1
|
Gao J, Tan P, Liu Y, Chen S, Liu J. Association Between Sleep Apnea and Tinnitus: A Meta-Analysis. EAR, NOSE & THROAT JOURNAL 2024:1455613241226853. [PMID: 38321723 DOI: 10.1177/01455613241226853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024] Open
Abstract
Objective: It remains unclear whether sleep apnea (SA) is associated with tinnitus in adults. Based on a systematic review and meta-analysis of observational studies, we investigated the association between SA and tinnitus in adult population. Methods: Observational studies relevant to our research were identified by searching PubMed, Embase, Web of Science, Wanfang, and China National Knowledge Infrastructure databases. Random-effects models were used when significant heterogeneity was observed; otherwise, fixed-effects models were used. Results: Eight case-control or cross-sectional studies, including 132,292 adults were included, and 1556 of them had SA. It was shown that SA was related to a higher prevalence of tinnitus (odds ratio [OR]: 1.65, 95% confidence interval: 1.14-2.39, P < .001) with moderate heterogeneity (P for Cochrane Q test = 0.04, I2 = 53%). Seven studies reported the association between obstructive SA and tinnitus, while the other one study reported the association between overall SA and tinnitus. Subgroup analyses showed that the association was not significant for mild (OR: 1.80, P = .17) or moderate (OR: 1.25, P = .53), but significant for severe SA (OR: 2.25, P = .008). In addition, the association between SA and tinnitus seemed to be stronger in studies from Italy or United States as compared to those from China (OR: 2.91 vs 1.35, P for subgroup difference = .02). The association was not significantly affected by study design, mean age, proportion of men, methods for diagnosis of SA, and controlling of age and sex (P for subgroup difference all > .05). Conclusion: Severe SA may be related to tinnitus in adults.
Collapse
Affiliation(s)
- Jing Gao
- Health Medicine Department, The 900th Hospital of the Chinese PLA Joint Logistics Support Force, Fuzhou, Fujian Province, P.R. China
| | - Ping Tan
- Health Medicine Department, The 900th Hospital of the Chinese PLA Joint Logistics Support Force, Fuzhou, Fujian Province, P.R. China
| | - Yunliang Liu
- Department of Otolaryngology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, P.R. China
| | - Shoujian Chen
- Health Medicine Department, The 900th Hospital of the Chinese PLA Joint Logistics Support Force, Fuzhou, Fujian Province, P.R. China
| | - Jianqing Liu
- Health Medicine Department, The 900th Hospital of the Chinese PLA Joint Logistics Support Force, Fuzhou, Fujian Province, P.R. China
| |
Collapse
|
2
|
Hildebrandt J, Koehler U, Conradt R, Hildebrandt O, Cassel W, Degerli MA, Viniol C. [Sleep disorders in patients with chronic tinnitus]. Laryngorhinootologie 2024; 103:47-52. [PMID: 37473777 DOI: 10.1055/a-2105-1145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
Tinnitus has a lifetime prevalence of 25% in Germany. A common comorbidity in chronic cases are sleep disorders. The aims of this study were to detect sleep disorders and to identify possible associations with tinnitus parameters.Fifty patients with chronic tinnitus were recruited. The patients underwent audiometry, polysomnography, and completed standardised questionnaires on tinnitus and sleep behaviour.Data were available in 30 men and 9 women (age 50.2 ± 11 y, BMI 28.8 ± 4.4 kg/m²). The median duration of tinnitus was 36 (9; 120) months with a severity score of 2.00 (1.00; 3.00). The mean Tinnitus Questionnaire (TF) score was 43.6 ± 17.1, the Epworth Sleepiness Scale (ESS) score was 8.41 ± 4.27, the Pittsburgh Sleep Quality Index (PSQI) score was 9.21 ± 4.32, and the Screening Scale for Chronic Stress (SSCS) score was 58.13 ± 9.58.Sleep diagnoses included 18 cases of insomnia, 4 cases of RLS, and 11 cases of OSA. Patients with sleep comorbidities showed higher tinnitus severity, PSQI scores, and body weight compared to those without sleep disorders.Worse sleep quality was associated with higher tinnitus severity (p=0.038) and more disruptive tinnitus (p=0.03). Patients with subjectively highly disruptive tinnitus reported higher chronic stress scores. Tinnitus duration was correlated with OSA-severity (p=0.026).More than two-thirds of tinnitus patients showed sleep disorders as comorbidity. A sleep screening appears useful in cases of increased tinnitus severity. Whether CPAP therapy is helpful in reducing tinnitus symptoms could not be conclusively determined but deserves further attention.
