Base de dados : MEDLINE
Pesquisa : A14.549.617.780.729 [Categoria DeCS]
Referências encontradas : 1583 [refinar]
Mostrando: 1 .. 10   no formato [Detalhado]

página 1 de 159 ir para página                         

  1 / 1583 MEDLINE  
              next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28468149
[Au] Autor:Yao K; Wang M; Yu W; Lu X
[Ad] Endereço:Department of Oral and Cranio-Maxillofacial Surgery, Sleep Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
[Ti] Título:Study on the Short-Time Remolding of Upper Airway After Uvulopalatopharyngoplasty.
[So] Source:J Craniofac Surg;28(3):688-692, 2017 May.
[Is] ISSN:1536-3732
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To verify the short-time remolding of upper airway in patients diagnosed with obstructive sleep disordered breathing after Uvulopalatopharyngoplasty (UPPP). METHODS: Twenty-one male adult patients aged 27 to 52 years followed up ranged from preoperation to 6 months after the operation. Lateral cephalometric radiographs (conventional and when pronouncing "i") were obtained 2 weeks preoperatively, 3 days postoperatively, and 1, 2, 3, 6 months after the surgery. The anterolateral diameters of different levels of upper airway and parameters of hyoid position of the patients were then measured. SAS 8.02 was used to analyze the differences by time. RESULTS: The study illustrated that the UPPP major affected the velopharyngeal and glossopharyngeal areas: parameters wane (P <0.05). On the other hand, UPPP leaded to the decline and retreat of hyoid. Most of the parameters remained metabolic. The nasopharynx kept statical (P >0.05) while the velopharyngeal parameters were increasing (P <0.05). The glossopharyngeal parameters increased in the first month after UPPP (P <0.05), while hypopharyngeal parameters underwent decline since 2 months after UPPP (P <0.05). The hyoid obtained decline and retreat (P <0.05) overall, while it endured a short-time climb in the first month after UPPP (P <0.05). CONCLUSION: Short-time upper airway remolding after UPPP existed.
[Mh] Termos MeSH primário: Remodelação das Vias Aéreas/fisiologia
Palato Mole/cirurgia
Faringe/cirurgia
Apneia Obstrutiva do Sono/cirurgia
Úvula/cirurgia
[Mh] Termos MeSH secundário: Adulto
Cefalometria
Seguimentos
Seres Humanos
Osso Hioide/cirurgia
Masculino
Meia-Idade
Nasofaringe/fisiopatologia
Nasofaringe/cirurgia
Período Pós-Operatório
Apneia Obstrutiva do Sono/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180126
[Lr] Data última revisão:
180126
[Sb] Subgrupo de revista:D
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1097/SCS.0000000000003476


  2 / 1583 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28738391
[Au] Autor:Li HY
[Ad] Endereço:Department of Otolaryngology, Chang Gung Memorial Hospital, School of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC.
[Ti] Título:Updated Palate Surgery for Obstructive Sleep Apnea.
[So] Source:Adv Otorhinolaryngol;80:74-80, 2017.
[Is] ISSN:1662-2847
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:Initially described in 1981, uvulopalatopharyngoplasty was the first surgical procedure specially designed at the palatal level for snoring and obstructive sleep apnea (OSA). To date, palatal surgery remains the most commonly used surgery for OSA. The advancement of this surgery over the past 30 years has been a process of evolution in concepts, examination, and technique to increase safety and effectiveness in the treatment of OSA. Concept changes have emerged in the disease etiology, purpose of surgery, treatment priorities, staging of operations, integration therapy, and surgical endpoints. Drug-induced sleep examination has become the mainstream for forming a surgical plan. The surgical technique has tended toward the functional expansion and stabilization of airway tissue instead of excision. Here, drug-induced sleep computed tomography is introduced. In addition, palatal surgery is further divided into palatoplasty and pharyngoplasty for individual clinical application.
[Mh] Termos MeSH primário: Palato Mole/cirurgia
Apneia Obstrutiva do Sono/cirurgia
[Mh] Termos MeSH secundário: Seres Humanos
Faringe/cirurgia
Ronco/cirurgia
Úvula/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170725
[St] Status:MEDLINE
[do] DOI:10.1159/000470869


