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Sleep Apnea Syndromes: HELP
Articles from Egypt
Based on 51 articles published since 2008
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These are the 51 published articles about Sleep Apnea Syndromes that originated from Egypt during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3
1 Review Pediatric Obstructive Sleep Apnea: Consensus, Controversy, and Craniofacial Considerations. 2017

Garg, Ravi K / Afifi, Ahmed M / Garland, Catharine B / Sanchez, Ruston / Mount, Delora L. ·Madison, Wis.; and Cairo, Egypt From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Wisconsin; and the Division of Plastic Surgery, Cairo University. ·Plast Reconstr Surg · Pubmed #29068938.

ABSTRACT: Pediatric obstructive sleep apnea, characterized by partial or complete obstruction of the upper airway during sleep, is associated with multiple adverse neurodevelopmental and cardiometabolic consequences. It is common in healthy children and occurs with a higher incidence among infants and children with craniofacial anomalies. Although soft-tissue hypertrophy is the most common cause, interplay between soft tissue and bone structure in children with craniofacial differences may also contribute to upper airway obstruction. Snoring and work of breathing are poor predictors of obstructive sleep apnea, and the gold standard for diagnosis is overnight polysomnography. Most healthy children respond favorably to adenotonsillectomy as first-line treatment, but 20 percent of children have obstructive sleep apnea refractory to adenotonsillectomy and may benefit from positive airway pressure, medical therapy, orthodontics, craniofacial surgery, or combined interventions. For children with impairment of facial skeletal growth or craniofacial anomalies, rapid maxillary expansion, midface distraction, and mandibular distraction have all been demonstrated to have therapeutic value and may significantly improve a child's respiratory status. This Special Topic article reviews current theories regarding the underlying pathophysiology of pediatric sleep apnea, summarizes standards for diagnosis and management, and discusses treatments in need of further investigation, including orthodontic and craniofacial interventions. To provide an overview of the spectrum of disease and treatment options available, a deliberately broad approach is taken that incorporates data for both healthy children and children with craniofacial anomalies.

2 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.

3 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.

4 Review Residual excessive sleepiness in patients with obstructive sleep apnea on treatment with continuous positive airway pressure. 2016

Dongol, Eptehal M / Williams, Adrian J. ·aSleep Disorders Centre, Guy's and St Thomas' NHS Foundation Trust bKing's College London, London, UK cQena Faculty of Medicine, South Valley University, Qena, Egypt. ·Curr Opin Pulm Med · Pubmed #27583668.

ABSTRACT: PURPOSE OF REVIEW: One of the most common causes of excessive daytime sleepiness in clinical practice is obstructive sleep apnea syndrome (OSAS). So far, continuous positive airway pressure (CPAP) is the most effective treatment for OSA. Some of the patients do not improve on CPAP and remain sleepy despite using CPAP.This review provides updated information about the possible causes of residual sleepiness whilst using the CPAP in patients with OSAS. RECENT FINDINGS: Prevalence of OSAS has increased recently to 23.4% in women and 49.7% in men. Periodic limb movement, behaviorally induced insufficient sleep syndrome and depression are the most common causes of persistent sleepiness on CPAP. Residual sleepiness after exclusion of all possible causes is 6%. SUMMARY: There is still lack of sufficient evidence about the accurate characteristics and possible causes of this residual sleepiness and how to address this in large prospective studies.

5 Review Diagnostic Role of Magnetic Resonance Imaging in Obstructive Sleep Apnea Syndrome. 2015

Abdel Razek, Ahmed Abdel Khalek. ·From the Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt. ·J Comput Assist Tomogr · Pubmed #25836021.

ABSTRACT: We aim to review the diagnostic role of magnetic resonance (MR) imaging in obstructive sleep apnea syndrome (OSAS). Basic background about sleep apnea, MR anatomy of the pharyngeal airway, and MR imaging sequences applied in obstructive sleep apnea are discussed. Static and dynamic MR imaging is used in the assessment of patients with OSAS. Magnetic resonance imaging can detect the level, degree, and cause of obstruction in the upper airway that guide the clinical diagnosis and treatment. Imaging is used for prediction of treatment outcome and monitoring and follow-up of patients with OSAS after therapy.

6 Clinical Trial Modified anterior palatoplasty and double suspension sutures (with or without tonsillectomy) in selected patients with obstructive sleep apnea: a preliminary report. 2018

Askar, Sherif M / El-Anwar, Mohammad W / Awad, Ali. ·Otorhinolaryngology, Head and Neck Surgery, Otorhinolaryngology, Head and Neck Surgery Department, Faculty of Medicine, Zagazig University, Omar Bin El-Khattab street, Zagazig City, Sharkia Governorate, Egypt. askr_sh@yahoo.com. · Otorhinolaryngology, Head and Neck Surgery, Otorhinolaryngology, Head and Neck Surgery Department, Faculty of Medicine, Zagazig University, Omar Bin El-Khattab street, Zagazig City, Sharkia Governorate, Egypt. ·Sleep Breath · Pubmed #29777431.