Collapse
Affiliation(s)
- Julia Hildebrandt
- Klinik für Innere Medizin/Schlafmedizin, Philipps-Universität Marburg, Marburg, Germany
| | - Ulrich Koehler
- Klinik für Innere Medizin/Schlafmedizin, Philipps-Universität Marburg, Marburg, Germany
| | - Regina Conradt
- Klinik für Innere Medizin/Schlafmedizin, Philipps-Universität Marburg, Marburg, Germany
| | - Olaf Hildebrandt
- Klinik für Innere Medizin/Schlafmedizin, Philipps-Universität Marburg, Marburg, Germany
| | - Werner Cassel
- Klinik für Innere Medizin/Schlafmedizin, Philipps-Universität Marburg, Marburg, Germany
| | - Mikail Aykut Degerli
- Klinik für Innere Medizin/Schlafmedizin, Philipps-Universität Marburg, Marburg, Germany
| | - Christian Viniol
- Klinik für Innere Medizin/Schlafmedizin, Philipps-Universität Marburg, Marburg, Germany
| |
Collapse
|
3
|
Awad M, Abdalla I, Jara SM, Huang TC, Adams ME, Choi JS. Association of Sleep Characteristics with Tinnitus and Hearing Loss. OTO Open 2024; 8:e117. [PMID: 38420352 PMCID: PMC10900921 DOI: 10.1002/oto2.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 01/21/2024] [Indexed: 03/02/2024] Open
Abstract
Objective The impact of poor sleep on tinnitus has been mainly attributed to central processes. There is an association between sleep disorders and hearing loss, but whether hearing levels mediate the association between sleep disorders and tinnitus is unknown. This study investigates the association between sleep characteristics, tinnitus, and hearing loss. Study Design Cross-sectional. Setting National Health and Nutrition Examination Survey (NHANES). Methods Study cohort includes 9693 adults (≥20 years) from the NHANES 2005 to 2018 who completed audiometric testing and questionnaires on tinnitus and sleep characteristics. Multivariable regression analyses were performed to quantify associations between sleep characteristics, tinnitus, and hearing loss. Results In this cohort, 29% (95% confidence interval [CI]: 28%-31%) reported trouble sleeping and 9% (95% CI: 8%-10%) reported being diagnosed with sleep disorders. Negative sleep characteristics (less hours of sleep, diagnosis of a sleep disorder, trouble sleeping, or OSA symptoms) were not associated with audiometry-measured hearing loss in multivariable models adjusted for demographics and comorbidities but were significantly associated with bothersome tinnitus. This association remained significant without substantial attenuation in multivariable models additionally adjusting for hearing levels: sleeping <8 h/day (vs ≥8) (odds ratio [OR]: 1.28 [95% CI: 1.08-1.52]), trouble sleeping (OR: 1.78 [95% CI: 1.45-2.19]), diagnosis of sleep disorders (OR: 1.57 [95% CI: 1.14-2.15]), and report of OSA symptoms (OR: 1.42 [95% CI: 1.08-1.88]). Conclusion Negative sleep characteristics were associated with tinnitus while there was no clinically meaningful association between sleep and hearing loss. Our findings suggest that the relationship between poor sleep and tinnitus is likely contributed by central processes without a major role of mediation via the peripheral auditory system.
