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Sleep Apnea Syndromes: HELP
Articles from Ravenna
Based on 3 articles published since 2010
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These are the 3 published articles about Sleep Apnea Syndromes that originated from Ravenna during 2010-2020.
 
+ Citations + Abstracts
1 Article Outcome predictors for non-resective pharyngoplasty alone or as a part of multilevel surgery, in obstructive sleep apnea-hypopnea syndrome. 2019

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

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

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

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

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

3 Article The importance of drug-induced sedation endoscopy (D.I.S.E.) techniques in surgical decision making: conventional versus target controlled infusion techniques-a prospective randomized controlled study and a retrospective surgical outcomes analysis. 2017

De Vito, Andrea / Agnoletti, Vanni / Zani, Gianluca / Corso, Ruggero Massimo / D'Agostino, Giovanni / Firinu, Elisabetta / Marchi, Chiara / Hsu, Ying-Shuo / Maitan, Stefano / Vicini, Claudio. ·Otorhinolaryngology and Oral Surgery Unit, Department of Head and Neck Surgery, Morgagni-Pierantoni Hospital, Forlì, Italy. dr.andrea.devito@gmail.com. · Anaesthesia and Intensive Care Unit, Emergency Department, M. Bufalini Hospital, Cesena, Italy. · Anesthesia and Intensive Care Unit, Santa Maria delle Croci Hospital, Ravenna, Italy. · Anaesthesia and Intensive Care Unit, Emergency Department, G.B. Morgagni-Pierantoni Hospital, Forlì, Italy. · Otorhinolaryngology and Oral Surgery Unit, Department of Head and Neck Surgery, Morgagni-Pierantoni Hospital, Forlì, Italy. · Department of Otolaryngology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan, Republic of China. ·Eur Arch Otorhinolaryngol · Pubmed #28213776.

ABSTRACT: Drug-Induced Sedation Endoscopy (DISE) consists of the direct observation of the upper airways during sedative-induced sleep, allowing the identification of the sites of pharyngeal collapse, which is the main pathological event in Obstructive Sleep Apnea (OSA). The Authors have compared Target Controlled Infusion (TCI) sedation endoscopy (TCI-DISE) technique to conventional DISE (CDISE), performed by a manual bolus injection of sedative agent, to recreate accurately and safely snoring and apnea patterns comparable to natural sleep. The authors conducted a prospective, randomized, long-term study and a retrospective analysis of surgical outcomes. The apnea-event observation and its correlation with pharyngeal collapse patterns is the primary endpoint; secondary endpoints are defined as stability and safety of sedation plan of DISE-TCI technique. From January 2009 to January 2011, OSA patients were included in the study and randomly allocated into two groups: the bolus injection conventional DISE group and the TCI-DISE group. Third endpoint is to compare the surgical outcomes enrolling OSA patients from January 2009 to June 2015. We recorded the complete apnea-event at oropharynx and hypopharynx levels in 15/50 pts in conventional DISE group (30%) and in 99/123 pts in TCI-DISE group (81%) (p < 0.0001). Four pts needed oxygen in conventional DISE group because a severe desaturation occurred during the first bolus of propofol (1 mg/kg) (p = 0.4872 ns). We recorded instability of the sedation plan in 13 patients of conventional DISE group (65%) and 1 patient of the TCI-DISE group (5%) (p = 0.0001). In 37 TCI-DISE group surgical patients we reported a significant reduction of postoperative AHI (from 42.7 ± 20.2 to 11.4 ± 10.3) in comparison with postoperative AHI in 15 C-DISE group surgical patients (from 41.3 ± 23.4 to 20.4 ± 15.5) (p = 0.05). Our results suggest the DISE-TCI technique as first choice in performing sleep-endoscopy because of its increased accuracy, stability and safety. However, it is mandatory an accurate assessment of PSG/PM, which allows us to differentiate OSA patients in whom UA anatomical abnormalities are predominant in comparison with not-anatomical pathophysiologic factors, achieving good surgical patient's selection and outcomes as a consequence.