ABSTRACT: BACKGROUND: Retropalatal region might be considered the most common site of obstruction in patients with snoring and OSA. We aimed at presentation of two combined techniques: modified anterior palatoplasty (MAP) and bilateral double suspension suture (DSS). METHODS: This prospective study was conducted on OSA patients with retro-palatal collapse only that was confirmed by nasoendoscopy during Muller's maneuver and drug induced sleep endoscopy. MAP and DSS were performed for all patients. Preoperative and 6 months after surgery, all patients underwent fiber-optic nasoendoscopy using the Muller maneuver and polysomnography, snoring scores, and Epworth Sleepiness Scale (ESS) values were assessed. RESULTS: Mean apnea hypopnea index (AHI) dropped significantly (p < 0.0001) from a mean of 28.6 ± 5.5 preoperatively to 8.3 ± 2.96 postoperatively. Successful outcome was reported in 26 patients (98.65%) while 3 patients (10.35%) were responders. The mean lowest oxygen (O CONCLUSION: Combined MAP and DSS (± tonsillectomy) could be considered as simple, reliable, easily trained, effective, and safe surgical treatment option for OSA patients with predominant retropalatal obstruction. It could be employed in a single-stage, multilevel work-up.

7 Clinical Trial The effect of adenotonsillectomy on obstructive sleep apnea in children with Down syndrome 2017

Abdel-Aziz, Mosaad / Azooz, Khaled / Naguib, Nader / Reda, Ramez / Kamel, Ahmed. ·a Department of Otolaryngology, Faculty of Medicine , Cairo University , Cairo , Egypt. · b Department of Otolaryngology, Faculty of Medicine , Beni Suef University , Beni Suef , Egypt. ·Acta Otolaryngol · Pubmed #28399695.

ABSTRACT: OBJECTIVE: Children with Down syndrome (DS) are liable to develop obstructive sleep apnea (OSA) due to many anatomical airway abnormalities. The tonsils and adenoid occupy part of the airway space, and their removal may be helpful in relieving airway obstruction. The aim of this study was to assess the effectiveness of adenotonsillectomy in the treatment of OSA in those children. METHODS: Fifty DS children with difficult breathing were recruited, and they were subjected to polysomnographic examination (PSG). Patients with apnea-hypopnea index (AHI) > 1 were considered to have OSA. Adenotonsillectomy was performed for patients who had OSA and adenotonsillar hypertrophy, and after 3 months PSG was done for them with recording of the same preoperative parameters. RESULTS: Forty-three children demonstrated OSA on PSG, and they were included in the study. The preoperative mean AHI was 9.18 (± 6.17) that improved postoperatively to 2.72 (± 3.80) with its normalization in 72% of patients. Also, significant improvement of arousal index, minimum oxygen saturation, desaturation index, and peak end-tidal CO CONCLUSION: Adenotonsillectomy is an effective method for the treatment of OSA in children with DS. However, the condition may persist in some children who usually have airway narrowing at multiple levels.

8 Clinical Trial Melatonin and sleep-related problems in children with intractable epilepsy. 2010

Elkhayat, Hamed A / Hassanein, Sahar M / Tomoum, Hoda Y / Abd-Elhamid, Iman A / Asaad, Tarek / Elwakkad, Amany S. ·Department of Pediatrics, Ain Shams University, Cairo, Egypt. ·Pediatr Neurol · Pubmed #20304327.

ABSTRACT: Children with epilepsy have high rates of sleep problems. Melatonin has been advocated in treatment of sleep disorders, and its beneficial effect has been confirmed in insomnia. The aim of this study was to assess melatonin levels in children with intractable epilepsy and its relation to pattern of sleep and characteristics of seizure disorder, as well as the effect of melatonin therapy on those parameters. The study was conducted on 23 children with intractable epilepsy and 14 children with controlled seizures. Patients were evaluated by psychometric sleep assessment and assay of diurnal and nocturnal melatonin levels. Children with intractable epilepsy received oral melatonin before bedtime. They were reassessed after 3 months. Children with intractable epilepsy had higher scores for each category of sleep walking, forcible teeth grinding, and sleep apnea. At the end of therapeutic trial, patients with intractable epilepsy exhibited significant improvement in bedtime resistance, sleep duration, sleep latency, frequent nocturnal arousals, sleep walking, excessive daytime sleepiness, nocturnal enuresis, forcible teeth grinding, sleep apnea, and Epworth sleepiness scores. There was also significant reduction in seizure severity. Thus, use of melatonin in patients with intractable seizures was associated with improvement of both many sleep-related phenomena and the severity of seizures.

9 Article Could Nasal Surgery Affect Multilevel Surgery Results for Obstructive Sleep Apnea? 2018

El-Anwar, Mohammad Waheed / Amer, Hazem S / Askar, Sherif M / Elsobki, Ahmed / Awad, Ali. ·Otorhinolaryngology, Head and Neck Surgery Department, Faculty of Medicine, Zagazig University, Zagazig. · Otorhinolaryngology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt. ·J Craniofac Surg · Pubmed #30169452.

