Indicates sessions with Audience Response Systems (ARS) or Poll Everywhere available
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Indicates sessions with recordings available for purchase.Abstract: There are several treatment options available to patients with obstructive sleep apnea (OSA). Staging surgeries which include volumetric tissue reduction (inferior turbinate, soft palate, tongue and tonsils), correction of nasal septum deviation, maxillomandibular advancement (MMA) and genial tubercle advancement (GTA) are designed to associate with significant levels of sleep disturbance. Uvulopalatopharyngoplasty (UPPP), inferior turbinate reduction and posterior midline glossectomy remain the common surgical procedure performed for OSA. Although reported success rates vary considerably. These success rates could be added to the success rate of MMA and GTA. Improvement of OSA outcomes with less postoperative pain is one of the majors of patient expectations. In case reduction of soft tissue needed, coblation-assisted UPPP, inferior turbinate reduction and posterior midline glossectomy could be an option for less postoperative pain control. Coblation (a plasma-mediated radiofrequency-based ablation device) is a minimally invasive, low thermal surgery for effective dissection and removal of tissue to precisely remove tissue at a low relative temperature (40-70°C) resulting in minimal thermal damage to surrounding soft tissues. Using coblation gives reduction in postoperative pain, should probably be encouraged in favour of a technique to achieve a significant reduction in sleep disturbance. It could be utilized as staging surgeries or simultaneously additional procedures for improvement of OSA outcomes.
References:
Sher AE, Schectman KB, Piccirillo JF, The efficacy of surgical modifications of the upper airway in adults with obstructive sleep apnea syndrome. Sleep 1996; 19:156-77.
Jin Hou MSc, Jing Yan MSc, Botao Wang MSc, Kang Zhu MSc, Ying Sheng MD, Guoxi Zheng PhD, and Quanqing Kang MD. Treatment of Obstructive Sleep Apnea-Hypopnea Syndrome With Combined Uvulopalatopharyngoplasty and Midline Glossectomy: Outcomes From a 5-Year Study. RESPIRATORY CARE • DECEMBER 2012 VOL 57 NO 12.