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Sleep Apnea Syndromes: HELP
Articles by Zachary S. Peacock
Based on 7 articles published since 2010
(Why 7 articles?)
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Between 2010 and 2020, Z. S. Peacock wrote the following 7 articles about Sleep Apnea Syndromes.
 
+ Citations + Abstracts
1 Review Radiology of Cleft Lip and Palate: Imaging for the Prenatal Period and throughout Life. 2015

Abramson, Zachary R / Peacock, Zachary S / Cohen, Harris L / Choudhri, Asim F. ·From the College of Medicine, University of Tennessee Health Science Center, Memphis, Tenn (Z.R.A.) · Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, Mass (Z.S.P.) · and Department of Radiology, Le Bonheur Children's Hospital, 848 Adams Ave, Room G216, Memphis, TN 38103 (H.L.C., A.F.C.). ·Radiographics · Pubmed #26562237.

ABSTRACT: Recent advances in prenatal imaging have made possible the in utero diagnosis of cleft lip and palate and associated deformities. Postnatal diagnosis of cleft lip is made clinically, but imaging still plays a role in detection of associated abnormalities, surgical treatment planning, and screening for or surveillance of secondary deformities. This article describes the clinical entities of cleft lip with or without cleft palate (CLP) and isolated cleft palate and documents their prenatal and postnatal appearances at radiography, ultrasonography (US), magnetic resonance (MR) imaging, and computed tomography (CT). Imaging protocols and findings for prenatal screening, detection of associated anomalies, and evaluation of secondary deformities throughout life are described and illustrated. CLP and isolated cleft palate are distinct entities with shared radiologic appearances. Prenatal US and MR imaging can depict clefting of the lip or palate and associated anomalies. While two- and three-dimensional US often can depict cleft lip, visualization of cleft palate is more difficult, and repeat US or fetal MR imaging should be performed if cleft palate is suspected. Postnatal imaging can assist in identifying associated abnormalities and dentofacial deformities. Dentofacial sequelae of cleft lip and palate include missing and supernumerary teeth, oronasal fistulas, velopharyngeal insufficiency, hearing loss, maxillary growth restriction, and airway abnormalities. Secondary deformities can often be found incidentally at imaging performed for other purposes, but detection is necessary because they may have considerable implications for the patient.

2 Review [Obstructive Sleep Apnea: review and a case presentation]. 2015

Fleissig, Y / Laviv, A / Peacock, Z S / Casap, N. · ·Refuat Hapeh Vehashinayim (1993) · Pubmed #26548146.

ABSTRACT: Obstructive sleep apnea may be a life threatening situation if does not get proper attention. Risk factors are easy to find, therefore general dental surgeons should be aware of them and refer if needed. This literature review clearly explains how obstructive sleep apnea is diagnosed and treated. We present a case of a patient with severe obstructive sleep apnea (apnea hypopnea index of 87.5/hour), who underwent bi jaw surgery with 2 piece Le Fort 1 maxiilary advancement, mandibular bilateral sagittal split osteotomy (BSSO) advancement, and genial tubercle advancement. Post-surgery sleep study demonstrated near resolution of previously severe obstructive sleep apnea with overall apnea hypopnea index (AHI) of 3.7/hour consistent with a successful surgical outcome.

3 Review Proceedings from the 2011 American Association of Oral and Maxillofacial Surgeons research summit. 2012

Peacock, Zachary S / Kademani, Deepak / Le, Anh D / Lee, Janice S / Hale, Robert G / Cunningham, Larry L. ·Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital and Harvard School of Dental Medicine, Boston, MA, USA. ·J Oral Maxillofac Surg · Pubmed #22608814.

ABSTRACT: -- No abstract --

4 Article Does the Medical Comorbidity Profile of Obstructive Sleep Apnea Patients Treated With Maxillomandibular Advancement Differ From That of Obstructive Sleep Apnea Patients Managed Nonsurgically? 2018

Ngo, Richard / Pullano, Elaina / Peacock, Zachary S / Lahey, Edward T / August, Meredith. ·Resident, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA. · Student, Harvard School of Dental Medicine, Boston, MA. · Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA. · Associate Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA. Electronic address: maugust@partners.org. ·J Oral Maxillofac Surg · Pubmed #29425754.