ABSTRACT: OBJECTIVE: To study the role of nasal surgery as a part of multilevel surgery for management of obstructive sleep apnea (OSA). METHODS: All patients underwent multilevel surgery for relieving OSA symptoms and they were classified according to type of surgical intervention into: group A (20 patients), who underwent hyoid suspension (Hyoidthyroidpexy), tonsillectomy, suspension (El-Ahl and El-Anwar) sutures and nasal surgery (inferior turbinate surgery). Group B (20 patients), who underwent hyoid suspension (Hyoidthyroidpexy), tonsillectomy and suspension sutures. Pre and postoperative sleep study, Epworth sleepiness scale, snoring score were reported and compared. RESULTS: Apnea hypoapnea index (AHI) dropped significantly in both groups. The mean preoperative AHI was significantly less in patients who had no nasal obstruction (P = 0.0367), while the difference in postoperative values was nonsignificant (P = 0.7358).The mean Epworth sleepiness scale improved significantly in both groups, but the difference between pre and postoperative values in both groups was nonsignificant. The lowest oxygen saturation elevated significantly in both groups, but the difference between pre and postoperative values in both groups was nonsignificant. As regards snoring scores, they dropped significantly in both groups. The preoperative snoring score was reported to be significantly more in patients who had associated nasal obstruction (group A) (P = 0.0113). But after surgery the difference in postoperative values was nonsignificant (P = 0.1296). CONCLUSION: Treatment of nasal obstruction should be considered a crucial component in the comprehensive management plan for OSA patients as it has significant impact on the patients' AHI and snoring.

10 Article Gender differences in morphological and functional outcomes after mandibular setback surgery. 2018

Dahy, Khaled / Takahashi, Katsu / Saito, Kazuyuki / Kiso, Honoka / Rezk, Ibrahim / Oga, Toru / Uozumi, Ryuji / Chin, Kazuo / Bessho, Kazuhisa. ·Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Otolaryngology-Head and Neck Surgery, Sohag University, Sohag, Egypt. Electronic address: khgamal@kuhp.kyoto-u.ac.jp. · Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan. · Department of Otolaryngology-Head and Neck Surgery, Sohag University, Sohag, Egypt. · Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan. · Department of Biomedical Statistics and Bioinformatics, Kyoto, Japan. ·J Craniomaxillofac Surg · Pubmed #29709333.

ABSTRACT: PURPOSE: The aim of this study was to examine and compare morphological and functional outcomes after either isolated mandibular setback or bimaxillary surgery in males and females. MATERIALS AND METHODS: A retrospective study was done on 52 patients, in whom surgical correction for mandibular prognathism was performed either by isolated mandibular setback (30 cases) or by bimaxillary surgery (22 cases). Morphological changes were studied using cephalograms and functional changes studied using impulse oscillometry (IOS) taken before surgery (T0), 3 months (T1) and 1 year after surgery (T2). Also 3% oxygen desaturation index (ODI) was measured at T0 and T2. RESULT: Posterior airway space decreased significantly in both groups and both sexes but more so in males after mandibular setback surgery and in females after bimaxillary surgery. Changes in supine R20 (central airway resistance at 20 Hz) and supine R5 (total airway resistance at 5 Hz) in IOS statistically significantly increased in the period T0-T1 in males compared with females after mandibular setback surgery (p < 0.05). CONCLUSION: Gender dimorphism is present according to morphological and functional outcomes, with males at a higher risk for obstructive sleep apnea (OSA) after mandibular setback surgery and females after bimaxillary surgery; however, compensatory changes act as a barrier against this.

11 Article Left Ventricular Structural and Functional Changes in Children With β-Thalassemia and Sickle Cell Disease: Relationship to Sleep-disordered Breathing. 2018

Elalfy, Mohsen S / Youssef, Omneya Ibrahim / Deghedy, Marwa M R / Abdel Naby, Mariam M. ·Department of Paediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt. ·J Pediatr Hematol Oncol · Pubmed #29494380.

ABSTRACT: Cardiovascular complications are well recognized in β-thalassemia and sickle cell disease (SCD). The objective of this study was to evaluate left ventricular (LV) structural and functional changes and their relationship to sleep-disordered breathing (SDB) in children with β-thalassemia and SCD. One hundred patients recruited from the hematology clinic were subjected to Pittsburgh Sleep Quality Index score; 26 patients had positive score (Pittsburgh Sleep Quality Index ≥5) (15 β-thalassemia major and 11 SCD) and were compared with 25 age-matched and sex-matched controls. All underwent polysomnography and tissue Doppler echocardiography. SDB was detected in 73% of thalassemia patients (all had increased LV mass index [LVMI], diastolic dysfunction [increased E/Em], and 53% had pulmonary hypertension [tricuspid valve resurgence (TR) velocity ≥2.5 m/s]) and in 46% of SCD patients ( all had increased LVMI, 81.8% had pulmonary hypertension, and 76% had diastolic dysfunction). Sleep O2 saturation of β-thalassemia patients negatively correlated with TR velocity and LVMI (P=0.027, 0.015), and lower asleep O2 saturation was associated with increased E/Em. In SCD patients, sleep and awake O2 saturation negatively correlated with TR velocity and E/Em (P=0.024 and 0.041), and lower sleep O2 saturation was associated with increased LV diameter (P=0.021). SDB is common and associated with LV structural and functional changes in β-thalassemia and SCD.

