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Tzironi G, Zubizarreta-Macho Á, Brunsó-Casellas J, Cabriada-Nuño V, Lobo Galindo AB, Albaladejo Martínez A, De Carlos-Villafranca F. Nasal and maxillary sinus volume change in patients with obstructive sleep apnea after bimaxillary advancement surgery. BMC Oral Health 2023; 23:879. [PMID: 37978478 PMCID: PMC10656828 DOI: 10.1186/s12903-023-03657-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 11/11/2023] [Indexed: 11/19/2023] Open
Abstract
The airway complex is modified by bimaxillary advancement surgery performed in patients suffering from obstructive sleep apnea (OSA). The aim of the present study is to analyse the volume of nasal and maxillary sinus after bimaxillary advancement surgery in patients suffering from OSA. The maxillary sinus and nasal complex of eighteen patients with OSA was measured through cone-beam computed tomography (CBCT) before and after they were treated with bimaxillary advancement surgery. Digital planning software was used to effectively measure the upper volume changes, as well as, statistical analysis of the results was performed.Methods Eighteen patients were diagnosed with OSA the severity of which was measured by the apnea hypopnea index and were selected and submitted to preoperative and postoperative CBCT scans. Afterwards, datasets were uploaded into therapeutic digital planning software (Dolphin Imaging) to measure the volume of the right and left maxillary sinus and nasal and maxillary sinus complex. Statistically analysis between preoperative and postoperative measures was performed by Student t-test statistical analysis.Results The paired t-test showed statistically significant volumetric reductions in the left maxillary sinus (p = 0.0004), right maxillary sinus (p < 0.0001) and nasal and maxillary sinus complex (p = 0.0009) after bimaxillary advancement surgery performed in patients suffering from OSA.Conclusion The results showed that bimaxillary advancement surgery reduces the maxillary sinus volume as well as, the fossa nasal and sinus complex volume.
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Affiliation(s)
- Georgia Tzironi
- Department of Surgery, Faculty of Medicine, University of Salamanca, 37008, Salamanca, Spain
| | - Álvaro Zubizarreta-Macho
- Department of Surgery, Faculty of Medicine, University of Salamanca, 37008, Salamanca, Spain.
- Department of Endodontics, Faculty of Health Sciences, Alfonso X El Sabio University, 28691, Madrid, Spain.
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, Avda. Universidad, 1. 28691. Villanueva de La Cañada, Madrid, Spain.
| | | | - Valentín Cabriada-Nuño
- Sleep and Ventilation Unit, Respiratory Division, Cruces University Hospital, Barakaldo, Spain
| | - Ana Belén Lobo Galindo
- Department of Surgery, Faculty of Medicine, University of Salamanca, 37008, Salamanca, Spain
| | | | - Félix De Carlos-Villafranca
- Department of Surgery and Medical-Surgical Specialties, Area of Orthodontics, Faculty of Medicine, University of Oviedo, Oviedo, Spain
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Herman H, Stern J, Alessi DM, Swartz KA, Gillespie MB. Office‐Based Multilevel Radiofrequency Ablation for Mild‐to‐Moderate Obstructive Sleep Apnea. OTO Open 2023; 7:e19. [PMID: 36998558 PMCID: PMC10046721 DOI: 10.1002/oto2.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/29/2022] [Accepted: 12/02/2022] [Indexed: 02/19/2023] Open
Abstract
Objective Investigate multilevel radiofrequency ablation (RFA) as an alternative therapy for patients with mild-to-moderate obstructive sleep apnea (OSA). Study Design Prospective, open-label, single-arm, nonrandomized clinical trial. Setting Multicenter academic and private clinics. Methods Patients with mild-to-moderate OSA (apnea-hypopnea index [AHI] 10-30; body mass index ≤ 32) were treated with 3 sessions of office-based RFA to the soft palate and tongue base. The primary outcome was a change in the AHI and oxygen desaturation index (ODI 4%). Secondary outcomes included subjective sleepiness level; snoring level; and sleep-related quality of life. Results Fifty-six patients were enrolled, with 43 (77%) completing the study protocol. Following 3 sessions of office-based RFA to the palate and base of the tongue, the mean AHI decreased from 19.7 to 9.9 (p = .001), while the mean ODI (4%) decreased from 12.8 to 8.4 (p = .005). Mean Epworth Sleepiness Scale scores declined from 11.2 (±5.4) to 6.0 (±3.5) (p = .001), while Functional Outcomes of Sleep Questionnaire scores improved from a mean of 14.9 at baseline to 17.4 (p = .001). The mean visual analog scale snoring scale was reduced from 5.3 (±1.4) at baseline to 3.4 (±1.6) at 6 months posttherapy (p = .001). Conclusion Office-based, multilevel RFA of the soft palate and base of the tongue is a safe and effective treatment option with minimal morbidity for properly selected patients with mild-to-moderate OSA who are intolerant or refuse continuous positive airway pressure therapy.
