File Name: advanced surgical techniques in snoring and obstructive sleep apnea .zip
This document addresses surgical treatments for obstructive sleep apnea OSA , such as uvulopalatopharyngoplasty UPPP , hyoid myotomy and jaw realignment surgery, laser surgery, radiofrequency ablation, palatal implants, and other procedures. This document does not address tonsillectomy, adenoidectomy or nasal surgery. Note: For information related to other technologies utilized in the diagnosis and management of sleep-related disorders, please see:. Hyoid myotomy and suspension, with or without mandibular osteotomy with genioglossus tongue advancement, for the treatment of OSA is considered medically necessary when ALL of the following criteria A-D below are met:. Jaw realignment surgery that is, maxillomandibular advancement is considered medically necessary when ALL of the following criteria A-D below are met:. Note: Individuals undergoing jaw realignment surgery may also undergo orthodontic therapy. Orthodontic therapy that is, placement of orthodontic brackets and wires may not be a covered benefit under all member benefit plans.
Gross, M. Apfelbaum, M. Committee Chair ; Robert A. Caplan, M. Connis, Ph. Nickinovich, Ph. Ward, M.
Obstructive sleep apnea OSA is a repetitive partial or complete upper airway collapse during sleep. OSA along with snoring and upper airway resistant syndrome fall into a broad category of sleep related breathing disorder SBD. Adverse consequences of OSA include: excessive daytime sleepiness EDS , hypertension, ischemic heart disease, metabolic syndrome, stroke and death. There are many modalities for OSA treatment; conservative approach includes weight reduction, positioning devices, continuous airway pressure CPAP , and oral appliances. Due to a large percentage of noncompliance with the conservative approach, surgical treatment is a valid option of OSA treatment. Surgical options are tracheostomy, uvulopalatopharyngoplasty, palatal pillars, radiofrequency ablation of soft palate or tongue, anterior mandibular osteotomy, hypoid suspension, tongue reduction, tongue suspension and telegnathic surgery maxillomandibular advancement.
The journal publishes 6 issues per year, mainly about respiratory system diseases in adults and clinical research. This work can range from peer-reviewed original articles to review articles, editorials, and opinion articles. The journal is printed in English, and is freely available in its web page as well as in Medline and other databases. The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two receding years. CiteScore measures average citations received per document published. Read more.
and Sleep Apnea is the first book to cover modern approaches to surgery for snoring and obstructive sleep apnea (OSA). There have been significant advances.
Georgalas et al. Prior to drug induced sedation, endoscopic evaluation had been reported in natural sleep by Borowiecki in 3. However, this technique was thought to be time consuming as the whole night of sleep recording was subsequently evaluated for the anatomical events. Thus, the technique of DISE which offered a reasonable snap-shot of the obstructive upper airway anatomy in a much shorter timescale was introduced. Since the inception of DISE, various sedative agents have been utilized to achieve the pharmacological sleep and these will be discussed in section A in a little more detail and an overview will be presented.
It seeks to promote medical-scientific writing and thereby support research and creativity in Medicine. The journal aims as well to support the medical-biological sciences related to health as to have a space for history, philosophy and ethics. Medical writing without relation to science is promoted: anecdotes, stories and short stories of doctors and patients. Determine if patients undergoing elective surgery have risk factors for obstructive sleep apnea syndrome OSAS , using the Stop-bang questionnaire.. Patients who entered a university hospital for surgery and met the inclusion criteria were asked to be weighed, measure, and answered questions about their sleep habit.
Aigner was an advanced practice registered nurse practitioner in Pulmonary and Sleep Medicine at the Central Texas Veterans Health Care System at the time the article was written and is now retired. Surgery remains an option for patients who cannot tolerate positive airway pressure treatment but carries risks that must be considered. Obstructive sleep apnea OSA is recognized primarily as a problem of the upper airway.