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Sleep Apnea Syndromes: HELP
Articles by Claudio Vicini
Based on 55 articles published since 2010
(Why 55 articles?)
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Between 2010 and 2020, C. Vicini wrote the following 55 articles about Sleep Apnea Syndromes.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3
1 Review Qualitative Phenotyping of Obstructive Sleep Apnea and Its Clinical Usefulness for the Sleep Specialist. 2020

Bosi, Marcello / De Vito, Andrea / Eckert, Danny / Steier, Joerg / Kotecha, Bhik / Vicini, Claudio / Poletti, Venerino. ·Pulmonary Operative Unit, Department of Thoracic Diseases, Morgagni-Pierantoni Hospital, Romagna Health Company, 47121 Forlì, Italy. · Head & Neck Department, Ear Nose Throat (ENT) Unit, Santa Maria delle Croci Hospital, Romagna Health Company, 48121 Ravenna, Italy. · Adelaide Institute for Sleep Health, A. Flinders University. Centre of Research Excellence, Adelaide 5049, Australia. · Lane Fox Unit/Sleep Disorders Centre, Guy's & St Thomas' National Health Service (NHS) Foundation Trust, London SE19RT, UK. · Centre of Human & Aerospace Physiological Sciences, Faculty of Life Sciences and Medicine, King's College, London WC2R 2LS, UK. · Nuffield Health Brentwood, Shenfield Road, Brentwood, Essex CM15 8EH, UK. · Head & Neck Department, ENT & Oral Surgery Unit, Morgagni-Pierantoni/Infermi Hospital, Romagna Health Company, 47121 Forlì, Italy. · Ear Nose and Throat (ENT) Clinic, Special Surgery Department, Arcispedale S. Anna Hospital, Ferrara University, 44124 Ferrara, Italy. · Department of Otolaryngology Head and Neck surgery, S.Orsola-Malpighi University Hospital, 40138 Bologna, Italy. · Department of Respiratory Diseases & Allergy, Aarhus University Hospital, 8200 Aarhus, Denmark. ·Int J Environ Res Public Health · Pubmed #32244892.

ABSTRACT: INTRODUCTION: The anatomical collapsibility of the upper airway, neuromuscular tone and function, sleep-wake and ventilatory control instability, and the arousal threshold all interact and contribute to certain pathophysiologic features that characterize different types of obstructive sleep apnea (OSA). A model of qualitative phenotypizationallowsus to characterize the different pathophysiological traits in OSA patients. METHODS: A narrative review was performed, to analyze the available literature evidence, with the purpose of generating a model of qualitative phenotypization to characterize pathophysiological traits in patients with OSA. RESULTS: 96 out of 3829 abstracts were selected for full-text review. Qualitative phenotyping model of OSA:Data concerning the OSA qualitative pathophysiological traits' measurement can be deducted by means of clinical PSG, grade of OSA severity, and therapeutic level of Continuous Positive Airway Pressure (CPAP) and are reported in the text. This approach would allow qualitative phenotyping with widely accessible methodology in a routine clinical scenario and is of particular interest for the sleep specialist, surgical treatment decision-making, and customized OSA multimodality treatment.

2 Review Assessment of obstructive sleep apnoea (OSA) in children: an update. 2019

Savini, S / Ciorba, A / Bianchini, C / Stomeo, F / Corazzi, V / Vicini, C / Pelucchi, S. ·ENT Department, University Hospital of Ferrara, Italy. · Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Azienda USL della Romagna, Forlì, Italy. ·Acta Otorhinolaryngol Ital · Pubmed #31708576.

ABSTRACT: -- No abstract --

3 Review Risk Factors for Obstructive Sleep Apnea Syndrome in Children: State of the Art. 2019

Gulotta, Giampiero / Iannella, Giannicola / Vicini, Claudio / Polimeni, Antonella / Greco, Antonio / de Vincentiis, Marco / Visconti, Irene Claudia / Meccariello, Giuseppe / Cammaroto, Giovanni / De Vito, Andrea / Gobbi, Riccardo / Bellini, Chiara / Firinu, Elisabetta / Pace, Annalisa / Colizza, Andrea / Pelucchi, Stefano / Magliulo, Giuseppe. ·Department of "Organi di Senso", University "Sapienza", 00185 Rome, Italy. · Department of "Organi di Senso", University "Sapienza", 00185 Rome, Italy. giannicola.iannella@uniroma1.it. · Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, 47121 Forlì, Italy. giannicola.iannella@uniroma1.it. · Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, 47121 Forlì, Italy. · Ear-Nose-Throat & Audiology Unit, University of Ferrara, 44121 Ferrara, Italy. · Department of Oral and Maxillo Facial Sciences, University "Sapienza", 00185 Rome, Italy. ·Int J Environ Res Public Health · Pubmed #31487798.

ABSTRACT: The obstructive sleep apnea syndrome (OSAS) represents only part of a large group of pathologies of variable entity called respiratory sleep disorders (RSD) which include simple snoring and increased upper airway resistance syndrome (UARS). Although the etiopathogenesis of adult OSAS is well known, many aspects of this syndrome in children are still debated. Its prevalence is about 2% in children from 2 to 8 years of age, mostly related to the size of the upper airways adenoid tissue. Several risk factors linked to the development of OSAS are typical of the pediatric age. The object of this paper is to analyze the state of the art on this specific topic, discussing its implications in terms of diagnosis and management.

4 Review Drug-Induced Sleep Endoscopy: Technique, Indications, Tips and Pitfalls. 2019

Carrasco-Llatas, Marina / Matarredona-Quiles, Silvia / De Vito, Andrea / Chong, Khai Beng / Vicini, Claudio. ·Department of Otolaryngology, Hospital Universitario Dr. Peset., 46017 Valencia, Spain. carrasco_mar@gva.es. · Department of Otolaryngology, Hospital Universitario Dr. Peset., 46017 Valencia, Spain. · Department of Otolaryngology; Ospedale Morgagni Pierantoni, 47121 Forli, Italy. · Department of Otolaryngology; Tan Tock Seng Hospital, Singapore 308433, Singapore. ·Healthcare (Basel) · Pubmed #31344900.

ABSTRACT: Drug-induced sleep endoscopy (DISE) is a diagnostic tool to assess the upper airway of snorers and obstructive sleep apnea patients in conditions that mimic natural sleep. Although DISE appears simple and similar to awake endoscopy, there are many aspects that need to be standardized in order to obtain reliable and reproducible information. In this article, we will recommend how to reliably perform DISE, its indications, and how to obtain and interpret the information of the upper airway.

