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Sleep Apnea Syndromes: HELP
Articles by Francesco Missale
Based on 3 articles published since 2010
(Why 3 articles?)
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Between 2010 and 2020, F. Missale wrote the following 3 articles about Sleep Apnea Syndromes.
 
+ Citations + Abstracts
1 Article Outcome predictors for non-resective pharyngoplasty alone or as a part of multilevel surgery, in obstructive sleep apnea-hypopnea syndrome. 2019

Missale, Francesco / Fragale, Marco / Incandela, Fabiola / Roustan, Valeria / Arceri, Carlotta / Barbieri, Andrea / Canevari, Frank Rikki / Peretti, Giorgio / Barbieri, Marco. ·IRCCS Ospedale Policlinico San Martino, Genoa, Italy. missale.francesco@gmail.com. · Department of Otorhinolaryngology, Head and Neck Surgery, University of Genoa, Genoa, Italy. missale.francesco@gmail.com. · Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy. missale.francesco@gmail.com. · IRCCS Ospedale Policlinico San Martino, Genoa, Italy. · Department of Otorhinolaryngology, Head and Neck Surgery, University of Genoa, Genoa, Italy. · Department of Otorhinolaryngology, Maxillofacial and Thyroid Surgery; Fondazione IRCCS, National Cancer Institute of Milan, University of Milan, Milan, Italy. · Department of Otorhinolaryngology, Ospedale Santa Maria Delle Croci, Ravenna, Italy. · Department of Anesthesiology, Hospital Policlinic San Martino, Genoa, Italy. · Department of Otorhinolaryngology, ASL4 Liguria, Chiavari (GE), Italy. ·Sleep Breath · Pubmed #31836994.

ABSTRACT: PURPOSE: Non-resective pharyngoplasty techniques have been shown to be effective to treat oropharyngeal collapse in patients affected by obstructive sleep apnea-hypopnea syndrome (OSAHS). The aim of our study is to evaluate outcome predictors in a cohort of patients affected by OSAHS and treated with non-resective pharyngoplasty, including variation of pharyngeal measures at the end of the surgical procedure. METHODS: A cohort of patients affected by OSAHS, with palatal or lateral pharyngeal wall collapse, who underwent non-resective pharyngoplasty, were enrolled between 2014 and 2017. Surgical procedures encompassed non-resective pharyngoplasty by expansion sphincter pharyngoplasty (ESP) or barbed antero-lateral pharyngoplasty with barbed reposition pharyngoplasty (BRP) or barbed suspension pharyngoplasty (BSP) techniques, eventually associated with nasal surgery. Pharyngeal measures were recorded intraoperatively and their variation at the end of the procedure was considered. Surgical success was evaluated at least 6 months after surgery with respiratory polygraphy and ESS questionnaire. Outcome predictors were examined by multivariable logistic regression and ROC curve analysis. RESULTS: Seventy patients met the study inclusion criteria. ESP, BRP, and BSP in a uni-/multilevel setting led to significant improvement of all respiratory polygraphic parameters and daily sleepiness (p < 0.0001). Outcome analysis showed that greater variation of antero-posterior pharyngeal measure was associated with success (p = 0.01), with an optimal cutoff value of 8.5 mm; low AHI CONCLUSIONS: Non-resective pharyngoplasty is effective in treating OSAHS patients affected by palatal or lateral pharyngeal wall collapse, and intraoperative variation of antero-posterior width may be a useful tool to predict surgical success.