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Affiliation(s)
| | | | | | | | - Marion Boyd Gillespie
- Department of Otolaryngology‐Head and Neck Surgery University of Tennessee Health Science Center (UTHSC) Memphis Tennessee USA
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Rossi C, Templier L, Miguez M, De La Cruz J, Curto A, Albaladejo A, Lagravère Vich M. Comparison of screening methods for obstructive sleep apnea in the context of dental clinics: A systematic review. Cranio 2020; 41:245-263. [PMID: 32981480 DOI: 10.1080/08869634.2020.1823104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To review the available bibliographic data to identify the best screening methods to detect potential obstructive sleep apnea (OSA) patients during dental clinical practice. METHODS Relevant studies published up to April 2020 were sourced from PubMed, Embase, MEDLINE, Cochrane, and LILACS databases. RESULTS Thirty studies were selected. For adults, the screening methods available to the dentist included questionnaires, scales, indexes, pulse oximetry, and anatomical factors. A combination of questionnaires is potentially the most reliable method to detect OSA risk. For children, only information on questionnaires and anatomical factors was found; two questionnaires accurately identified potential OSA risk cases. Anatomical factors also displayed a significant relation with OSA for both populations. CONCLUSION Dentists have a fundamental role in early detection of potential OSA cases since they can use the methods identified in this review to perform an initial screening of the population. ABBREVIATIONS OSA: Obstructive sleep apnea; PSG: Polysomnography; HST: Home sleep study; BMI: Body mass index; PPV: Positive predictive value; NPV: Negative predictive value; AHI: Apnea hypopnea index; RDI: Respiratory disturbance index; ODI: Oxygen desaturation index; PSQ: Pediatric Sleep Questionnaire; SRBD: Sleep-related breathing disorder; CSHQ: Children's Sleep Habits Questionnaire; ESS: Epworth Sleepiness Scale; PSQI: Pittsburgh Sleep Quality Index.
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Affiliation(s)
- Cecilia Rossi
- Department of Orthodontics, University of Alfonso X El Sabio, Madrid, Spain
- PhD Student of Faculty of Medicine, University of Salamanca, Salamanca, Spain
| | - Laura Templier
- Department of Orthodontics, University of Alfonso X El Sabio, Madrid, Spain
- PhD Student of Faculty of Medicine, University of Salamanca, Salamanca, Spain
| | - Manuel Miguez
- Dental Sleep Medicine Program, Catholic University of Murcia UCAM, Murcia, Spain
| | - Javier De La Cruz
- Department of Orthodontics, University of Alfonso X El Sabio, Madrid, Spain
| | - Adrián Curto
- Department of Pediatric Dentistry, Faculty of Medicine, University of Salamanca, Salamanca, Spain
| | - Alberto Albaladejo
- Orthodontics, Faculty of Medicine, University of Salamanca, Salamanca, Spain
| | - Manuel Lagravère Vich
- Division of Orthodontics, School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Alberta, Canada
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Sun J, Li X, Guo J, Han F, Zhang H. Identification of obstructive sleep apnea syndrome by ambulatory electrocardiography: clinical evaluation of time-domain and frequency-domain analyses of heart rate variability in Chinese patients. Cell Biochem Biophys 2011; 59:165-70. [PMID: 20960073 DOI: 10.1007/s12013-010-9128-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The application of ambulatory electrocardiography to identify obstructive sleep apnea syndrome (OSAS) patients was evaluated using time-domain and frequency-domain analyses of heart rate variability (HRV). For this, overnight sleep pattern was investigated in 95 individuals (48 OSAS(+) patients and 47 OSAS(-) controls) by polysomnography and 24-h ambulatory electrocardiography. Apnea scores were calculated using two different HRV analyses. Average age and body mass index, and percentages of men and of patients with history of hypertension and/or diabetes were higher in study group as compared with control group. PNN50(night), SDNNI(day-night) and SDNNI(day-night) in time-domain analysis were more sensitive than other indices. In frequency-domain analysis, mean night-time total power, night-time VLF power, night-time LF power, and the difference between these measures in day and night were significantly higher in study group. LF/HF ratio was also significantly higher in study group in day-time or night-time with a significant difference (P < 0.05) between day and night. At sleep apnea risk score >4, sensitivity, specificity, and positive predictive value were, respectively, 81.25, 46.81, and 64.21%. At sleep apnea risk scores >5, 6, or 7, the specificity increased, while the sensitivity and positive predictive value decreased. In conclusion, time-domain and frequency-domain HRV analyses are useful methods for OSAS screening, and the frequency-domain analysis is more sensitive.
