Search Our Scientific Publications & Authors

Acta Otorrinolaringol Esp (Engl Ed) 2022 May-Jun;73(3):191-195

Unidad Multidisciplinar de Sueño, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.

Hypertrophy of adenotonsillar tissue is the most common cause of OSAS in otherwise healthy children, and therefore adenotonsillectomy is the first line treatment. Scientific societies recommend nocturnal follow-up PSG to assess for residual OSAS in children with preoperative evidence for moderate to severe OSAS, obesity, craniofacial anomalies that obstruct the upper airway and neurological disorders, based on the increasing trend of publications reporting residual OSAS after adenotonsillectomy. Follow-up PSG values in children with a pre-operative diagnosis of severe OSAS were analysed retrospectively, and compared to the parents' impression after ENT surgery. Read More

Int J Pediatr 2022 6;2022:8074094. Epub 2022 May 6.

Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.

Down syndrome (DS) or trisomy 21 is caused due to the presence of additional chromosome 21 in humans. DS can exist either as free trisomy 21 (nondisjunction), Robertsonian translocated DS, or as mosaic DS. Obstructive sleep apnea (OSA) is a complex condition with serious health implications for pediatric individuals with DS. Read More

Sleep 2022 May;45(5)

Brigham and Women's Hospital, Division of Sleep and Circadian Disorders, Boston, MA, USA.

Study Objectives: Obstructive sleep apnea is associated with neurobehavioral dysfunction, but the relationship between disease severity as measured by the apnea-hypopnea index and neurobehavioral morbidity is unclear. The objective of our study is to compare the neurobehavioral morbidity of mild sleep-disordered breathing versus obstructive sleep apnea.

Methods: Children 3-12 years old recruited for mild sleep-disordered breathing (snoring with obstructive apnea-hypopnea index < 3) into the Pediatric Adenotonsillectomy Trial for Snoring were compared to children 5-9 years old recruited for obstructive sleep apnea (obstructive apnea-hypopnea 2-30) into the Childhood Adenotonsillectomy Trial. Read More

Methods 2022 May 6. Epub 2022 May 6.

Division of Pulmonary Medicine, Boston Children's Hospital, and Harvard Medical School, Boston, MA, USA.

Purpose: This study was performed to develop and evaluate a method of detecting pediatric obstructive sleep apnea (OSA) using a multilayer perception (MLP) model based on single-channel nocturnal oxygen saturation (SpO) with or without clinical data.

Methods: Polysomnography data for 888 children with OSA and 417 unaffected children were included. An MLP model was proposed based on the features obtained from SpO and combined features of SpO and clinical data to screen symptomatic children for OSA. Read More

J Chin Med Assoc 2022 May 2. Epub 2022 May 2.

Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC.

Obstructive sleep apnea (OSA) is characterized by partial or complete airway blockage during sleep. Nocturnal nasal obstruction usually leads to mouth breathing while sleeping, which worsens sleep apnea by aggravating tongue base and lateral pharyngeal wall collapse. The pathogenesis of OSA is multifactorial, and the precipitating factors vary significantly among individuals. Read More

J Clin Sleep Med 2022 May 2. Epub 2022 May 2.

Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC.

Study Objectives: Patients with obstructive sleep apnea (OSA) have a disproportionate increase in post-operative complications and medical emergency team activation (META). We previously introduced DOISNORE50 (D-diseases, O-observed apnea, I-insomnia, S-snoring, N-neck circumference > 18 inches, O-obesity with BMI > 32, R-are you male, E-excessive daytime sleepiness, 50-age ≥ 50) from sleep questionnaire ISNORED (IS) using features associated with increased odds of META in perioperative patients. Performance of DOISNORE50 (DOISNORE) had yet to be tested. Read More

Sci Rep 2022 Apr 26;12(1):6761. Epub 2022 Apr 26.

Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82 Gumi-ro 173rd Street, Bundang-gu, Seongnam, Gyeonggi‑do, 13620, South Korea.

Although snoring is the most common subjective symptom in obstructive sleep apnea (OSA), an international consensus on the definition of snoring is lacking. This study aimed to define snoring by analyzing correlations between snoring parameters and the apnea hypopnea index (AHI). We retrospectively analyzed the polysomnography data of patients with OSA. Read More

Sleep Breath 2022 Apr 23. Epub 2022 Apr 23.

School of Medicine, Campus Bio-Medico University, Via Alvaro del Portillo 21, 00128, Rome, Italy.

Introduction: Recently, new non-invasive electrical stimulation devices have been developed with the aim to increase the tongue muscle tone for patients with obstructive sleep apnoea (OSA) and snorers. The aim of this study was to provide a review of the first results found in the literature regarding the efficacy of non-invasive electric stimulation devices for the treatment of primary snoring and OSA.