5 Review Transoral Robotic Surgery for Obstructive Sleep Apnea: Past, Present, and Future. 2019

Vicini, Claudio / Montevecchi, Filippo. ·Otolaryngology-Head and Neck Surgery, University of Ferrara, Via Aldo Moro 8, Ferrara 44124, Italy; Head and Neck Department, ENT & Oral Surgery Unit, G.B. Morgagni - L. Pierantoni Hospital, ASL of Romagna, Via Carlo Forlanini 34, Forlì 47100, Italy. · Head and Neck Department, ENT & Oral Surgery Unit, G.B. Morgagni - L. Pierantoni Hospital, ASL of Romagna, Via Carlo Forlanini 34, Forlì 47100, Italy. Electronic address: filippomontevecchi72@gmail.com. ·Sleep Med Clin · Pubmed #30709535.

ABSTRACT: Nocturnal upper airway collapse often involves the obstruction at the tongue base. Several surgical procedures have been developed in recent years to address this area in continuous positive airway pressure-nonadherent patients and include hyolingual advancement, tongue suture suspension, and various lingual resection techniques. Traditional tongue base resection is generally done either via a transcervical technique or transorally with an endoscope for visualization. Each of these approaches has significant potential limitations. The unsurpassed visualization, dexterity, and control provided by the Da Vinci Surgical System offer many benefits for the surgeon compared with the other technologies.

6 Review Drug-Induced Sleep Endoscopy in Treatment Options Selection. 2019

Chong, Khai Beng / De Vito, Andrea / Vicini, Claudio. ·Department of Otorhinolaryngology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore. Electronic address: khai_beng_chong@ttsh.com.sg. · Head and Neck Department, ENT and Oral Surgery Unit, Morgagni-Pierantoni Hospital, AUSL of Romagna, Via Carlo Forlanini 34, Forlì 47121, Italy. ·Sleep Med Clin · Pubmed #30709531.

ABSTRACT: Drug-induced sleep endoscopy is a safe and practical technique to evaluate the dynamic upper airway collapse during sleep. We review drug-induced sleep endoscopy in adults, including its indications, technique, evaluation of upper airway collapse, and clinical application. Drug-induced sleep endoscopy is useful to improve treatment options selection for patients with obstructive sleep apnea, especially for those who are unable to accept or tolerate continuous positive airway pressure therapy. Owing to a lack of standardization for drug-induced sleep endoscopy, it is difficult to compare the published literature from different sleep centers across the world.

7 Review Laryngopharyngeal reflux in obstructive sleep apnoea patients: Literature review and meta-analysis. 2018

Magliulo, Giuseppe / Iannella, Giannicola / Polimeni, Antonella / De Vincentiis, Marco / Meccariello, Giuseppe / Gulotta, Giampiero / Pasquariello, Benedetta / Montevecchi, Filippo / De Vito, Andrea / D'Agostino, Giovanni / Gobbi, Riccardo / Cammaroto, Giovanni / Vicini, Claudio. ·Department of 'Organi di Senso', University "Sapienza", Rome, Italy. Electronic address: giuseppemagliuloorl@yahoo.com. · Department of 'Organi di Senso', University "Sapienza", Rome, Italy. · Department of Oral and Maxillo Facial Sciences, University "Sapienza", Rome, Italy. · Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Forlì, Italy. · Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Forlì, Italy; Department ENT & Audiology, University of Ferrara, Ferrara, Italy. ·Am J Otolaryngol · Pubmed #30224217.

ABSTRACT: PURPOSE: Laryngopharyngeal reflux (LPR) is a frequent condition in Obstructive Sleep Apnoea (OSA) patients and different studies have been published in the last years about this topic. A review of the published literature regarding LPR in OSA patients has been reported. A meta-analysis to evaluate the incidence of LPR in OSA patients and correlate LPR positivity with OSA patients' characteristics has been performed. METHODS: A comprehensive review of the English language literature about LPR in OSA patients was performed using the most important electronic databases (PubMed, EMBASE, the Cochrane Library etc.). A total of 10 papers studying LPR in OSA were assessed and considered eligible for the meta-analysis. RESULTS: The data analysis regarding 870 identified OSA patients showed that 394 patients were LPR +, while 476 were LPR-. The meta-analysis showed no statistical difference regarding the AHI value between LPR + patients and LPR- patients (p = 0,3). Mean BMI was more higher in LPR + patients than in the patients without LPR, showing a significant statistical difference (p = 0.001). CONCLUSION: Current international literature demonstrates a high incidence of LPR (45.2%) in OSA patients. The severity of AHI in OSA patients would not seem to correlate with the presence of laryngopharyngeal reflux. The OSA patients with LPR showed a higher BMI compared with LPR- patients.

8 Review Phenotyping the pathophysiology of obstructive sleep apnea using polygraphy/polysomnography: a review of the literature. 2018

Bosi, Marcello / De Vito, Andrea / Kotecha, Bhik / Viglietta, Luca / Braghiroli, Alberto / Steier, Joerg / Pengo, Martino / Sorrenti, Giovanni / Gobbi, Riccardo / Vicini, Claudio / Poletti, Venerino. ·AUSL of Romagna, Department Thoracic Diseases, Pulmonary Operative Unit, Morgagni-Pierantoni Hospital, Forlì, Italy. · AUSL of Romagna, Head and Neck Department, ENT Unit, Morgagni-Pierantoni Hospital, Via Dei Gerolimini 12, 47121, Forlì, Italy. dr.andrea.devito@gmail.com. · Department of Otolaryngology-Head and Neck Surgery, Royal National Throat, Nose and Ear Hospital, London, UK. · AUSL of Romagna, Department of Thoracic Diseases, Pulmonary Operative Unit, Umberto I Hospital, Lugo, Italy. · Department of Pulmonary Rehabilitation, Sleep Laboratory, Istituti Clinici Scientifici Maugeri, SPA SB, IRCCS, Veruno, Italy. · Faculty of Life Sciences and Medicine, King's College London, London, UK. · Lane Fox Respiratory Unit/Sleep Disorders Centre, Guy's and St. Thomas' NHS Foundation Trust, London, UK. · AOU of Bologna, ENT Clinic, Faculty of Medicine, Sant'Orsola-Malpighi Hospital, Bologna, Italy. · AUSL of Romagna, Head and Neck Department, ENT Unit, Morgagni-Pierantoni Hospital, Via Dei Gerolimini 12, 47121, Forlì, Italy. · University of Ferrara, Ferrara, Italy. · Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark. ·Sleep Breath · Pubmed #29318567.