  3 / 1583 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28738337
[Au] Autor:Yaremchuk K; Garcia-Rodriguez L
[Ti] Título:The History of Sleep Surgery.
[So] Source:Adv Otorhinolaryngol;80:17-21, 2017.
[Is] ISSN:1662-2847
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:Snoring and the subsequent diagnosis of obstructive sleep apnea (OSA) was a life-threatening medical condition with no available treatment until the late 20th century. An early description of OSA was provided by Charles Dickens in his 1836 novel Pickwick Papers with the description of a "fat boy" who was thought to be lazy and always falling asleep but likely displayed hypersomnolence from OSA. It was not until 1976 that Ikematsu first described uvulopalatopharyngoplasty (UPPP) as an alternative surgical treatment of "snoring," with a reported cure rate of 81%. The only other surgical procedure for OSA was permanent tracheostomy, but patients suffered from social stigma from the visible stoma with skin flaps and complications such as tracheal granulomas and tracheitis. UPPP was introduced in the USA as an alternative to permanent tracheostomy by Fujita in 1981. Since then, multiple surgical approaches and combinations of approaches have surfaced, with variable success rates.
[Mh] Termos MeSH primário: Apneia Obstrutiva do Sono/história
Ronco/história
[Mh] Termos MeSH secundário: História do Século XX
Seres Humanos
Faringe/cirurgia
Apneia Obstrutiva do Sono/cirurgia
Ronco/cirurgia
Traqueostomia/história
Úvula/cirurgia
[Pt] Tipo de publicação:HISTORICAL ARTICLE; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170725
[St] Status:MEDLINE
[do] DOI:10.1159/000470683


  4 / 1583 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28526655
[Au] Autor:Schwab RJ; Leinwand SE; Bearn CB; Maislin G; Rao RB; Nagaraja A; Wang S; Keenan BT
[Ad] Endereço:Division of Sleep Medicine, Philadelphia, PA; Center for Sleep & Circadian Neurobiology, Philadelphia, PA. Electronic address: rschwab@mail.med.upenn.edu.
[Ti] Título:Digital Morphometrics: A New Upper Airway Phenotyping Paradigm in OSA.
[So] Source:Chest;152(2):330-342, 2017 Aug.
[Is] ISSN:1931-3543
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: OSA is associated with changes in pharyngeal anatomy. The goal of this study was to objectively and reproducibly quantify pharyngeal anatomy by using digital morphometrics based on a laser ruler and to assess differences between subjects with OSA and control subjects and associations with the apnea-hypopnea index (AHI). To the best of our knowledge, this study is the first to use digital morphometrics to quantify intraoral risk factors for OSA. METHODS: Digital photographs were obtained by using an intraoral laser ruler and digital camera in 318 control subjects (mean AHI, 4.2 events/hour) and 542 subjects with OSA (mean AHI, 39.2 events/hour). RESULTS: The digital morphometric paradigm was validated and reproducible over time and camera distances. A larger modified Mallampati score and having a nonvisible airway were associated with a higher AHI, both unadjusted (P < .001) and controlling for age, sex, race, and BMI (P = .015 and P = .018, respectively). Measures of tongue size were larger in subjects with OSA vs control subjects in unadjusted models and controlling for age, sex, and race but nonsignificant controlling for BMI; similar results were observed with AHI severity. Multivariate regression suggests photography-based variables capture independent associations with OSA. CONCLUSIONS: Measures of tongue size, airway visibility, and Mallampati scores were associated with increased OSA risk and severity. This study shows that digital morphometrics is an accurate, high-throughput, and noninvasive technique to identify anatomic OSA risk factors. Morphometrics may also provide a more reproducible and standardized measurement of the Mallampati score. Digital morphometrics represent an efficient and cost-effective method of examining intraoral crowding and tongue size when examining large populations, genetics, or screening for OSA.
[Mh] Termos MeSH primário: Apneia Obstrutiva do Sono/patologia
[Mh] Termos MeSH secundário: Adulto
Desenho de Equipamento
Feminino
Seres Humanos
Hipertrofia/patologia
Lasers
Masculino
Meia-Idade
Tamanho do Órgão
Tonsila Palatina/patologia
Fenótipo
Fotografia
Polissonografia/métodos
Língua/patologia
Úvula/patologia
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170521
[St] Status:MEDLINE