Material And Methods: An electronic search was performed on PubMed/MEDLINE, Google Scholar, and Ovid databases. Read More

J Clin Sleep Med 2022 Apr 26. Epub 2022 Apr 26.

Department of Orofacial Pain and Dysfunction, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.

Study Objectives: The primary aim was to predict upper airway collapse sites found in drug-induced sleep endoscopy (DISE) from demographic, anthropometric, clinical examination, sleep study, and snoring sound parameters in obstructive sleep apnea (OSA) patients. The secondary aim was to identify the above-mentioned parameters that are associated with complete concentric collapse of the soft palate (CCCp).

Methods: All OSA patients who underwent DISE and simultaneous snoring sound recording were enrolled in this study. Read More

Nat Sci Sleep 2022 23;14:277-290. Epub 2022 Feb 23.

Biostatistics Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City, Taiwan.

Purpose: Obstructive sleep apnea/hypopnea syndrome (OSA) results in repeated oxygen desaturation, repeated arousals, and episodic nocturnal activation of sympathetic nervous system during sleep. Untreated OSA is strongly associated with an increase of cardio- and cerebrovascular disorders, as well as the damages of ophthalmological microstructures. However, previous literature only simply studied the association between the ophthalmic disorders and OSA. Read More

JAMA Otolaryngol Head Neck Surg 2022 Apr 14. Epub 2022 Apr 14.

Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.

Importance: Breathing sounds during sleep are an important characteristic feature of obstructive sleep apnea (OSA) and have been regarded as a potential biomarker. Breathing sounds during sleep can be easily recorded using a microphone, which is found in most smartphone devices. Therefore, it may be easy to implement an evaluation tool for prescreening purposes. Read More

Nat Sci Sleep 2022 31;14:547-556. Epub 2022 Mar 31.

Biostatistics Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.

Objective: To determine the presence of lower urinary tract symptoms (LUTS), and overactive bladder (OAB) symptoms in men with obstructive sleep apnea/hypopnea syndrome (OSA) and the effects of transoral robotic surgery (TORS) for the treatment of OSA on these conditions.

Materials And Methods: One hundred twenty-three patients with a diagnosis of OSA were prospectively enrolled. The evaluations of LUTS and OAB symptoms were based on self-administered questionnaires containing international prostate symptom score (IPSS) and OAB symptom score (OABSS), respectively. Read More

Eur Arch Otorhinolaryngol 2022 Mar 25. Epub 2022 Mar 25.

Department of Otorhinolaryngology, Head and Neck Surgery, Division of Surgery and Cancer Diseases, Turku University Hospital, POB 52, 20521, Turku, Finland.

Purpose: This single-group, retrospective, pre-test-post-test study was performed to examine clinical outcomes in treating obstructive sleep apnoea (OSA) with tonsillectomy alone and had the longest follow-up periods to date.

Methods: We analysed 151 tonsillectomies in our district between the years 2004 and 2018 that had either sleep apnoea or snoring listed as a diagnosis. Twenty-one patients met our criteria and were included. Read More

J Pers Med 2022 Mar 16;12(3). Epub 2022 Mar 16.

Department of Orthodontics, School of Dentistry, National and Kapodistrian, University of Athens, 157 72 Athens, Greece.

Background: Mandibular advancement devices for obstructive sleep apnea treatment are becoming increasingly popular among patients who do not prefer CPAP devices or surgery. Our study aims to evaluate the literature regarding potential dental and skeletal side effects caused by mandibular advancement appliances used for adult OSA treatment.

Methods: Electronic databases were searched for published and unpublished literature along with the reference lists of the eligible studies. Read More

J Thorac Dis 2022 Feb;14(2):227-237

Beijing Tongren Hospital, Capital Medical University, Beijing, China.

Background: Obstructive sleep apnea (OSA) is a common disorder and associated with motor vehicle accidents, reduced quality of life and various comorbidities. It is necessary to identify clinical parameters that may predict the presence and severity of OSA.

Methods: Subjects with suspected OSA were consecutively recruited for development and validation of the models. Read More

Sleep Sci 2022 Jan-Mar;15(Spec 1):293-299

Universidade Federal de São Paulo, Department of Otorhinolaryngology and Head and Neck Surgery - São Paulo - SP - Brazil.

The aim of this case report was to evaluate the polysomnography indices, air space in the oropharyngeal region and quality of life scores using the OSA-18 questionnaire in a patient diagnosed with obstructive sleep apnea before and after rapid maxillary expansion (RME). It is a case report with a male patient, seven years old, with maxillary hypoplasia, who underwent adenotonsillectomy surgery two years ago, had restless sleep, snore more than five times a week. Pre- and post-treatment diagnostic tests were performed, including nasofibroscopy, polysomnography, computed tomography, orthodontic records and the OSA-18 quality of life questionnaire. Read More

Otolaryngol Head Neck Surg 2022 Mar 8:1945998221083288. Epub 2022 Mar 8.