ABSTRACT: Continuous positive airway pressure (CPAP) is the first-line treatment for the majority of patients affected by obstructive sleep apnea syndrome (OSA). However, long-term compliance with CPAP therapy may result limited and alternatives to CPAP therapy are required to address the increasing need to provide tailored therapeutic options. Understanding the pathophysiological traits (PTs) of OSA patients [upper airway (UA) anatomical collapsibility, loop gain (LG), arousal threshold (AT), and UA gain (UAG)] lies at the heart of the customized OSA treatment. However, sleep research laboratories capable to phenotype OSA patients are sparse and the diagnostic procedures time-consuming, costly, and requiring significant expertise. The question arises whether the use of routine clinical polysomnography or nocturnal portable multi-channel monitoring (PSG/PM) can provide sufficient information to characterize the above traits. The aim of the present review is to deduce if the information obtainable from the clinical PSG/PM analysis, independently of the scope and context of the original studies, is clinically useful to define qualitatively the PTs of individual OSA patients. In summary, it is possible to identify four patterns using PSG/PM that are consistent with an altered UA collapsibility, three that are consistent with altered LG, two with altered AT, and three consistent with flow limitation/UA muscle response. Furthermore, some PSG/PM indexes and patterns, useful for the suitable management of OSA patient, have been discussed. The delivery of this clinical approach to phenotype pathophysiological traits will allow patients to benefit in a wider range of sleep services by facilitating tailored therapeutic options.

9 Review The importance of obstructive sleep apnoea and hypopnea pathophysiology for customized therapy. 2017

Bosi, Marcello / De Vito, Andrea / Gobbi, Riccardo / Poletti, Venerino / Vicini, Claudio. ·Pneumology Unit, Morgagni-Pierantoni Hospital, Forlì, Italy. · Head & Neck Department, Ear-Nose-Throat Unit, Morgagni-Pierantoni Hospital, 47121, Forlì, Italy. dr.andrea.devito@gmail.com. · Head and Neck Department, ENT Unit, Sant'Orsola University Hospital, Bologna, Italy. · Head & Neck Department, Ear-Nose-Throat Unit, Morgagni-Pierantoni Hospital, 47121, Forlì, Italy. ·Eur Arch Otorhinolaryngol · Pubmed #27470114.

ABSTRACT: The objective of this study is to highlight the importance of anatomical and not-anatomical factors' identification for customized therapy in OSAHS patients. The data sources are: MEDLINE, The Cochrane Library and EMBASE. A systematic review was performed to identify studies that analyze the role of multiple interacting factors involved in the OSAHS pathophysiology. 85 out of 1242 abstracts were selected for full-text review. A variable combinations pathophysiological factors contribute to realize differentiated OSAHS phenotypes: a small pharyngeal airway with a low resistance to collapse (increased critical closing pressure), an inadequate responses of pharyngeal dilator muscles (wakefulness drive to breathe), an unstable ventilator responsiveness to hypercapnia (high loop gain), and an increased propensity to wake related to upper airway obstruction (low arousal threshold). Identifying if the anatomical or not-anatomical factors are predominant in each OSAHS patient represents the current challenge in clinical practice, moreover for the treatment decision-making. In the future, if a reliable and accurate pathophysiological pattern for each OSAHS patient can be identified, a customized therapy will be feasible, with a significant improvement of surgical success in sleep surgery and a better understanding of surgical failure.

10 Review Transoral robotic surgery for the management of obstructive sleep apnea: a systematic review and meta-analysis. 2017

Meccariello, Giuseppe / Cammaroto, Giovanni / Montevecchi, Filippo / Hoff, Paut T / Spector, Matthew E / Negm, Hesham / Shams, Medhat / Bellini, Chiara / Zeccardo, Ermelinda / Vicini, Claudio. ·Otolaryngology and Stomatology Unit, Department of Head-Neck Surgeries, G.B. Morgagni-L.Pierantoni Hospital, Azienda USL della Romagna, via Carlo Forlanini, 34, Forlì, Italy. drmeccariello@gmail.com. · Department of Otorhinolaryngology, University of Messina, Messina, Italy. · Otolaryngology and Stomatology Unit, Department of Head-Neck Surgeries, G.B. Morgagni-L.Pierantoni Hospital, Azienda USL della Romagna, via Carlo Forlanini, 34, Forlì, Italy. · Department of Otolaryngology-Head and Neck Surgery, St Joseph Mercy Health System, Ann Arbor, MI, USA. · Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health System, Ann Arbor, MI, USA. · Department of Otolaryngology, Faculty of Medicine, Cairo University, Cairo, Egypt. · Department of Otolaryngology Head and Neck Surgery, Rumailah Hospital, Hamad Medical Corporation, Doha, Qatar. ·Eur Arch Otorhinolaryngol · Pubmed #27221389.

ABSTRACT: Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a serious social health problem with significant implications on quality of life. Surgery for OSAHS has been criticized due to a lack of evidence to support its efficacy as well as the heterogeneous reporting of published outcomes. Moreover, the transoral robotic surgery (TORS) in the management of OSAHS is still in a relative infancy. Nevertheless, a review and meta-analysis of the published articles may be helpful. Among 195 articles, eight studies were included in the analysis. The mean of enrolled patients was 102.5 ± 107.9 (range 6-289) comprising a total of 820 cases. The mean age was 49 ± 3.27 and 285 patients underwent a previous sleep apnea surgery. The uvulopalatopharyngoplasty (UPPP) was the most common palatal procedure. The mean rate of failure was 34.4 % (29.5-46.2 %). Complications occurred in 21.3 % of the patients included in the analysis, most of them were classified as minor. Transient dysphagia represented the most common complication (7.2 %) followed by bleeding (4.2 %). TORS for the treatment of OSAHS appears to be a promising and safe procedure for selected patients seeking an alternative to continuous positive airway pressure (CPAP), although further researches are urgently needed.