2 Article Barbed suspension pharyngoplasty for treatment of lateral pharyngeal wall and palatal collapse in patients affected by OSAHS. 2019

Barbieri, Marco / Missale, Francesco / Incandela, Fabiola / Fragale, Marco / Barbieri, Andrea / Roustan, Valeria / Canevari, Frank Rikki / Peretti, Giorgio. ·IRCCS Ospedale Policlinico San Martino, Genoa, Italy. · Department of Otorhinolaryngology, Head and Neck Surgery, University of Genoa, Genoa, Italy. · IRCCS Ospedale Policlinico San Martino, Genoa, Italy. missale.francesco@gmail.com. · Department of Otorhinolaryngology, Head and Neck Surgery, University of Genoa, Genoa, Italy. missale.francesco@gmail.com. · Department of Otorhinolaryngology, Maxillofacial and Thyroid Surgery, Fondazione IRCCS, National Cancer Institute of Milan, University of Milan, Milan, Italy. · Department of Otorhinolaryngology, Ospedale Santa Maria Delle Croci, Ravenna, Italy. ·Eur Arch Otorhinolaryngol · Pubmed #30993468.

ABSTRACT: PURPOSE: The aim of this study is to analyze the efficacy of a new modified pharyngoplasty technique with barbed sutures: barbed suspension pharyngoplasty (BSP). METHODS: We enrolled patients affected by obstructive sleep apnea-hypopnea syndrome (OSAHS), having the main site of obstruction at the palatal and lateral pharyngeal walls, who refused or failed to tolerate CPAP therapy and underwent non-resective pharyngoplasty with barbed sutures between January 2014 and October 2017. Two surgical techniques with barbed sutures were used: barbed reposition pharyngoplasty (BRP) and BSP; the main characteristics of the latter are a double passage of the needle, each side, through the soft palate. RESULTS: Forty-two patients met the study inclusion criteria and were included in the analysis. Twenty-two patients underwent BRP and 20 BSP. Patients treated with both BRP and BSP achieved significant improvement in polysomnographic parameters: AHI, ODI, t90%, and daily sleepiness tested by the ESS questionnaire (p < 0.001). There were no significant differences between groups considering gender, age, or severity of OSAHS (p > 0.05). Outcomes were also comparable (p = 0.10) in the two groups; patients who underwent BSP had successful treatment in 100% of cases, compared to 86% with BRP, with a cure rate of 40% vs. 18%. CONCLUSIONS: BSP is a novel surgical technique that is effective in treating oropharyngeal collapse and can be tailored for patients with high collapsibility of the soft palate who might benefit from the palatal stiffness given by multiple passages of the suture inside it.

3 Article Transoral glossoepiglottopexy in the treatment of adult obstructive sleep apnoea: a surgical approach. 2018

Roustan, V / Barbieri, M / Incandela, F / Missale, F / Camera, H / Braido, F / Mora, R / Peretti, G. ·Department of Otorhinolaryngology and Head and Neck Surgery, University of Genoa, IRCCS AUO San Martino-IST, Genoa, Italy. · Allergy and Respiratory Diseased Clinic DIMI, University of Genoa, IRCCS AUO San Martino-IST, Genoa, Italy. ·Acta Otorhinolaryngol Ital · Pubmed #29756614.

ABSTRACT: SUMMARY: The treatment of obstructive sleep apnoea syndrome (OSAS) is still a matter of debate; among the different therapeutic alternatives, both surgical and conservative, treatment with continuous positive airway pressure (CPAP) is considered the "gold standard". The recent scientific literature reports that even if CPAP represents an effective solution for sleep apnoeas, 12% of patients do not benefit from its use. In most cases, primary collapse of the epiglottis is responsible for failure. We developed a surgical technique that provides a stable support to the epiglottis without influencing its function during swallowing while preserving laryngeal anatomy and physiology. The procedure we propose is based on that conceived by Monnier for children affected by laryngomalacia. We analysed a group of 20 patients who underwent glossoepiglottopexy between January 2015 and September 2016 and compared data (AHI, ODI, t90, ESS, EAT10, etc.) collected before and 6 months after surgery to demonstrate the safety and effectiveness of our glossoepiglottopexy (GEP). The results allow us to consider GEP as a valid choice to treat adults who suffer from sleep apnoeas.