12 Article The Relationship Between Cephalogram Analysis and Oxygen Desaturation Index During Sleep in Patients Submitted for Mandibular Setback Surgery. 2018

Dahy, Khaled Gamal / Takahashi, Katsu / Saito, Kazuyuki / Kakeno, Azumi / Kiso, Honoka / Isobe, Yu / Mishima, Sayaka / Asai, Keita / Moussa, Abd-Elmateen / Shahat, Badawy / Rezk, Ibrahim / Oga, Toru / Morita, Satoshi / Chin, Kazuo / Bessho, Kazuhisa. ·Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan. · Department of Otolaryngology, Sohag University, Sohag, Egypt. · Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University. · Department of Biomedical Statistics and Bioinformatics, Kyoto, Japan. ·J Craniofac Surg · Pubmed #29481513.

ABSTRACT: OBJECTIVES: The aim of this study was to examine the relationship between morphologic factors of mandibular protrusion patients and clinical indices of obstructive sleep apnea (OSA). METHODS: Fifty-two Japanese patients divided into 2 groups: 1 jaw surgery group (30 patients) and 2 jaw surgery group (22 patients). Morphologic changes were studied using cephalograms taken before surgery and 1 year after surgery. Functional changes studied using impulse oscillometry and pulse oximetry during sleep, both of which are clinically useful measures in assessing OSA, taken before surgery and 1 year after surgery. RESULT: Lower face cage area significantly decreased in 1 jaw group than in 2 jaw group patients. Positive significant correlation was found between changes in 3% oxygen desaturation index (ODI) and changes of tongue area and vertical position of the hyoid bone in 1 jaw surgery group. Multiple regression analysis indicates that tongue area and airway area were independently significant predictors of 3% ODI in 1 jaw group patients. CONCLUSION: In 2 jaw surgery, maxillary surgery compensated for the effect of mandibular setback surgery. Mandibular setback surgery to mandibular protrusion patients was performed within the range of adequate movement distance, but precautions for risk of postoperative obstructive sleep apnea syndrome should be considered.

13 Article The Impact of Velopharyngeal Surgery on the Polysomnographic Parameters After Cleft Palate Repair. 2018

Abdel-Aziz, Mosaad / Hussien, Ayman / Kamel, Ahmed / Azooz, Khaled / Fawaz, Mohamed. ·Department of Otolaryngology, Faculty of Medicine, Cairo University. · Department of Otolaryngology, Faculty of Medicine, Beni Suef University, Egypt. ·J Craniofac Surg · Pubmed #29381603.

ABSTRACT: Velopharyngeal surgical procedures may have adverse effect on the airway of the patients with velopharyngeal insufficiency (VPI). The aim of this study was to evaluate the polysomnographic parameters (PSG) in patients who underwent corrective surgery for treatment of VPI. The study included 39 patients who underwent 1 of 3 velopharyngeal surgical techniques; Furlow palatoplasty (12 patients), pharyngeal flap (18 patients), and sphincter pharyngoplasty (9 patients). The patients were subjected to PSG, and they were considered to have obstructive sleep apnea (OSA) with apnea-hypoapnea index (AHI) >1.Comparison of PSG parameters of patients showed insignificant difference regarding the total sleep time, sleep efficiency, arousal index, desaturation index, and minimum oxygen saturation. Significant difference was detected regarding peak end-tidal CO2 and AHI. Pharyngeal flap was detected as the most surgical technique that worsened the PSG parameters with OSA in 78% of patients, followed by sphincter pharyngoplasty with OSA in 56% of patients. Furlow palatoplasty was detected as the least impacting technique on the airway in 25% of patients who demonstrated OSA. In conclusion, velopharyngeal surgery has a variable impact on the PSG; pharyngeal flap has the most worsening effect followed by sphincter pharyngoplasty, while Furlow palatoplasty has the least adverse effect.

14 Article Double suspension sutures: A simple surgical technique for selected cases of obstructive sleep apnoea: Our experience with twenty-two patients. 2018

Askar, S M / El-Anwar, M W. ·Faculty of Medicine, Head and Neck Surgery Department, Zagazig University, Zagazig, Egypt. ·Clin Otolaryngol · Pubmed #29288566.

ABSTRACT: -- No abstract --

15 Article Medium to long-term outcomes of bariatric surgery in older adults with super obesity. 2018

Elbahrawy, Aly / Bougie, Alexandre / Loiselle, Sarah-Eve / Demyttenaere, Sebastian / Court, Olivier / Andalib, Amin. ·Center for Bariatric Surgery, Division of General Surgery, Department of Surgery, McGill University, Montreal, QC, Canada; Department of Clinical and Experimental Surgery, Medical Research Institute, Alexandria University, Alexandria, Egypt. Electronic address: aly.elbahrawy@mail.mcgill.ca. · Center for Bariatric Surgery, Division of General Surgery, Department of Surgery, McGill University, Montreal, QC, Canada. ·Surg Obes Relat Dis · Pubmed #29249586.