ABSTRACT: PURPOSE: Obstructive sleep apnea (OSA) patients with retrognathia and measurable anatomic airway determinants may represent a subset of OSA patients and have distinct comorbidity profiles. Our aim was to compare the medical comorbidities of OSA patients managed surgically with maxillomandibular advancement with those of nonsurgical patients. PATIENTS AND METHODS: In this cross-sectional retrospective study, patients for both cohorts were identified through the Massachusetts General Hospital oral and maxillofacial surgery data registry and the Massachusetts General Hospital Research Patient Data Registry. The inclusion criteria consisted of clinical records documenting body mass index (BMI), apnea-hypopnea index, respiratory disturbance index, and/or oxygen nadir. The primary predictor variable was the treatment modality chosen: surgical (maxillomandibular advancement) or nonsurgical. Demographic information and OSA parameters were evaluated. The primary outcome variable was the number of documented comorbidities in each group. Two-sample t tests were used for continuous variables, whereas χ RESULTS: The nonsurgical cohort consisted of 71 patients (67.6% men), and the surgical cohort consisted of 51 patients (84.3% men). Comparison of descriptive characteristics showed that the nonsurgical cohort had a higher average age (49 ± 9.4 years) than the surgical cohort (41 ± 10.7 years, P < .001). In addition, a higher average BMI was present in the nonsurgical group (42.3 ± 11.9 in nonsurgical group vs 29.7 ± 5.5 in surgical group, P < .001). Polysomnogram parameters were comparable with the exception of a higher Epworth Sleepiness Scale score in the surgical cohort (15.5 ± 5.30 in surgical group vs 9.90 ± 6.80 in nonsurgical group, P = .005). The nonsurgical cohort had a higher total number of comorbidities (7 ± 4 in nonsurgical group vs 4 ± 3 in surgical group, P < .001). Hypertension, cardiovascular disease, hyperlipidemia, pulmonary hypertension, obstructive pulmonary disease, and type 2 diabetes mellitus had higher prevalences within the nonsurgical group. CONCLUSIONS: The results of this study suggest that nonsurgically managed OSA patients tend to have more complex medical comorbidity profiles than those managed surgically. Obesity (BMI >30) was more prevalent in the nonsurgical cohort, which may be contributory. The additive contribution of OSA needs to be further elucidated.

5 Article Is the Pyriform Ligament Important for Alar Width Maintenance After Le Fort I Osteotomy? 2015

Peacock, Zachary S / Susarla, Srinivas M. ·Assistant Professor, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, Massachusetts General Hospital, Boston, MA. Electronic address: zpeacock@partners.org. · Resident, Department of Plastic and Reconstructive Surgery, Johns Hopkins Hospital, Johns Hopkins Medical School, Baltimore, MD. ·J Oral Maxillofac Surg · Pubmed #26608155.

ABSTRACT: PURPOSE: To determine whether identification and incorporation of the pyriform ligament in the alar cinch results in decreased alar base widening compared with standard alar cinch techniques. MATERIALS AND METHODS: This was a retrospective case series and the sample was composed of patients undergoing Le Fort I osteotomy. Intraoperatively, the pyriform ligament was identified and incorporated in the alar cinch suture. Greatest alar width (GAW) measured immediately after closure was compared with GAW measured at least 5 months postoperatively. The change in alar base width was compared with that reported in the literature using other alar cinch techniques. Two case examples are reported. RESULTS: The sample was composed of 15 patients (mean age, 27.1 yr; 27% female). The mean postoperative change in GAW was 1.0 ± 0.6 mm (2.59 ± 1.59%). Postoperative change in alar base width reported in the literature ranged from 0.5 to 10.8%. CONCLUSION: The pyriform ligament is easily identified during exposure of the maxilla and pyriform aperture and can be used to control widening of the alar base after Le Fort I osteotomy.