11 Review Tongue reduction for OSAHS: TORSs vs coblations, technologies vs techniques, apples vs oranges. 2017

Cammaroto, Giovanni / Montevecchi, Filippo / D'Agostino, Giovanni / Zeccardo, Ermelinda / Bellini, Chiara / Galletti, Bruno / Shams, Medhat / Negm, Hesham / Vicini, Claudio. ·Department of Otolaryngology, University of Messina, Via Consolare Valeria 1, 98100, Messina, Italy. giovanni.cammaroto@hotmail.com. · ENT and Oral Surgery Unit, Department of Special Surgery, Ospedale Morgagni Pierantoni, Forlì, Italy. · Department of Otolaryngology, University of Messina, Via Consolare Valeria 1, 98100, Messina, Italy. · Department of Otolaryngolgy, Head and Neck Surgery, Hamad Medical Corporation, Rumailah Hospital, Doha, Qatar. · Department of Otorhinolaryngology, Faculty of Medicine, University of Cairo, Cairo, Egypt. ·Eur Arch Otorhinolaryngol · Pubmed #27221388.

ABSTRACT: Coblation tongue surgery and Trans-oral robotic surgery (TORS) proved to be the most published therapeutical options for the treatment of patients affected by obstructive sleep apneas (OSAHS). A systematic review of the literature and an analysis of the data are presented. The mean rates of failure were 34.4 and 38.5 %, respectively in TORS and Coblation groups. Complications occurred in 21.3 % of the patients treated with TORS and in 8.4 % of the patients treated with Coblation surgery. TORS seems to give slightly better results, allowing a wider surgical view and a measurable, more consistent removal of lingual tissue. However, the higher rate of minor complication and the significant costs of TORS must also be considered. Moreover, both technologies may be applied to a wide range of surgical techniques, each of them with different effectiveness.

12 Review Reconsidering first-line treatment for obstructive sleep apnea: a systematic review of the literature. 2016

Rotenberg, Brian W / Vicini, Claudio / Pang, Edward B / Pang, Kenny P. ·Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada. brian.rotenberg@sjhc.london.on.ca. · St. Joseph's Hospital, Room B2-501, 268 Grosvenor Street, London, ON, N6A 4V2, Canada. brian.rotenberg@sjhc.london.on.ca. · Head & Neck Department, ASL of Romagna, ENT and Oral Surgery Unit, Morgagni-Pierantoni Hospital (Forlì), Ospedale degli Infermi (Faenza), Forlì, Italy. · Asia Sleep Centre, Paragon, Singapore. ·J Otolaryngol Head Neck Surg · Pubmed #27048606.

ABSTRACT: BACKGROUND: Continuous positive airway pressure (CPAP) is typically recommended as first line therapy for obstructive sleep apnea, but the adherence rate of CPAP is problematic. This study's objective was to systematically review the literature relating to CPAP as first line therapy for OSA and compare it to surgical literature on the same topic. METHODS: A systematic review was conducted according to PRISMA guidelines, examining Medline-Ovid, Embase, and Pubmed databases. The primary search objective was to identify all papers reporting the results of (1) randomized clinical trials (RCT) of CPAP for the treatment of adults with OSA; and (2) both randomized and non-randomized clinical trials and case series on the surgical treatment of OSA in adults. A PhD-level biostatistician first screened papers, and then those that met study criteria were retrieved and analyzed using standardized forms for each author. The primary outcomes were adherence rates of CPAP. RESULTS: A total of 82 controlled clinical trials for CPAP and 69 controlled and non-controlled surgery trials were identified for analysis. Variation in CPAP use within reported RCT trials were identified, and the majority of patients in the studies would eventually be considered non-adherent to CPAP. CONCLUSIONS: When considering the numerous patient-related factors that come into play when CPAP is prescribed, the concept of CPAP as gold-standard therapy for OSA should be reconsidered. In many cases surgery can provide a better overall outcome. This study's results suggest that certain patients with OSA may be managed more effectively with surgery than CPAP, without confounding issues of treatment adherence.

13 Review Italian recommendations on dental support in the treatment of adult obstructive sleep apnea syndrome (OSAS). 2015

Levrini, Luca / Sacchi, Franco / Milano, Francesca / Polimeni, Antonella / Cozza, Paolo / Bernkopf, Edoardo / Segù, Marzia / Anonymous3590860 / Zucconi, Marco / Vicini, Claudio / Brunello, Enrico. ·Dipartimento di Scienze Chirurgiche e Morfologiche, Università degli Studi dell'Insubria, Varese, Italy. · Società Italiana Medicina del Sonno Odontoiatrica, Milano, Italy. · Società Italiana Medicina del Sonno Odontoiatrica, Bologna, Italy. · Dipartimento di Scienze Odontostomatologiche e Maxillo Facciali, Università di Roma "Sapienza", Roma, Italy. · Università degli Studi di Roma "Tor Vergata", Roma, Italy. · Associazione Nazionale Dentisti Italiani, Vicenza, Italy. · Unità per lo Studio del dolore orofacciale e dei disordini temporomandibolari, University of Pavia, Italy. ·Ann Stomatol (Roma) · Pubmed #26941893.

ABSTRACT: BACKGROUND: The aim of the present article is to present a set of proposed clinical recommendations aimed at Italian dentists involved in the management of patients with obstructive sleep apnea syndrome or snoring. METHODS: With the purpose of creating a study group, some of the most important Italian scientific societies operating in fields relevant to the issue of sleep medicine in dentistry were asked to appoint a representative. Each member of the study group was required to answer questions regarding the clinical management of OSAS and snoring. RESULTS: Oral appliances can be used to treat: - simple snoring, in patients who do not respond to, or do not appear to be suitable candidates for behavioral measures such as weight loss or positional therapy; - mild or moderate OSAS, in patients who prefer OAs to continuous positive airway pressure (CPAP) or who are not suitable candidates for CPAP, because of its failure or failure of behavioral approaches like weight loss or positional therapy; - severe OSAS, in patients who do not respond to or do not tolerate CPAP and in whom no indication for either maxillofacial or ENT surgery appears applicable. CONCLUSIONS: The application of oral appliances is highly desirable in cases of simple snoring or mild to moderate OSAS, whereas considerable caution is warranted when treating severe OSAS. It is fundamental to ensure that the patient understands his problem and, at the same time, to present all the various treatment options.

14 Review Transoral robotic sleep surgery: the obstructive sleep apnea-hypopnea syndrome. 2014

Crawford, Julia A / Montevecchi, Fliippo / Vicini, Claudio / Magnuson, J Scott. ·Head and Neck Surgery Center of Florida, Celebration Health, Florida Hospital, Suite 305, 410 Celebration Place, Celebration, FL 34747, USA. · Special Surgery Department, Otolaryngology-Head and Neck & Oral Surgery Unit, University of Pavia in Forlì, Morgagni Pierantoni Hospital, Via Carlo Forlanini, 34, FL 47100, Italy. · Head and Neck Surgery Center of Florida, Celebration Health, Florida Hospital, Suite 305, 410 Celebration Place, Celebration, FL 34747, USA. Electronic address: scott.magnuson@flhosp.org. ·Otolaryngol Clin North Am · Pubmed #24882797.