ABSTRACT: BACKGROUND: Indications and outcomes of bariatric surgery in older adults suffering from morbid obesity remain controversial. We aimed to evaluate safety and medium to long-term outcomes of bariatric procedures in this patient population. SETTING: University Hospital, Canada. METHODS: This is a single-center retrospective study of a prospectively collected database. We included patients aged ≥60 years who underwent sleeve gastrectomy, Roux-en-Y gastric bypass, or biliopancreatic diversion with duodenal switch between January 2006 and December 2014 and had at least 2 years of follow-up. RESULTS: Of patients, 115 underwent bariatric surgeries (11 patients had 2 procedures). There were 66 were super-obese patients (body mass index>50 kg/m CONCLUSION: Bariatric surgery is safe and effective in improving obesity-related co-morbidities in older patients suffering from morbid obesity. Age alone should not preclude older patients from getting the best bariatric procedure for obesity and related co-morbidities.

16 Article Evolution of soft palate surgery techniques for obstructive sleep apnea patients: A comparative study for single-level palatal surgeries. 2018

Rashwan, Mohamed S / Montevecchi, Filippo / Cammaroto, Giovanni / Badr El Deen, Mohamed / Iskander, Nagi / El Hennawi, Diaa / El Tabbakh, Mohammed / Meccariello, Giuseppe / Gobbi, Riccardo / Stomeo, Francesco / Vicini, Claudio. ·Faculty of Medicine, Department of Otorhinolaryngology, Suez Canal University Teaching Hospitals, Ismailia, Egypt. · Head and Neck Department - ENT & Oral Surgery Unit, G.B. Morgagni - L. Pierantoni Hospital, Forlì - ASL of Romagna, Italy. · Department of Otorhinolaryngology, University of Messina, Messina, Italy. · ENT & Audiology Department, University of Ferrara, Ferrara, Italy. ·Clin Otolaryngol · Pubmed #29106778.

ABSTRACT: OBJECTIVES: To compare the results of tissue preservation techniques of soft palate surgeries including expansion sphincter pharyngoplasty (ESP) and barbed reposition pharyngoplasty (BRP) for patients suffering from obstructive sleep apnoea (OSA) with the traditional uvulopalatopharyngoplasty (UPPP). DESIGN: Interventional comparative study. SETTING: Morgagni-Pierantoni Hospital. PARTICIPANTS: Seventy-five patients were included in the study, divided into three groups with 25 patients per group: UPPP, ESP or BRP. MAIN OUTCOMES MEASURES: Polysomnography was carried out for all patients pre- and postoperatively; the postoperative results were recorded at least 6 months after surgery. All patients were assessed preoperatively using drug-induced sleep endoscopy. Epworth Sleepiness Scale and body mass index (BMI) were registered for all patients before and after surgery. RESULTS: The mean of pre- and postoperative differences of apnoea-hypopnoea index values was higher in BRP group than ESP: 15.76 ± 14.5 Vs 10.13 ± 5.3; P < .05 and UPPP groups: 15.76 ± 14.5 vs 6.08 ± 5.5; P < .0005. The mean of differences of oxygen desaturation index values was higher in BRP group than UPPP group: 15.09 ± 17.6 vs 7.13 ± 6.8; P < .0005, but not significantly higher than ESP group: 15.09 ± 17.6 vs 6.48 ± 7.9; P > .05. The mean of differences of ESS values was higher in BRP group than ESP group: 5.52 ± 4.1 vs 4.84 ± 3.3; P < .005 and UPPP groups: 5.52 ± 4.1 vs 1.36 ± 1.9; P < .005. Finally, the pre- and postoperative means of differences of lowest oxygen saturation values were not statistically significant among the three groups (P > .05). CONCLUSION: Barbed reposition pharyngoplasty (BRP) can be considered an effective procedure on the basis of the postoperative outcomes. ESP still proves to be a good technique especially when performed by experienced surgeons. Both techniques proved to be superior to UPPP.

17 Article Let's know from our patients: PPOPS score for palate surgery evaluation/a pilot study. 2018

Rashwan, Mohamed S / Montevecchi, Filippo / Firinua, Elisabetta / Dachuri, Sandeep / Obaidat, Hayfa / Gobbi, Riccardo / Cammaroto, Giovanni / Nuzzo, Simona / Vicini, Claudio. ·Department of Otorhinolaryngology, Faculty of medicine, Suez Canal University Teaching Hospitals, Ismailia, Egypt. m_salaheldin@med.suez.edu.eg. · Head and Neck Department, ENT and Oral Surgery Unit, G.B. Morgagni-L. Pierantoni Hospital, Forlì, ASL of Romagna, Romagna, Italy. · Department of Head and Neck Surgery, Otolaryngology Jordanian Royal Medical Services, King Hussein Medical Centre, Amman, Jordan. · Department of Otorhinolaryngology, University of Messina, Messina, Italy. · Biostatistics Unit, G.B. Morgagni-L. Pierantoni Hospital, Forlì, ASL of Romagna, Romagna, Italy. ·Eur Arch Otorhinolaryngol · Pubmed #29094197.