Collapse
Affiliation(s)
- Matthew Awad
- University of Minnesota School of Medicine Minneapolis Minnesota USA
| | - Ibrahim Abdalla
- University of Minnesota School of Medicine Minneapolis Minnesota USA
| | - Sebastian M Jara
- Caruso Department of Otolaryngology-Head & Neck Surgery University of Southern California Los Angeles California USA
| | - Tina C Huang
- Department of Otolaryngology-Head & Neck Surgery University of Minnesota Minneapolis Minnesota USA
| | - Meredith E Adams
- Department of Otolaryngology-Head & Neck Surgery University of Minnesota Minneapolis Minnesota USA
| | - Janet S Choi
- Caruso Department of Otolaryngology-Head & Neck Surgery University of Southern California Los Angeles California USA
| |
Collapse
|
4
|
Gallo KEB, Corrêa CDC, Gonçalves CGDO, Correia Baran JB, Marques JM, Zeigelboim BS, José MR. Effect of Tinnitus on Sleep Quality and Insomnia. Int Arch Otorhinolaryngol 2023; 27:e197-e202. [PMID: 37125358 PMCID: PMC10147471 DOI: 10.1055/s-0041-1735455] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 05/07/2021] [Indexed: 05/02/2023] Open
Abstract
Introduction Tinnitus is a conscious perception of a sound resulting from abnormal activity within the nervous system. A relevant percentage of tinnitus patients report symptoms severe enough to significantly affect quality of life, including sleep disorders. Objective To analyze the sleep quality, insomnia, daytime sleepiness, and risk of obstructive sleep apnea (OSA) in participants with tinnitus. Methods The sample comprised 18 adults and older adults aged between 18 and 85 years old (mean age = 58.7 ± 17.5 years old), females and males, with complaint of continuous tinnitus for > 1 month. The instruments used were the Tinnitus Handicap Inventory (THI) questionnaire, the Insomnia Severity Index, the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, and the STOP-Bang questionnaire. Results By means of the THI questionnaire, the tinnitus severity degree reported by most participants was mild (27.8%) and moderate (27.8%), having a positive (r = 0.582) and significant (0.011) correlation to sleep quality, measured by means of the Pittsburgh questionnaire. There was a positive correlation between the Insomnia Severity Index and tinnitus handicap (r = 0.499; p = 0.035). A total of 72.2% of the participants self-assessed their sleep quality as poor, in addition to moderate insomnia (27.8%), although there is low risk of OSA (66.7%), without complaints of excessive daytime sleepiness (72.2%). Conclusion Subjects with tinnitus complaint self-rated their sleep quality as poor. Moreover, the higher the reported tinnitus handicap, the greater the symptoms of insomnia. There was no influence of tinnitus in relation to daytime sleepiness and no relationship between the severity of tinnitus and the risk of OSA.
Collapse
Affiliation(s)
| | - Camila de Castro Corrêa
- Curso de Fonoaudiologia, Centro Universitário Planalto do Distrito Federal, Brasília, DF, Brazil
| | | | | | - Jair Mendes Marques
- Programa de Pós-Graduação em Distúrbios da Comunicação, Universidade Tuiuti do Paraná, Curitiba, PR, Brazil
| | - Bianca Simone Zeigelboim
- Programa de Pós-Graduação em Distúrbios da Comunicação, Universidade Tuiuti do Paraná, Curitiba, PR, Brazil
| | - Maria Renata José
- Programa de Pós-Graduação em Distúrbios da Comunicação, Universidade Tuiuti do Paraná, Curitiba, PR, Brazil
- Address for correspondence Maria Renata José, PhD Universidade Tuiuti do ParanáRua Padre Ladislau Kula, n° 395, Santo Inácio, Curitiba, PR, CEP 82.010–210Brasil
| |
Collapse
|
5
|
Weber FC, Schlee W, Langguth B, Schecklmann M, Schoisswohl S, Wetter TC, Simões J. Low Sleep Satisfaction Is Related to High Disease Burden in Tinnitus. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11005. [PMID: 36078720 PMCID: PMC9518088 DOI: 10.3390/ijerph191711005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 08/29/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
Previous studies have shown a high prevalence of sleep disturbances in tinnitus patients. However, no study has yet evaluated subjective sleep satisfaction. The present study aimed to investigate associations of self-reported sleep satisfaction with sociodemographic factors, tinnitus-related distress, depression, and self-reported quality of life. This is a retrospective analysis of 2344 outpatients with tinnitus presenting at a tertiary German tinnitus clinic from 2010 to 2020. Patients who filled in five questionnaires (Tinnitus Handicap Inventory (THI), Tinnitus Questionnaire (TQ), Major Depression Inventory (MDI), Tinnitus Sample Case History Questionnaire (TSCHQ), and the World Health Organization Quality of Life Brief Version (WHOQOL-Bref)) were included. Based on the question about sleep satisfaction in the WHOQOL-Bref, group classification into (I) sleep-satisfied, (II) neither satisfied or dissatisfied, and (III) sleep-dissatisfied patients was performed. Associations between sleep satisfaction and quality