ABSTRACT: Nocturnal upper airway collapse is often multi-level in nature but typically will involve some degree of obstruction at the level of the tongue-base. Several surgical procedures have been developed in recent years to address this area in patients resistant to continuous positive airway pressure. This article outlines a novel way to treat obstructive sleep apnea lingual obstruction using the da Vinci robotic surgical system. This technique offers significant potential advantages over other established approaches and it should be included in the surgical armamentarium of sleep surgeons.

15 Guideline European position paper on drug-induced sedation endoscopy (DISE). 2014

De Vito, Andrea / Carrasco Llatas, Marina / Vanni, Agnoletti / Bosi, Marcello / Braghiroli, Alberto / Campanini, Aldo / de Vries, Nico / Hamans, Evert / Hohenhorst, Winfried / Kotecha, Bhik T / Maurer, Joachim / Montevecchi, Filippo / Piccin, Ottavio / Sorrenti, Giovanni / Vanderveken, Olivier M / Vicini, Claudio. ·Special Surgery Department, Ear-Nose-Throat Unit, Morgagni-Pierantoni Hospital, Via Forlanini 34, 47121, Forlì, Italy. ·Sleep Breath · Pubmed #24859484.

ABSTRACT: BACKGROUND: Although drug-induced sedation endoscopy (DISE) represents the most widespread diagnostic tool for upper airway endoscopic evaluation of snoring and obstructive sleep apnea hypopnea syndrome (OSAHS), many controversies exist about how to perform the sedation, the indications for DISE, and how to report DISE findings. The present position paper reports on a consensus as proposed by a group of European experts in the field of DISE after discussion during a recent dedicated meeting. METHODS: The authors have evaluated all the available evidence reported in the literature and have compared experience among various departments in leading European centers in order to provide a standardization of the DISE procedure and an in-depth insight in the main aspects of this technique. RESULTS: A proposal of the DISE procedure standardization has been achieved with a general agreement concerning the terminology, indications, contraindications, required preliminary examinations, setting, technical equipment required, staffing, local anesthesia and nasal decongestion, patient positioning, basis and special diagnostic maneuvers, and the applied sedation drugs and observation windows. Otherwise, no consensus has been reached on a scoring and classification system. CONCLUSIONS: Although consensus has been reached on several aspects of the DISE procedure, some topics remain open to future research, such as a better analysis of the importance of positional aspects during DISE and a further comparison of the differences in degree, level and pattern of upper airway collapse observed during DISE versus during natural sleep and awake endoscopy. Finally, a universally accepted scoring and classification system is lacking.

16 Article Transoral Endoscopic Coblation Tongue Base Surgery in Obstructive Sleep Apnea: Resection versus Ablation. 2020

Bahgat, Ahmed / Bahgat, Yassin / Alzahrani, Rajab / Montevecchi, Filippo / Cammaroto, Giovanni / Vicini, Claudio. ·Department of Otorhinolaryngology, Alexandria University, Alexandria, Egypt, ahmedyassinbahgat@gmail.com. · Department of Otorhinolaryngology, Alexandria University, Alexandria, Egypt. · Department of Surgery, ENT Division, Medical College, Albaha University, Albaha, Saudi Arabia. · Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Azienda USL della Romagna, Forlì, Italy. ·ORL J Otorhinolaryngol Relat Spec · Pubmed #32375151.

ABSTRACT: BACKGROUND: A new transoral tongue base surgical procedure for the treatment of snoring and obstructive sleep apnea (OSA) is described. It is named "Robo-Cob" technique because it is similar to transoral robotic surgery (TORS) but it is performed by means of coblation technology in order to resect the tongue base in countries where TORS is not an available option for such benign conditions. METHODS: In this prospective, randomized, controlled trial, the new Robo-Cob technique was carried out in 25 adult OSA patients with confirmed tongue base hypertrophy at preoperative drug-induced sedation endoscopy. The results of this procedure were compared with the coblation endoscopic lingual lightening (CELL) technique used to ablate (or minimally resect) the central part of the tongue base, in another 25 adult OSA patients with similar characteristics (age, sex, preoperative body mass index and Apnea-Hypopnea Index, AHI). The base of tongue surgery was part of multilevel surgery including also septoturbinoplasty and barbed reposition pharyngoplasty (with/without tonsillectomy). RESULTS: In this study, the Robo-Cob technique is proved to be feasible and effective in all cases either alone or when combined with other procedures in multilevel surgical settings. No/minimal intraoperative or postoperative complications were observed. Postoperative pain as measured by visual analog scale ranged from 3 to 7. No tracheostomy was done in any patient. Objective clinical improvement was confirmed by a level 3 polygraphy performed 6 months after surgery. There was significant difference in operative time at the level of the tongue base between Robo-Cob and CELL techniques, with shorter times observed within the Robo-Cob group. Moreover, the Robo-Cob technique provided tongue base tissue specimens that allowed measurement of the volume that ranged from 5 to 17 cm3 (mean 11.64 ± 3.49 cm3). It was found that resection of at least 10 cm3 of tongue base tissue was associated with better outcomes in terms of postoperative AHI reduction. CONCLUSION: In this study, the added values of using coblation for resection and not ablation appear to be the short surgical time, the low postoperative tissue edema, and the possibility of providing tissue specimens to measure resected volumes.

17 Article Lateral pharyngoplasty techniques for obstructive sleep apnea syndrome: a comparative experimental stress test of two different techniques. 2020

Iannella, Giannicola / Magliulo, Giuseppe / Di Luca, Milena / De Vito, Andrea / Meccariello, Giuseppe / Cammaroto, Giovanni / Pelucchi, Stefano / Bonsembiante, Anna / Maniaci, Antonino / Vicini, Claudio. ·Department of 'Organi Di Senso', University "Sapienza", Via Satrico 7, 00183, Rome, Italy. giannicolaiannella@hotmail.it. · Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Forlì, Italy. giannicolaiannella@hotmail.it. · Department of 'Organi Di Senso', University "Sapienza", Via Satrico 7, 00183, Rome, Italy. · Department of ENT, University of Catania, Catania, Italy. · Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Forlì, Italy. · Department ENT and Audiology, University of Ferrara, Ferrara, Italy. ·Eur Arch Otorhinolaryngol · Pubmed #32144568.