ABSTRACT: AIM: To introduce a questionnaire that can be used to assess the post-operative perception of the patients after palatal surgery. The questionnaire was named: Palate Post-Operative Problems Score (PPOPS). STUDY DESIGN: Pilot study. PATIENTS AND METHODS: The study was performed at Morgagni-Pierantoni hospital, Forli. Forty patients suffering from obstructive sleep apnea (OSA) who performed either expansion sphincter pharyngoplasty (ESP) or barbed reposition pharyngoplasty (BRP) in our hospital were divided into two groups, 20 patients per group. The patients' answers to the PPOPS questionnaire were recorded and their total scores were compared in addition to each item separately. PPOPS questionnaire consists of 12 items scored from 0 to 3 with a total score from 0 to 36. RESULTS: The overall average scores between both groups were similar being 4.05 for the BRP and 4.35 for the ESP with P value 0.4. From the results of the questionnaire, the patients favoured choosing BRP than ESP although some items showed better results among ESP patients and the difference between both techniques is not statistically significant. Every item score was separately compared and described in details later in the results. CONCLUSION: PPOPS questionnaire can be an additional useful tool for the assessment of any kind of palatal surgery through detailed analysis of the patients' perception for their surgery. BRP and ESP are similar procedures in the idea and results.

18 Article Prospective multicentre study on barbed reposition pharyngoplasty standing alone or as a part of multilevel surgery for sleep apnoea. 2018

Montevecchi, F / Meccariello, G / Firinu, E / Rashwan, M S / Arigliani, M / De Benedetto, M / Palumbo, A / Bahgat, Y / Bahgat, A / Lugo Saldana, R / Marzetti, A / Pignataro, L / Mantovani, M / Rinaldi, V / Carrasco, M / Freire, F / Delgado, I / Salamanca, F / Bianchi, A / Onerci, M / Agostini, P / Romano, L / Benazzo, M / Baptista, P / Salzano, F / Dallan, I / Nuzzo, S / Vicini, C. ·Head and Neck Department, ENT & Oral Surgery Unit, G.B. Morgagni - L. Pierantoni Hospital, Forlì - Infermi Hospital, Faenza - ASL of Romagna, Forli, University of Ferrrara, Italy. · Department of Otolaryngology Head and Neck Surgery, Fazzi Hospital, Lecce, Italy. · Department of Otorhinolaryngology, Alexandria University, Alexandria, Egypt. · Department of Otorhinolaryngology, Grupo Medico San Pedro, Monterrey, Mexico. · Department of Otolaryngology, Fabrizio Spaziani Hospital, Frosinone, Italy. · Department of Otolaryngology, Department of Clinical Sciences and Community Health, Fondazione I.R.C.C.S. Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy. · Department of Otorhinolaryngology, Doctor Peset University Hospital, Valencia, Spain. · Department of Otolaryngology, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal. · Department of Otolaryngology, S. Pio X Hospital, Milan, Italy. · Ear Nose Throat-Head and Neck Surgery Department, Faculty of Medicine, Hacettepe University, Ankara, Turkey. · Department of Otolaryngology, San Bassiano Hospital, Bassano del Grappa, Vicenza, Italy. · Department of Otolaryngology Head Neck Surgery, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy. · Department of Otolaringology, Campus Universitario, University of Navarra, Pamplona, Spain. · Otorhinolaryngologic Unit, San Giovanni di Dio e Ruggi d' Aragona University Hospital, Salerno, Italy. · First Otorhinolaryngologic Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy. · Biostatistics Unit, G.B. Morgagni - L. Pierantoni Hospital, Forlì - ASL of Romagna, Forli, Italy. ·Clin Otolaryngol · Pubmed #28981208.

ABSTRACT: OBJECTIVES: The aim of this study was to demonstrate in a prospective multicentre study that Barbed Reposition Pharyngoplasty (BRP) procedure is safe and effective in management of obstructive sleep apnoea/hypopnea syndrome (OSAHS) patients. DESIGN: Prospective study. SETTING: Multicentre study. PARTICIPANTS: Patients suffering from obstructive sleep apnoea. MAIN OUTCOMES MEASURES: Values of postoperative apnoea-hypopnea index (AHI), oxygen desaturation index (ODI), epworth sleepiness scale (ESS). RESULTS: 111 Barbed Reposition Pharyngoplasty procedures standing alone or as a part of multilevel surgery for OSAHS, performed between January and September 2016, were analysed in 15 different centres. The average hospitalisation period was 2.5 ± 0.5 days. The mean patient age was 46.3 ± 10.5 years. The average body mass index at the time of the procedure was 27.9 ± 3.2, and the majority of the patients were men (83%). The mean preoperative and postoperative apnoea/hypopnea index was 33.4 ± 19.5 and 13.5 ± 10.3, respectively (P < .001). The mean preoperative and postoperative ESS score was 10.2 ± 4.5 and 6.1 ± 3.6, respectively (P < .001). The mean preoperative and postoperative ODI were 29.6 ± 20.7 and 12.7 ± 10.8, respectively (P < .001). CONCLUSIONS: Patients undergoing BRP standing alone or as part of a multilevel approach for the treatment of OSAHS have a reasonable expectation for success with minimal morbidity.