Department of Otolaryngology, Eastern Virginia Medical School; Department of Pediatric Sleep Medicine, Children's Hospital of The King's Daughters, Norfolk, Virginia, USA.

Objective: Caregivers frequently report poor quality of life (QOL) in children with sleep-disordered breathing (SDB). Our objective is to assess the correlation between caregiver- and child-reported QOL in children with mild SDB and identify factors associated with differences between caregiver and child report.

Study Design: Analysis of baseline data from a multi-institutional randomized trial. Read More

Sleep Breath 2022 Feb 25. Epub 2022 Feb 25.

School of Medicine, Unit of Integrated Therapies in Otolaryngology, Campus Bio-Medico University, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo 21, 00128, Rome, Italy.

Background: Recently, the use of barbed pharyngoplasty (BP) has become widespread in snoring and obstructive sleep apnoea (OSA) palatal surgery, but there are no studies regarding the short- and long-term complications resulting from these different techniques. This systematic review aimed to report the complications and side effects of different BP techniques.

Methods: An electronic search was performed on PubMed/MEDLINE, Google Scholar, and Ovid databases. Read More

J Clin Sleep Med 2022 Mar 1. Epub 2022 Mar 1.

Faculty of Medicine and Health, University of Sydney, Australia.

Study Objectives: The success of surgical treatment for pediatric sleep-disordered breathing is typically assessed using the mixed and obstructive apnea-hypopnea index (MOAHI). Although an important metric, previous work has shown that snoring and stertor are also associated with sleep disruption. Our aim was to assess the efficacy of surgery using the Sonomat, a non-contact sleep assessment system, that accurately records complete and partial upper airway obstruction. Read More

Int J Environ Res Public Health 2022 02 21;19(4). Epub 2022 Feb 21.

Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Via Carlo Forlanini, 34, 47121 Forlì, Italy.

Obstructive sleep apnea (OSA) syndrome is a respiratory sleep disorder characterized by partial or complete recurrent episodes of upper airway collapse that occur during the night. The OSA manifests with a reduction (hypopnea) or complete cessation (apnea) of airflow in the upper airways, associated with breathing effort. OSA is a frequent and often underestimated pathology affecting between 2 and 5% of the middle-aged population. Read More

Braz J Otorhinolaryngol 2022 Jan 4. Epub 2022 Jan 4.

Hospital Universitario Doctor Peset, Department of Otolaryngology, Head and Neck Surgery, Valencia, Spain.

Objectives: Hypertrophic palatine tonsils play a role in the blockage of the upper airway, one of the known causes of Obstructive Sleep Apnea (OSA). Therefore, it is possible that there is an association between tonsil size and the success of pharyngeal surgery during OSA treatment. The main objective of this study was to evaluate the relationship between tonsil grade and volume, as well as to establish whether a relationship exists between tonsil size and the success rate of pharyngeal surgery (tonsillectomy and pharyngoplasty with barbed sutures). Read More

Sleep 2022 Feb 12. Epub 2022 Feb 12.

Brigham and Women's Hospital, Division of Sleep and Circadian Disorders, Boston, MA, USA.

Study Objectives: Obstructive sleep apnea is associated with neurobehavioral dysfunction, but the relationship between disease severity as measured by the apnea-hypopnea index and neurobehavioral morbidity is unclear. The objective of our study is to compare the neurobehavioral morbidity of mild sleep-disordered breathing versus obstructive sleep apnea.

Methods: Children 3-12 years old recruited for mild sleep-disordered breathing (snoring with obstructive apnea-hypopnea index<3) into the Pediatric Adenotonsillectomy Trial for Snoring were compared to children 5-9 years old recruited for obstructive sleep apnea (obstructive apnea-hypopnea 2-30) into the Childhood Adenotonsillectomy Trial. Read More

Otolaryngol Head Neck Surg 2022 Feb 8:1945998221075298. Epub 2022 Feb 8.

Surgery Service, Department of Veterans Affairs Medical Center, San Francisco, California, USA.

Objectives: To characterize the treatment goals and values of adult patients with obstructive sleep apnea (OSA).

Study Design: Mixed methods design based on semistructured interviews followed by cross-sectional surveys.

Setting: Academic medical center and integrated managed care consortium. Read More

Eur Arch Otorhinolaryngol 2022 Feb 6. Epub 2022 Feb 6.

School of Medicine, Campus Bio-Medico University, Unit of Integrated Therapies in Otolaryngology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy, Via Alvaro del Portillo 21, 00128, Rome, Italy.