ABSTRACT: PURPOSE: To show the different effects of expansion sphincter pharyngoplasty (ESP) and barbed reposition pharyngoplasty (BRP) on muscle tension and muscle fiber tearing using a comparative experimental stress test with a frog thigh muscle model. METHODS: Frog thigh muscle was used for this experimental study. A Barbed suture was used to simulate the BRP pharyngoplasty whereas a Vicryl 3-0 suture was used to simulate the ESP technique. The other extremity of the suture was attached to traction scales. The traction scales were used to measure the weight relative to the amount of force required to obtain muscle breaking. Both surgical techniques were simulated on the frog muscle. Traction was performed until muscle breaking was observed, measuring the value of force needed to obtain muscle rupture. RESULTS: Specimen muscle breakdown in the ESP simulation occurred with an average value of 0.7 kg of traction force. Contrarily, specimen muscle breakdown in the BRP simulation with Barbed suture occurred with an average value of 1.5 kg of traction force CONCLUSION: During simulation of the ESP technique, specimen muscle breakdown occurred with an average value of traction force lower than in the BRP technique. During traction the multiple lateral sustaining suture loops of BRP could ensure greater stability then the single pulling tip suture of ESP with minor risk of muscle fiber damage.

18 Article Long-Term Subjective Outcomes of Barbed Reposition Pharyngoplasty for Obstructive Sleep Apnea Syndrome Treatment. 2020

Iannella, Giannicola / Vallicelli, Bianca / Magliulo, Giuseppe / Cammaroto, Giovanni / Meccariello, Giuseppe / De Vito, Andrea / Greco, Antonio / Pelucchi, Stefano / Sgarzani, Rossella / Corso, Ruggero Massimo / Napoli, Gloria / Bianchi, Giulia / Cocuzza, Salvatore / Maniaci, Antonino / Vicini, Claudio. ·Department of 'Organi di Senso', University "Sapienza", Viale dell'Università, 33, 00185 Rome, Italy. · Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Via Carlo Forlanini, 34, 47121 Forlì, Italy. · Department ENT & Audiology, University of Ferrara, Via Savonarola, 9, 44121 Ferrara, Italy. · Department of Emergency, Burn Center, Bufalini Hospital, Azienda USL della Romagna, viale Giovanni Ghirotti, 286, 47521 Cesena, Italy. · Intensive Care Unit, Morgagni-Pierantoni Hospital, AUSL of Romagna, Via Carlo Forlanini, 34, 47121 Forlì, Italy. · Department of Otolaryngology, University of Catania, Via S. Sofia, 78, 95125 Catania, Italy. ·Int J Environ Res Public Health · Pubmed #32121007.

ABSTRACT:

19 Article Positional Obstructive Sleep Apnea Syndrome in Elderly Patients. 2020

Iannella, Giannicola / Magliulo, Giuseppe / Lo Iacono, Cristina Anna Maria / Bianchi, Giulia / Polimeni, Antonella / Greco, Antonio / De Vito, Andrea / Meccariello, Giuseppe / Cammaroto, Giovanni / Gobbi, Riccardo / Brunori, Marco / Di Luca, Milena / Montevecchi, Filippo / Pace, Annalisa / Visconti, Irene Claudia / Milella, Claudia / Solito, Carmen / Pelucchi, Stefano / Cerritelli, Luca / Vicini, Claudio. ·Department of 'Organi di Senso', University "Sapienza",Viale dell'Università, 33, 00185 Rome, Italy. · Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Via Carlo Forlanini, 34, 47121 Forlì, Italy. · Department of Cardiovascular, Respiratory, Nephrologic, Anaesthesiologic and Geriatric Sciences, Sapienza University, Viale dell'Università, 33, 00185 Rome, Italy. · Department ENT & Audiology, University of Ferrara, Via Savonarola, 9, 44121 Ferrara, Italy. · Department of Oral and Maxillo Facial Sciences, University "Sapienza", Viale dell'Università, 33, 00185 Rome, Italy. · Department of ENT, University of Catania, Via S. Sofia, 78, 95125 Catania, Italy. · ENT Unit Villa Serena, Via del Camaldolino, 8, 47121 Forlì, Italy. ·Int J Environ Res Public Health · Pubmed #32050596.

ABSTRACT:

20 Article Long-term complications of palate surgery: A multicenter study of 217 patients. 2019

Pang, Kenny P / Vicini, Claudio / Montevecchi, Filippo / Piccin, Ottavio / Chandra, Sudipta / Yang, Hyung C / Agrawal, Vikas / Chung, Joseph C K / Chan, Yiong H / Pang, Scott B / Pang, Kathleen A / Pang, Edward B / Rotenberg, Brian. ·Asia Sleep Centre, Paragon, Singapore. · G.B. Morgagni-L. Pierantoni Hospital, University of Ferrara and Bologna, Forli, Italy. · Sant'Orsola-Malpighi University Hospital, Bologna, Italy. · Belle Vue Clinic and Hospital, Kolkata, India. · Chonnam National University Hospital, Gwangju, South Korea. · Specialty ENT Hospital, India. · Tuen Mun Hospital, Hong Kong. · Biostatistics Unit, Singapore. · School of Medicine, National University Singapore, Singapore. · School of Medicine, University of Glasgow, Glasgow, United Kingdom. · Western University, London, Ontario, Canada. ·Laryngoscope · Pubmed #31765026.

ABSTRACT: OBJECTIVES/HYPOTHESIS: To investigate long-term complications of newer reconstructive palate surgery techniques. STUDY DESIGN: Retrospective case-series analysis. METHODS: Retrospective six-country clinical study of OSA patients who had nose and palate surgery. RESULTS: There were 217 patients, mean age = 43.9 ± 12.5 years, mean body mass index = 25.9 ± 4.7, mean preoperative apnea-hypopnea index [AHI] = 30.5 ± 19.1, follow-up 41.3 months. A total of 217 palatal procedures were performed, including 50 expansion sphincter pharyngoplasties (ESP), 34 functional expansion pharyngoplasties (FEP), 40 barbed reposition pharyngoplasties (BRP), 64 modified uvulopalatopharyngoplasties (mUPPP), 11 uvulopalatal flap procedures (UPF), nine suspension pharyngoplasties (SP), eight relocation pharyngoplasties (RP), and one z-pharyngoplasty (ZPP). Complications included were constant and/or felt twice per week; dry throat (7.8%), throat lump feeling (11.5%), throat phlegm (10.1%), throat scar feeling (3.7%), and difficulty swallowing (0.5%). Of the 17 patients who had a dry throat complaint, two were constant (one SP, one RP), 15 were occasional (10 mUPPP, three SP, two BRP). Of the 25 patients with the throat lump feeling, four were constant (three RP, one ZPP), 21 were occasional (10 mUPPP, five SP, five UPF, one BRP). Of the 22 patients with the throat phlegm feeling, four were constant (two SP, two RP), 18 were occasional (10 mUPPP, four BRP, two FEP, two SP). Of the eight patients with throat scar feeling, eight were occasional (four SP, two mUPPP, one FEP, one RP), none were constant. One patient had difficulty swallowing (RP procedure). There was no velopharyngeal incompetence, taste disturbance, nor voice change. Highest symptom complaints were mUPPP, SP, and RP, whereas the lowest symptom complaint was ESP. CONCLUSIONS: Newer palatal techniques have shown to have less long-term complications compared to the older ablative techniques. LEVEL OF EVIDENCE: 4 Laryngoscope, 2019.