19 Article Voice and Swallowing Outcomes after Hyoid Suspension Surgery in Patients with Obstructive Sleep Apnea. 2017

Askar, Sherif M / Quriba, Amal S / Hassan, Elham M / Awad, Ali M / Bessar, Ahmad A. ·Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt. · Phoniatric Unit, Department of Otorhinolaryngology - Head and Neck Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt. · Radio-Diagnosis Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt. ·Folia Phoniatr Logop · Pubmed #29763895.

ABSTRACT: OBJECTIVE: The role of hyoidthyroidpexia (HTP) surgery in the management of patients with obstructive sleep apnea (OSA) is well described with good reported outcomes. The effect of HTP on other laryngeal functions is not well discussed. This study was designed to evaluate voice and swallowing outcomes after HTP. PATIENTS AND METHODS: This study was applied on a selected group of OSA patients. HTP (as a sole procedure) was performed in 17 patients and 14 patients had simultaneous palatal procedures (e.g., anterior palatoplasty). Pre- and postoperative assessment of voice and swallowing were done. RESULTS: Comparison between pre- and postoperative results of voice and swallowing measures revealed a nonsignificant difference. CONCLUSION: HTP (as a sole technique or as part of a multilevel intervention) could help with airway collapse and might be considered a safe, simple, and effective technique in the management of selected patients experiencing OSA. In addition, it seems to have no hazardous effect on either the voice or swallowing function of patients.

20 Article Sleep disorders in patients with erectile dysfunction. 2017

Kalejaiye, Odunayo / Raheem, Amr Abdel / Moubasher, Amr / Capece, Marco / McNeillis, Sara / Muneer, Asif / Christopher, Andrew N / Garaffa, Giulio / Ralph, David J. ·St. Peter's Andrology Centre and the Institute of Urology, University College London Hospitals, London, UK. · Department of Andrology, Cairo University, Cairo, Egypt. ·BJU Int · Pubmed #28710780.

ABSTRACT: OBJECTIVE: To assess the prevalence of obstructive sleep apnoea (OSA) in men presenting with erectile dysfunction (ED) at a single centre. PATIENTS AND METHODS: All men attending a specialised andrology outpatient department with a new diagnosis of ED were included in this prospective study. All patients completed three questionnaires: the International Index of Erectile Function (IIEF) and two sleep questionnaires [the Obstructive Sleep Apnoea Screening questionnaire and the Insomnia Severity Index (ISI)]. Their ED management was subsequently undertaken in accordance with local and European guidelines. An OSA diagnosis was made based on a score of ≥3 on the Obstructive Sleep Apnoea Screening questionnaire and those patients were referred for specialist management. RESULTS: Between February and September 2016, 129 patients with ED completed the study questionnaires. In all, 71 patients (55%) had a score of ≥3 on the Obstructive Sleep Apnoea Screening questionnaire, indicating a need for specialist sleep referral. Men who scored ≥3 on the Obstructive Sleep Apnoea Screening questionnaire were significantly older (61.4 vs 46.5 years; P < 0.001) and had a significantly higher body mass index (29.4 vs 26.7 kg/m CONCLUSION: Men presenting to the andrology clinic with ED are at significant risk of having undiagnosed sleep disorders. This has serious adverse health consequences, as well as being associated with potential dangers at work and travel. The patient compliance was high with 78% completing all three questionnaires. It is feasible to screen this population for sleep disturbance and this should be part of the ED assessment.

21 Article Single triangular suture: A modified technique for hyoid suspension as a treatment for obstructive sleep apnea: Our experience with 24 patients. 2017

Askar, S M / El-Anwar, M W / Amer, H S / Awad, A. ·Otorhinolaryngology, Head and Neck Surgery Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt. ·Clin Otolaryngol · Pubmed #28653474.

ABSTRACT: -- No abstract --

22 Article Barbed reposition pharyngoplasty in multilevel robotic surgery for obstructive sleep apnoea. 2017

Vicini, C / Meccariello, G / Cammaroto, G / Rashwan, M / Montevecchi, F. ·Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Forlì, Italy. · Department of Otolaryngology, University of Messina, Italy. · Department of Otolaryngology, Suez Canal University Teaching Hospitals, Ismailia, Egypt. ·Acta Otorhinolaryngol Ital · Pubmed #28516964.

ABSTRACT: The surgical treatment of obstructive sleep apnoea in patients who are non-compliant with continuous positive airway pressure therapy still represents a valid alternative. In recent years, the multilevel approach is becoming more diffuse in routine surgical practice, especially since the introduction of transoral robotic surgery. Barbed reposition pharyngoplasty in multilevel robotic surgery for OSA may represent a valid option to surgically approach the soft palate. Herein, we describe the technique and preliminary results of our experience.