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Affiliation(s)
- Jianling Sun
- Department of Cardiology, Aviation Industry Central Hospital, An Ding Men Wai Bei Yuan Road 3, Beijing, 100012, China.
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Can M, Açikgöz Ş, Mungan G, Bayraktaroğlu T, Koçak E, Güven B, Demirtas S. Serum cardiovascular risk factors in obstructive sleep apnea. Chest 2006; 129:233-237. [PMID: 16478836 DOI: 10.1378/chest.129.2.233] [Citation(s) in RCA: 98] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Obstructive sleep apnea (OSA) patients have increased cardiovascular morbidity and mortality. The cardiovascular markers associated with OSA are currently not defined. OBJECTIVES The aims of this study were to determine whether OSA is associated with serum cardiac risk markers and to investigate the relationship between them. METHODS Sixty-two male patients were classified into two groups with respect to apnea-hypopnea index (AHI): group 1, sleep apnea (n = 30), with AHI > 5; and group 2 (n = 32), with AHI < 5. We compared cardiovascular risk factors in both groups with control subjects (n = 30) without OSA (AHI < 1). Serum cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A-I, apolipoprotein B, lipoprotein (a), C-reactive protein (CRP), and homocysteine were measured. Statistical significance was assessed with analysis of variance at p < 0.05. In correlation analysis, Pearson correlation was used. RESULTS There was no significant difference between group 1 and group 2 in total cholesterol, LDL-C, HDL-C, triglyceride, apolipoprotein A-I, apolipoprotein B, and lipoprotein (a). All of the M-mode echocardiographic parameters were in the normal reference range. Serum homocysteine and CRP levels were significantly increased in group 1 compared to group 2 (p < 0.05). Serum CRP values were increased in both group 1 and group 2 when compared with control subjects (p < 0.05). Serum homocysteine values were higher in group 1 than in control subjects (p < 0.05). CONCLUSIONS Our results show that OSA syndrome is associated not only with slight hyperhomocysteinemia but also with increased CRP concentrations. Increased plasma concentrations of homocysteine and CRP can be useful in clinical practice to be predictor of long-term prognosis for cardiovascular disease and the treatment of OSA.
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Affiliation(s)
- Murat Can
- Faculty Of Medicine, Department Of Biochemistry, Department Of Internal Medicine, Karaelmas University, Zonguldak.
| | - Şerefden Açikgöz
- Faculty Of Medicine, Department Of Biochemistry, Department Of Internal Medicine, Karaelmas University, Zonguldak
| | - Görkem Mungan
- Faculty Of Medicine, Department Of Biochemistry, Department Of Internal Medicine, Karaelmas University, Zonguldak
| | - Taner Bayraktaroğlu
- Faculty Of Medicine, Department Of Biochemistry, Department Of Internal Medicine, Karaelmas University, Zonguldak
| | - Erdem Koçak
- Faculty Of Medicine, Department Of Biochemistry, Department Of Internal Medicine, Karaelmas University, Zonguldak
| | - Berrak Güven
- Faculty Of Medicine, Department Of Biochemistry, Department Of Internal Medicine, Karaelmas University, Zonguldak
| | - Selda Demirtas
- Faculty Of Medicine, Department Of Biochemistry, Ufuk University, Ankara, Turkey
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