21 Article Aging effect on sleepiness and apneas severity in patients with obstructive sleep apnea syndrome: a meta-analysis study. 2019

Iannella, Giannicola / Vicini, Claudio / Colizza, Andrea / Meccariello, Giuseppe / Polimeni, Antonella / Greco, Antonio / de Vincentiis, Marco / de Vito, Andrea / Cammaroto, Giovanni / Gobbi, Riccardo / Bellini, Chiara / Firinu, Elisabetta / Pelucchi, Stefano / Gulotta, Giampiero / Visconti, Irene Claudia / di Luca, Milena / Magliulo, Giuseppe. ·Department of 'Organi Di Senso', University "Sapienza", Via Satrico 7, 00183, Rome, Italy. giannicolaiannella@hotmail.it. · Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Forlì, Italy. giannicolaiannella@hotmail.it. · Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Forlì, Italy. · Department ENT and Audiology, University of Ferrara, Ferrara, Italy. · Department of 'Organi Di Senso', University "Sapienza", Via Satrico 7, 00183, Rome, Italy. · Department of Oral and Maxillo Facial Sciences, University "Sapienza", Rome, Italy. · Department of ENT, University of Catania, Catania, Italy. ·Eur Arch Otorhinolaryngol · Pubmed #31482333.

ABSTRACT: PURPOSE: Different authors have reported that aging could be associated with changes in obstructive sleep apnea (OSA) related parameters (apnea/hypopnea index, SpO METHODS: In this paper, we reviewed the literature regarding the studies which compared older (> 65 years old) and young (< 65 years old) OSA patients regarding the effect of aging on daytime sleepiness (ESS evaluation) and OSA severity (AHI evaluation). A meta-analysis to evaluate the effect of age on daytime sleepiness and OSAS severity was also performed to corroborate previously reported experience. RESULTS: Meta-analysis showed no statistical (p = 0.8) differences regarding AHI differences emerged from the comparison of the two groups of patients. Elderly patients (> 65 years old) showed less daytime sleepiness, showing a statistical difference in the meta-analysis of data (p = 0.004) CONCLUSION: Although a direct correlation between aging and AHI values would seem to be present, no significant differences in baseline AHI between young (< 65-years-old) and elderly (> 65-years-old) patients emerged in this meta-analysis study. The effects of OSAS on daytime sleepiness seem to be much more prominent in young or middle-aged patients than in elderly patients.

22 Article Obstructive sleep apnoea syndrome and endothelial function: potential impact of different treatment strategies-meta-analysis of prospective studies. 2019

Cammaroto, Giovanni / Costa, Francesco / Ruiz, Maria Victoria Garcia / Andò, Giuseppe / Vicini, Claudio / Montevecchi, Filippo / Galletti, Claudio / Galletti, Francesco / Valgimigli, Marco. ·Department of Otolaryngology, University of Messina, Messina, Italy. giovanni.cammaroto@hotmail.com. · Department of Otolaryngology, Hospital Morgagni Pierantoni, Forlì, Italy. giovanni.cammaroto@hotmail.com. · Institut Clinic Cardiovascular, Hospital Clinic, Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), IDIBAPS, University of Barcelona, Barcelona, Spain. · Department of Clinical and Experimental Medicine, Policlinic "G. Martino", University of Messina, Messina, Italy. · Área del Corazón, Hospital Universitario Virgen de La Victoria, Campus Teatinos s/n, 29010, Málaga, Spain. · Department of Otolaryngology, Hospital Morgagni Pierantoni, Forlì, Italy. · Department of Anaesthesiology, University of Messina, Messina, Italy. · Department of Otolaryngology, University of Messina, Messina, Italy. · Swiss Cardiovascular Center Bern, Bern University Hospital, Bern, Switzerland. ·Eur Arch Otorhinolaryngol · Pubmed #31197532.

ABSTRACT: PURPOSE: Previous studies have shown an association between obstructive sleep apnoea syndrome (OSAS) and cardiovascular events. Whether this association is mediated by an impairment of endothelial function, which is itself a driver of elevated cardiovascular risk, has yet to be clarified, as it is the eventual protective role of several OSAS treatments. The aim of our meta-analysis is to evaluate the effect of various OSAS treatments on endothelial function calculated by means of flow-mediated dilatation (FMD). METHODS: We conducted a meta-analysis of prospective studies including patients affected by mild to severe OSAS treated with continuous positive airway pressure (CPAP), surgery, oral appliance and medical treatments. FMD was measured before and after treatment RESULTS: After pooling results from different treatment strategies, OSAS treatment showed a positive impact on endothelial function (Mean Difference [MD] = 2.58; 95% CI 1.95-3.20; p < 0.00001). CONCLUSIONS: Our study supports the hypothesis that several modalities of treatment for OSAS positively impact endothelial function. Whether this effect also associates with an improvement of clinical outcomes remains to be ascertained.