of life, depression, tinnitus distress, and tinnitus characteristics were analyzed by group differences and a multinomial regression model with elastic net penalization. A total of 42.38% of patients were satisfied or very satisfied with sleep, whereas 40.91% of patients were dissatisfied or very dissatisfied with sleep. The remaining patients reported being neither satisfied nor dissatisfied with sleep. Sleep-dissatisfied patients were significantly more burdened in questionnaires on depressive symptoms (MDI), tinnitus distress (TQ, THI), and quality of life (WHOQOL-Bref). In addition, they suffered significantly more often from comorbidities such as headache, neck pain, or temporomandibular joint disorder (TMJ). The elastic net regression based on sum scores of THI, TQ, MDI, the four domains of WHOQOL-Bref, as well as all individual questions from the TSCHQ was able to classify patients satisfied with their sleep with an accuracy of 79%, 87.8% sensitivity, and 70.4% specificity. The model could not identify patients indifferent with the quality of their sleep (neither satisfied nor dissatisfied) (sensitivity: 0%; specificity: 100%). The accuracy of the model to predict patients dissatisfied with their sleep was 80.7%, with 83% sensitivity and 78.4% specificity. Poor physical and mental health (Domain I/II WHOQOL-Bref) as well as tinnitus distress were the strongest predictors of sleep dissatisfaction. Conversely, for sleep satisfaction, good physical and mental health as well as low tinnitus distress were the strongest predictors. The division into sleep-satisfied and sleep-dissatisfied tinnitus patients allows a very good discrimination regarding disease burden as indicated by depression, tinnitus distress, quality of life, and pain-related comorbidities. Physical and mental health as well as tinnitus distress seem to be strongly related to sleep satisfaction underscoring the concept of "tinnitus" versus "tinnitus disorder", but also the importance of sleep satisfaction as a global health indicator. Moreover, these data indicate the relevance of addressing sleep disorders in the therapeutic management of chronic tinnitus patients.
Collapse
Affiliation(s)
- Franziska C. Weber
- Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany
- Interdisciplinary Tinnitus Centre, University of Regensburg, 93053 Regensburg, Germany
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany
- Interdisciplinary Tinnitus Centre, University of Regensburg, 93053 Regensburg, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany
- Interdisciplinary Tinnitus Centre, University of Regensburg, 93053 Regensburg, Germany
| | - Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany
- Interdisciplinary Tinnitus Centre, University of Regensburg, 93053 Regensburg, Germany
| | - Stefan Schoisswohl
- Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany
- Interdisciplinary Tinnitus Centre, University of Regensburg, 93053 Regensburg, Germany
- Department of Psychology, Bundeswehr University Munich, 85577 Neubiberg, Germany
| | - Thomas C. Wetter
- Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany
- Center for Sleep Medicine, University of Regensburg, 93053 Regensburg, Germany
| | - Jorge Simões
- Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany
- Interdisciplinary Tinnitus Centre, University of Regensburg, 93053 Regensburg, Germany
| |
Collapse
|
6
|
Diao T, Ma X, Li J, Lai JT, Yu L, Zhang J, Wang Y, Zheng H, Jing Y, Han L. Long-Term Prognosis of Tinnitus Associated with Idiopathic Sudden Sensorineural Hearing Loss. Audiol Neurootol 2021; 26:461-469. [PMID: 34167116 DOI: 10.1159/000514814] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 01/28/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To analyze the factors affecting the long-term prognosis of tinnitus accompanied by unilateral idiopathic sudden sensorineural hearing loss (SSNHL). METHODS A total of 161 patients with sudden hearing loss (HL) accompanied by tinnitus were enrolled. All patients had two separate telephone follow-ups and were asked about changes in tinnitus. The severity of tinnitus at admission and the outcome at discharge were assessed in terms of the patients' sex, age, level of HL, type of audiogram, etc. Results: The prognosis of tinnitus after SSNHL had no relationship with grades of HL or hearing recovery. Initial tinnitus level was remarkably associated with tinnitus improvement at discharge and was an independent risk factor for the long-term prognosis of residual tinnitus after SSNHL (odds ratio 0.722, 95% confidence interval 0.550-0.949, p = 0.019), and the median recovery time was 23.00 ± 3.80 months. CONCLUSIONS Residual tinnitus after SSNHL has a tendency of self-recovery. The short-term prognosis of tinnitus may be related to psychological changes caused by hearing recovery, while the long-term prognosis of residual tinnitus after SSNHL is related only to the initial tinnitus level, with a median recovery time of approximately 2 years.
