Aynacı, Murat Karaman, Burak Kerşin, Mahmut Ozan Fındık
Techniques developed for surgical treatment of base of tonguehypertrophy, which can be a cause for OSAS development, include genioglossus advancement, tongue root radiofrequency ablation and hyoid suspension. The traditional method of transoral approach to the base of tongue includes endoscope or a surgical microscope as equipment. But in these techniques, the view of the surgical field is limited so the depth perception impairs. Cervical methods are also described for the access to the base of tongue with performing pharyngotomy for which the morbidity expected to be seriously high [9].
Z-palatopharyngoplasty combined with 70-degree endoscopy-assisted coblator partial medial glossectomy on severe obstructive sleep apnea
Published in Acta Oto-Laryngologica, 2019
Huaihong Chen, Jiangping Wang, Xiaoxing Huang, Yuanshou Huang, Juan Lu, Xiangping Li
Handler summarized 12 studies of OSA patients with UPPP plus hyoid suspension or genioglossus advancement, these studies achieved an overall effectiveness of 61.1% [13]. This demonstrated that the effectiveness of multi-level surgery was significantly higher than classic UPPP. For patients with OSA who underwent UPPP combined with partial midline glossectomy, the 5-year long-term surgical effectiveness rate was 73.53% [15].