23 Article Laryngopharyngeal Reflux Diagnosis in Obstructive Sleep Apnea Patients Using the Pepsin Salivary Test. 2019

Iannella, Giannicola / Vicini, Claudio / Polimeni, Antonella / Greco, Antonio / Gobbi, Riccardo / Montevecchi, Filippo / De Vito, Andrea / Meccariello, Giuseppe / Cammaroto, Giovanni / D'Agostino, Giovanni / Pace, Annalisa / Cascella, Raffaella / Brunori, Marco / Lo Iacono, Cristina Anna Maria / Pelucchi, Stefano / Magliulo, Giuseppe. ·Department of 'Organi di Senso', University "Sapienza", Viale dell'Università 33, 00161 Rome, Italy. giannicola.iannella@uniroma1.it. · Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Via Carlo Forlanini, 34, 47121 Forlì, Italy. claudio@claudiovicini.com. · Department ENT and Audiology, University of Ferrara, Via Aldo Moro, 8, 44124 Ferrara, Italy. claudio@claudiovicini.com. · Department of Oral and Maxillo Facial Sciences, University "Sapienza", Via Caserta, 6, 00161 Rome, Italy. antonella.polimeni@uniroma1.it. · Department of 'Organi di Senso', University "Sapienza", Viale dell'Università 33, 00161 Rome, Italy. antonio.greco@uniroma1.it. · Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Via Carlo Forlanini, 34, 47121 Forlì, Italy. dr.riccardogobbi@gmail.com. · Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Via Carlo Forlanini, 34, 47121 Forlì, Italy. filippomontevecchi72@gmail.com. · Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Via Carlo Forlanini, 34, 47121 Forlì, Italy. dr.andrea.devito@gmail.com. · Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Via Carlo Forlanini, 34, 47121 Forlì, Italy. drmeccariello@gmail.com. · Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Via Carlo Forlanini, 34, 47121 Forlì, Italy. giovanni.cammaroto@hotmail.com. · Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Via Carlo Forlanini, 34, 47121 Forlì, Italy. giovanni.dagostino77@gmail.com. · Department of 'Organi di Senso', University "Sapienza", Viale dell'Università 33, 00161 Rome, Italy. annalisapace90@gmail.com. · Department of 'Organi di Senso', University "Sapienza", Viale dell'Università 33, 00161 Rome, Italy. raffaellacascella@virgilio.it. · Department of Cardiovascular, Respiratory, Nephrologic, Anaesthesiologic and Geriatric Sciences, Sapienza University, Viale dell'Università 33, 00161 Rome, Italy. marco.brunori@uniroma1.it. · Department of Cardiovascular, Respiratory, Nephrologic, Anaesthesiologic and Geriatric Sciences, Sapienza University, Viale dell'Università 33, 00161 Rome, Italy. cristina.loiacono@uniroma1.it. · Department ENT and Audiology, University of Ferrara, Via Aldo Moro, 8, 44124 Ferrara, Italy. stefano.pelucchi@unife.it. · Department of 'Organi di Senso', University "Sapienza", Viale dell'Università 33, 00161 Rome, Italy. giuseppe.magliulo@uniroma1.it. ·Int J Environ Res Public Health · Pubmed #31185704.

ABSTRACT: BACKGROUND: To investigate the presence of laryngopharyngeal reflux in patients with obstructive sleep apnea (OSA) employing the salivary pepsin concentration method. To compare the results of pepsin concentration with the severity of the pathology. METHODS: Seventy-five OSA patients (44 males, 31 females) were enrolled in the study. For each patient, the AHI (apnea-hypopnea index) and the BMI (body mass index) were initially evaluated. All the patients enrolled were assessed using the reflux symptom index (RSI) and the reflux finding score (RFS) in order to perform a clinical diagnosis of laryngopharyngeal reflux. In all patients a salivary sample was taken to estimate the presence of pepsin and its concentration. RESULTS: The incidence of LPR (laryngopharyngeal reflux) in OSA patients, evaluated using the salivary pepsin concentration test (PEP-test), was found to be 32% of cases. Linear regression testing did not show any correlation between AHI and pepsin concentration in salivary samples ( CONCLUSION: A high number of patients with OSA seem to show positivity for salivary pepsin, correlated to an LPR. There does not appear to be a correlation between the severity of apnea and the grade of salivary pepsin reflux. On the other hand, direct correlation between BMI and the value of pepsin in salivary specimens was observed.

24 Article Nasal pathologies in patients with obstructive sleep apnoea. 2019

Magliulo, G / Iannella, G / Ciofalo, A / Polimeni, A / De Vincentiis, M / Pasquariello, B / Montevecchi, F / Vicini, C. ·Department of "Organi di Senso", University "Sapienza", Rome, Italy. · Department of Oral and Maxillo Facial Sciences, University "Sapienza", Rome, Italy. · Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Forlì, Italy. ·Acta Otorhinolaryngol Ital · Pubmed #30933181.

ABSTRACT: -- No abstract --

25 Article The aging effect on upper airways collapse of patients with obstructive sleep apnea syndrome. 2018

Vicini, Claudio / De Vito, Andrea / Iannella, Giannicola / Gobbi, Riccardo / Corso, Ruggero Massimo / Montevecchi, Filippo / Polimeni, Antonella / De Vincentiis, Marco / Meccariello, Giuseppe / D'agostino, Giovanni / Cammaroto, Giovanni / Stomeo, Francesco / Magliulo, Giuseppe. ·Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Forlì, Italy. · Department ENT and Audiology, University of Ferrara, Ferrara, Italy. · Department of 'Organi di Senso', University "Sapienza", Via Satrico 7, 00183, Rome, Italy. giannicolaiannella@hotmail.it. · Intensive Care Unit, Morgagni-Pierantoni Hospital, Forlì, Italy. · Department of Oral and Maxillo Facial Sciences, University "Sapienza", Rome, Italy. · Department of 'Organi di Senso', University "Sapienza", Via Satrico 7, 00183, Rome, Italy. ·Eur Arch Otorhinolaryngol · Pubmed #30317385.

ABSTRACT: PURPOSE: To evaluate, using drug-induced sleep endoscopy (DISE), sites of upper airway obstruction and pattern of collapse in patients over 65 years old affected by obstructive sleep apnea. To compare sites and pattern of collapse of elderly patients with a group of patients younger than 65 years. METHODS: A group of 55 patients aged over 65 years were enrolled in this prospective study. Fifty patients under 65 years old were collected in the control group. Polysomnographic data and clinical parameters such as the daytime sleepiness, and body mass index were evaluated for both groups of patients. All patients underwent DISE examination with VOTE classification. RESULTS: The AHI value increased with aging whereas elderly patients presented a reduction in daytime sleepiness. Elderly patients showed a higher incidence of total collapse in the velum region compared to younger patients (90.9% vs 70%;); the older patients showed a lower degree of total oropharyngeal lateral wall collapse with respect to younger patients, (20% vs 50%). No difference in tongue base collapse emerged between the two subgroups of patients. CONCLUSION: Elderly patients showed a higher incidence of total collapse in the velum and a lower incidence in the oropharyngeal lateral wall compared to younger patients.

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