6 Article Orthognathic surgery in patients over 40 years of age: indications and special considerations. 2014

Peacock, Zachary S / Lee, Cameron C Y / Klein, Katherine P / Kaban, Leonard B. ·Assistant Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital and Harvard School of Dental Medicine, Boston, MA. Electronic address: zpeacock@partners.org. · DMD Candidate, Harvard School of Dental Medicine, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital and Harvard School of Dental Medicine, Boston, MA. · Instructor in Orthodontics, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital and Harvard School of Dental Medicine, Boston, MA. · Walter C. Guralnick Professor and Chairman, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital and Harvard School of Dental Medicine, Boston, MA. ·J Oral Maxillofac Surg · Pubmed #24836418.

ABSTRACT: PURPOSE: To assess indications, incidence, patient experience, and outcomes of orthognathic surgery in patients over 40 years of age. PATIENTS AND METHODS: This was a retrospective cohort study of all patients who underwent orthognathic surgical procedures at Massachusetts General Hospital from 1995 to 2012. Demographic variables, including age, gender, indications, date, and type of operation, were documented. Patients were divided into 2 groups by date of operation: 1) 1995 to 2002 and 2) 2003 to 2012. The predictor variable was age (>40 vs <40 yr). Outcome variables included indications for treatment, date of operation, length of hospital stay, and removal of hardware. RESULTS: During the study period, 1,420 patients underwent 2,170 procedures; 911 patients (1,343 procedures) met the inclusion criteria. Group 1 consisted of 260 subjects (346 procedures, 35 patients ≥40 yr old, 13.5%) and group 2 consisted of 651 subjects (997 procedures, 89 patients ≥40 yr old, 13.8%). Subjects over 40 had longer hospital stays (P ≤ .0001) than those under 40. Indications for men were more frequently functional problems, whereas women sought esthetic improvements (P = .0001). Subjects over 40 were 2.51, 2.44, and 2.72 times more likely to require hardware removal 6 months (P = .0245), 12 months (P = .0073), and 24 months (P = .0003) postoperatively than those younger than 40. CONCLUSION: Motivation to undergo orthognathic surgery varies by age and gender. Older patients, particularly men, tend to seek treatment for functional rather than esthetic reasons. Patients older than 40 years had longer hospital stays and an increased rate of postoperative hardware removal.

7 Article Effects of mandibular distraction osteogenesis on three-dimensional airway anatomy in children with congenital micrognathia. 2013

Abramson, Zachary R / Susarla, Srinivas M / Lawler, Matthew E / Peacock, Zachary S / Troulis, Maria J / Kaban, Leonard B. ·Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA, USA. ·J Oral Maxillofac Surg · Pubmed #22632931.

ABSTRACT: PURPOSE: To assess the 3-dimensional (3D) computed tomography (CT) changes in airway size and shape in children with congenital micrognathia treated by mandibular distraction osteogenesis (DO). PATIENTS AND METHODS: This was a retrospective study of patients with congenital micrognathia, treated by mandibular DO, who had pre- and postoperative 3D maxillofacial CT scans from the hard palate to the hyoid bone. Digital 3D-CT reconstructions were made before and after distraction. Demographic (age, gender, and diagnosis) and anatomic (airway size and shape) variables were recorded and analyzed. The pre-distraction measures of size and shape were compared with the post-distraction measures. P≤.05 was considered significant. RESULTS: During the study period (1999 to 2010), 17 children with congenital micrognathia underwent mandibular DO. Of these patients, 11 (3 females) met the inclusion criteria. The mean age was 6.8 years (range 1.3 to 20.6). All subjects had first and second pharyngeal arch deformities. Nine were tracheostomy dependent before distraction. Postdistraction increases in the anteroposterior diameter (153%), lateral airway diameter (70%), airway volume (76%), minimal retroglossal (162%) and retropalatal (77%), and minimal cross-sectional areas (282%) were obtained. The mean airway length decreased after distraction by 4 mm DO also affected the airway shape: the airway surface area and airway compactness increased after distraction. Six subjects were decannulated or had their tracheostomies capped. Three subjects remained tracheostomy dependent after distraction. The reasons for continued tracheostomy included copious secretions, muscle hypotonia, hypopharnygeal stenosis, and mandibular hypomobility. CONCLUSIONS: DO for congenital micrognathia increases airway size, decreases airway length, and alters the shape as measured using 3D-CT.