Collapse
Affiliation(s)
- Tongxiang Diao
- Department of Otolaryngology, Head and Neck Surgery, People's Hospital, Peking University, Beijing, China
| | - Xin Ma
- Department of Otolaryngology, Head and Neck Surgery, People's Hospital, Peking University, Beijing, China
| | - Jingjing Li
- Department of Otolaryngology, Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jen-Tsung Lai
- Department of Otorhinolaryngology, Taiwan Kuang-Tien General Hospital, and Taiwan Tinnitus Association, Taichung, Taiwan
| | - Lisheng Yu
- Department of Otolaryngology, Head and Neck Surgery, People's Hospital, Peking University, Beijing, China
| | - Jilei Zhang
- Department of Otolaryngology, Head and Neck Surgery, People's Hospital, Peking University, Beijing, China
| | - Yixu Wang
- Department of Otolaryngology, Head and Neck Surgery, People's Hospital, Peking University, Beijing, China
| | - Hongwei Zheng
- Department of Otolaryngology, Head and Neck Surgery, People's Hospital, Peking University, Beijing, China
| | - Yuanyuan Jing
- Department of Otolaryngology, Head and Neck Surgery, People's Hospital, Peking University, Beijing, China
| | - Lin Han
- Department of Otolaryngology, Head and Neck Surgery, People's Hospital, Peking University, Beijing, China
| |
Collapse
|
7
|
Abstract
In Japan, there have been no examinations of tinnitus with respect to personality traits, and only a few studies have investigated sleep disorders in tinnitus. Understanding the association between these can aid in selecting and developing effective treatment options for patients with tinnitus. This study aimed to clarify the relationship between tinnitus severity, personality, and sleep disorders, in patients with chronic tinnitus in Japan. We retrospectively evaluated the personality factors of 56 patients presenting with tinnitus using the NEO Five-Factor Inventory (NEO-FFI), which examines five personality characteristics, including Neuroticism, Extraversion, Openness, Agreeableness, and Conscientiousness. We evaluated tinnitus severity, sleep disorders, depression, and anxiety using the Tinnitus Handicap Inventory, Pittsburgh Sleep Quality Index (PSQI), Self-Rating Depression Scale, and State-Trait Anxiety Inventory, respectively. Neuroticism and tinnitus severity were positively correlated (r = 0.548, p < 0.001). Sleep disorders were observed in 73.2% of patients; however, there was no correlation between the PSQI score and tinnitus severity or between PSQI score and scores of the five NEO-FFI items. Sleep disorders are frequently experienced by patients with chronic tinnitus, regardless of tinnitus severity or personality. Understanding the relationship between personality and tinnitus severity could lead to better management of tinnitus.