Introduction: Oropharyngeal surgery for Obstructive Sleep Apnea (OSA) has evolved from a radical excision of "redundant" soft tissue for the enlargment of the airway to a minimally invasive reconstruction to fulfill both preservation of pharyngeal function and improvement of sleep apnea. Recently, Alianza surgical technique has been successfully introduced as a new, non-resective procedure aimed to treat concentric pharyngeal collapse at the velum using Barbed Sutures. The aim of this study was to show the effectiveness and safety of Alianza technique as standalone surgical treatment in selected patients with moderate-severe OSA and concentric pharyngeal collapse that refused or did not tolerate Continuous Positive Airway Pressure therapy. Read More

Sleep Breath 2022 Feb 5. Epub 2022 Feb 5.

Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea.

Background: Excessive collapse of the soft palate and lateral pharyngeal wall narrowing are established causes of loud snoring and sleep apnea in subjects with obstructive sleep apnea (OSA). Therefore, delicate surgical techniques are needed to reshape the soft palate and create sufficient tension in the lateral pharyngeal wall. This study aimed to determine the therapeutic outcome and favorable indications of soft-palate webbing flap pharyngoplasty in subjects with OSA and primary snoring. Read More

Sleep Breath 2022 Feb 5. Epub 2022 Feb 5.

Unit of Otorhinolaryngology-Head and Neck Surgery, Humanitas San Pio X, Via Francesco Nava, 31, 20159, Milan, Italy.

Background: Barbed snore surgery (BSS) was recently introduced for the management of obstructive sleep apnea (OSA) with optimistic clinical outcomes associated with a low complication rate. The purpose of the present study was to describe the surgical learning curve of the BSS to determine the effect of surgeon experience on surgical procedure time and complication rates.

Methods: Patients who underwent tonsillectomy with barbed lateral pharyngoplasty were divided in two different groups based on surgeon experience. Read More

Eur Arch Otorhinolaryngol 2022 May 31;279(5):2679-2687. Epub 2022 Jan 31.

Faculty of Medicine, Otorhinolaryngology, Head and Neck Surgery Department, Zagazig University, Zagazig, Egypt.

Purpose: This study tried to assess the surgical outcome of anterolateral advancement palatoplasty (ALP) with simultaneous tonsillectomy for the treatment of retropalatal obstruction in selected cases of obstructive sleep apnea (OSA).

Methods: In this clinical trial, 22 adult OSA patients having predominant retropalatal collapse were managed by ALP and tonsillectomy.Thirteen patients had positional OSA (PP) and 9 patients had non-positional (NPP). Read More

Am J Otolaryngol 2022 Mar-Apr;43(2):103317. Epub 2021 Dec 14.

Otorhinolaryngology Research Center, Department of Otolaryngology and Head and Neck Surgery, Amiralmomenin Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

Background: The goal of this study was to evaluate the effects of adenotonsillectomy on heart function based on echocardiography indices in children with primary snoring (PS) and mild obstructive sleep apnea due to adenotonsillar hypertrophy (ATH).

Methods: 55 children (aged 7 to 11 years old) with PS and ATH who were a candidate for adenotonsillectomy from August 2018 to June 2019 evaluated. A history of Upper Respiratory Tract Obstruction was obtained, clinical examination was performed and the cases suspicious for moderate to severe degrees of Obstructive Sleep Apnea Syndrome were excluded. Read More

Sleep Sci 2021 Jan-Mar;14(4):330-336

Universidade Federal de São Paulo, Department of Otorhinolaryngology and Head and Neck Surgery - São Paulo - SP - Brazil.

Introduction: Few studies have addressed long-term quality of life related to residual snoring after adenotonsillectomy. The aim of this study was to compare scores from the OSA-18 questionnaire between children with residual snoring and non-snoring children two or more years after adenotonsillectomy.

Material And Methods: The sample comprised 25 children divided into two groups, a group of 14 snoring children, and a control group of 11 non-snoring children. Read More

Asian J Neurosurg 2021 Oct-Dec;16(4):817-820. Epub 2021 Dec 18.

Department of Oral Medicine and Radiology, Saraswati Dhanwantari Dental College and Hospital and Post-Graduate Research Institute, Parbhani, Maharashtra, India.

Background And Aim: Snoring, which falls within the spectrum of sleep-related breathing disorders, is considered to be one of the common symptoms of airway obstruction. Lateral cephalometric analysis is an effective way of diagnosing airway obstruction by evaluating skeletal and soft-tissue abnormalities in patients with sleep-disordered breathing. The present study was planned to analyze the pharyngeal space among snorers and nonsnorers in retroglossal region and in the region of the hypopharynx at the level of epiglottis. Read More