23 Article Adenosine Diphosphate-Induced Platelets Aggregability in Polysomnographically Verified Obstructive Sleep Apnea. 2017

Alkhiary, Wael / Morsy, Nesreen E / Yousef, Aida M / El-Saddik, Amr Mohamed / Arram, Eman O. ·1 Department of Clinical Pathology, Mansoura Faculty of Medicine, Mansoura University, Egypt. · 2 Department of Chest Medicine, Mansoura Faculty of Medicine, Mansoura University, Egypt. ·Clin Appl Thromb Hemost · Pubmed #26276686.

ABSTRACT: Obstructive sleep apnea syndrome (OSAS) is a risk factor for arterial thrombosis and cardiovascular morbidity. Activated platelets play key roles in the development of atherothrombosis, thus may be involved in these complications of OSAS. Herein, we evaluated the relationship between severity of OSAS and the degree of platelet aggregates as a marker of activated platelets in 64 patients with OSAS. Platelet aggregations were determined by means of optical aggregometry, using adenosine diphosphate (ADP) as an agonist. Compared with the control group, ADP-induced platelet aggregability was increased in patients with total OSAS, severe OSAS, and in mild to moderate OSAS. Moreover, ADP-induced platelet aggregation was correlated with the Epworth sleepiness scale (ESS) in patients with severe OSAS. Obstructive sleep apnea syndrome is associated with enhanced platelets aggregations, which may predispose the cardiovascular sequels. The ESS may be important in predicting platelet activation and thus atherothrombotic complications in those with OSAS.

24 Article Oximetry in obese children with sleep-disordered breathing. 2016

Evangelisti, Melania / Shafiek, Hanaa / Rabasco, Jole / Forlani, Martina / Montesano, Marilisa / Barreto, Mario / Verhulst, Stijn / Villa, Maria Pia. ·Pediatric Sleep Disease Center, Child Neurology, NESMOS Department, School of Medicine and Psychology, Sapienza University of Rome, S. Andrea Hospital, Rome, Italy. · Department of Chest Diseases, Faculty of Medicine, Alexandria University, Alexandria, Egypt. · Department of Pediatric Pulmonology, Cystic Fibrosis Clinic and Pediatric Sleep Medicine, Antwerp University Hospital, Edegem, Belgium. · Pediatric Sleep Disease Center, Child Neurology, NESMOS Department, School of Medicine and Psychology, Sapienza University of Rome, S. Andrea Hospital, Rome, Italy. Electronic address: mariapia.villa@uniroma1.it. ·Sleep Med · Pubmed #27938925.

ABSTRACT: BACKGROUND: Obesity is an important risk factor for obstructive sleep apnea syndrome (OSAS), and obese children with OSAS have frequently shown oxygen desaturations when compared with normal-weight children. The aim of our study was to investigate the oximetry characteristics in children with obesity and sleep-disordered breathing (SDB). METHODS: Children referred for suspected OSAS were enrolled in the study. All children underwent sleep clinical record (SCR), pulse oximetry, and polysomnography (PSG). RESULTS: A total of 248 children with SDB were recruited (128 obese and 120 normal-weight children). Obese children showed higher oxygen desaturation index (ODI) and lower nadir oxygen saturation (nadir SaO CONCLUSION: Obese children with SDB have a more significant oxygen desaturation; adeno-tonsillar hypertrophy is not the only important risk factor for its development but also the presence of malocclusions.

25 Article Expansion Pharyngoplasty by New Simple Suspension Sutures without Tonsillectomy. 2016

El-Ahl, Magdy Abdalla Sayed / El-Anwar, Mohammad Waheed. ·Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt. · Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt mwenteg@yahoo.com. ·Otolaryngol Head Neck Surg · Pubmed #27650805.

ABSTRACT: The aim of this study was to introduce and assess a new minimally invasive expansion pharyngoplasty for obstructive sleep apnea (OSA) using bilateral new advancement sutures without tonsillectomy. Among 24 patients who had OSA with Friedman stage II or III and type I Fujita, bilateral sutures were performed to advance and stabilize palatopharyngeus and palatoglossus muscles anterolaterally. Mean apnea hypopnea index decreased significantly from 28.6 ± 4.2 preoperatively to 8.9 ± 4.9 postoperatively. The lowest oxygen saturation increased significantly from 79.25 ± 4.12 to 89.29 ± 4.12. Moreover, the visual analog score showed statistically significant reduction in the snoring intensity from a preoperative mean of 8.2 ± 1.4 to 2.1 ± 1.4 at 6 months postoperatively. Significant improvements were also documented in the Epworth Sleepiness Scale, as its mean decreased from 11.7 ± 2.9 preoperatively to 5.1 ± 2.2 postoperatively. In conclusion, the described new sutures could significantly correct OSA in patients with retropalatal obstruction and lateral pharyngeal walls collapse with easy applicability and no reported complication.

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