Collapse
|
8
|
Ma X, Li JJ, Lai JT, Yu LS. An Integrated Physical Regulation Theory and Classification of Acute Tinnitus. Curr Med Sci 2021; 41:84-86. [PMID: 33582910 DOI: 10.1007/s11596-021-2322-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 10/28/2020] [Indexed: 10/22/2022]
Abstract
Tinnitus, acute or chronic, is one of the most common and refractory disorders. Acute tinnitus is a symptom that is a warning sign when compared with chronic tinnitus. Although hearing loss initiates acute tinnitus, the relationship between hearing loss and tinnitus is far from straightforward. Other factors beyond the auditory system may play important roles in the occurrence of acute tinnitus. To address this issue, we propose an integrated regulation theory of the possible physical causes of acute tinnitus, and summarize a classification system for acute tinnitus based on this regulation theory to help guide clinical treatment.
Collapse
Affiliation(s)
- Xin Ma
- Department of Otorhinolaryngology, Peking University People's Hospital, Beijing, 100044, China
| | - Jing-Jing Li
- Department of Otorhinolaryngology, Distinct Clinic, Chengdu, 610041, China
| | - Jen-Tsung Lai
- Department of Otorhinolaryngology, Taiwan Kuang-Tien General Hospital, and Taiwan Tinnitus Association, Taichung, 433, China.
| | - Li-Sheng Yu
- Department of Otorhinolaryngology, Peking University People's Hospital, Beijing, 100044, China.
| |
Collapse
|
9
|
State-of-the Art in Reconstructive Palatal Surgery Techniques for Obstructive Sleep Apnea. CURRENT SLEEP MEDICINE REPORTS 2020. [DOI: 10.1007/s40675-020-00168-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
|
10
|
Li HY, Lee LA, Hsin LJ, Fang TJ, Lin WN, Chen HC, Lu YA, Lee YC, Tsai MS, Tsai YT. Intrapharyngeal surgery with integrated treatment for obstructive sleep apnea. Biomed J 2019; 42:84-92. [PMID: 31130252 PMCID: PMC6541889 DOI: 10.1016/j.bj.2019.02.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 01/28/2019] [Accepted: 02/19/2019] [Indexed: 11/25/2022] Open
Abstract
Obstructive sleep apnea (OSA) is a common disease in adults, which influences human relations, quality of life and associates with major complications. Continuous positive airway pressure (CPAP) is the gold standard treatment modality in OSA patients. For patients incompliant or unwilling to CPAP therapy, surgery is an alternative treatment. Sleep surgery for OSA include intrapharyngeal surgery, extrapharyngeal surgery and bariatric surgery addressing upper airway soft tissue, maxillofacial bone, and obesity, respectively. Among sleep surgeries, intrapharyngeal surgery (soft tissue surgery) is widespread used and serves overwhelming majority in OSA surgical patients. Despite the popularity of intrapharyngeal surgery, its outcomes can be influenced by multiple factors and consequently need conjunctive remedy to enhance at the short-term and sustain in the long-term. In this article, we introduce updated indications for treating OSA, practical principle in decision-making between CPAP and surgery, hybrid procedures in treating obstruction at the nose, palate, tongue and epiglottis, and postoperative integrated treatment including oropharyngeal myofunctional therapy (local), positional therapy (regional), and body weight reduction (systemic), and circadian rhythm (central). In summary, intrapharyngeal surgery is a target-oriented procedure that needs to be performed precisely and combines with integrated treatment as a holistic care for OSA patients.
Collapse
Affiliation(s)
- Hsueh-Yu Li
- Department of Otolaryngology - Head and Neck Surgery, Sleep Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Li-Ang Lee
- Department of Otolaryngology - Head and Neck Surgery, Sleep Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Li-Jen Hsin
- Department of Otolaryngology - Head and Neck Surgery, Sleep Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Tuan-Jen Fang
- Department of Otolaryngology - Head and Neck Surgery, Sleep Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wan-Ni Lin
- Department of Otolaryngology - Head and Neck Surgery, Sleep Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Hung-Chin Chen
- Department of Otolaryngology - Head and Neck Surgery, Sleep Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Yi-An Lu
- Department of Otolaryngology - Head and Neck Surgery, Sleep Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Yi-Chan Lee
- Department of Otolaryngology - Head and Neck Surgery, Sleep Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Ming-Shao Tsai
- Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan
| | - Yao-Te Tsai
- Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan
| |
Collapse
|
11
|
|