  5 / 1583 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28508712
[Au] Autor:Friedman JJ; Salapatas AM; Bonzelaar LB; Hwang MS; Friedman M
[Ad] Endereço:1 University of Illinois College of Medicine, Chicago, Illinois, USA.
[Ti] Título:Changing Rates of Morbidity and Mortality in Obstructive Sleep Apnea Surgery.
[So] Source:Otolaryngol Head Neck Surg;157(1):123-127, 2017 Jul.
[Is] ISSN:1097-6817
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objective Whereas uvulopalatopharyngoplasty (UPPP) was the standard surgical procedure for obstructive sleep apnea prior to 2007, multilevel surgery has become the standard since that time. This study compares morbidity and mortality rates of the stand-alone UPPP with those of multilevel sleep surgery that includes UPPP. Methods Patients undergoing UPPP between 2007 and 2014 were identified in the American College of Surgeons National Surgical Quality Improvement Program database. UPPP was defined by Current Procedural Terminology codes 42145 and 42950. Primary outcomes were incidence of morbidity and mortality. Rates were compared between a control group with UPPP only and a group with multilevel surgery. Results A total of 2674 cases were analyzed. The incidence of complications in the UPPP-only group was 1.6% (0.09% fatal); in the multilevel surgery group, 4.63% (0.19% fatal). The difference in overall and nonfatal complications is statistically significant ( P < .01); however, values for fatal complications are too low for comparison. There is a statistically significant ( P < .01) positive correlation ( R = 0.92) between year of operation and rate of complications, with increased incidence of complications in more recent years. Discussion Complication rates for multilevel sleep surgery are higher than those of stand-alone UPPP, and overall complication rates have been increasing in recent years. As UPPP supplemented with multilevel surgery is now the standard surgical treatment for most cases of obstructive sleep apnea-hypopnea syndrome, historical complication rates based predominantly on patients undergoing UPPP only underestimate complication rates of modern sleep surgery. Implications for Practice It is reasonable to inform patients that multilevel procedures bring an increased risk of complications, and patient selection should be guided accordingly.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos Otorrinolaringológicos/métodos
Apneia Obstrutiva do Sono/mortalidade
Apneia Obstrutiva do Sono/cirurgia
[Mh] Termos MeSH secundário: Idoso
Feminino
Seres Humanos
Incidência
Masculino
Meia-Idade
Morbidade
Palato Mole/cirurgia
Faringe/cirurgia
Complicações Pós-Operatórias/epidemiologia
Estudos Retrospectivos
Resultado do Tratamento
Estados Unidos/epidemiologia
Úvula/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170824
[Lr] Data última revisão:
170824
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170517
[St] Status:MEDLINE
[do] DOI:10.1177/0194599817706500


  6 / 1583 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28322112
[Au] Autor:Brietzke SE; Ishman SL; Cohen S; Cyr DD; Shin JJ; Kezirian EJ
[Ad] Endereço:1 Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
[Ti] Título:National Database Analysis of Single-Level versus Multilevel Sleep Surgery.
[So] Source:Otolaryngol Head Neck Surg;156(5):955-961, 2017 May.
[Is] ISSN:1097-6817
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objective Recent evidence suggests that multilevel sleep surgery improves outcomes when compared with palate surgery alone for most patients. The study objective was to compare demographic and outcomes data for palate surgery (uvulopalatopharyngoplasty [UPPP]) alone versus multilevel surgery through a national insurance claims database. Study Design Retrospective cohort study. Setting National insurance claims database. Subjects and Methods An adult cohort undergoing single-level UPPP versus UPPP with nasal and/or tongue/hypopharyngeal surgery was identified in the Truven Health Analytics MarketScan Research Databases for the years 2010 through 2012. Demographic and outcomes data were assessed at short-term (≤14 days), intermediate (15-60 days), and long-term (61-183 days) intervals via a multivariate regression model adjusted for age, sex, geographic region, insurance type, and the Charlson-Deyo comorbidity score. The primary long-term complication considered was positive airway pressure (PAP) equipment supply, implying possible treatment failure. Results The cohort included 14,633 patients: 7559 (51.6%), UPPP alone; 5219 (35.7%), UPPP + nasal surgery; 1164 (7.95%), UPPP + tongue/hypopharyngeal surgery; and 691 (4.7%), UPPP + nasal + tongue/hypopharyngeal surgery. Demographic data were similar among the groups. UPPP alone had lower rates of postoperative bleeding than UPPP + tongue/hypopharyngeal surgery (4.31% vs 6.19%, P = .004). Multivariate modeling indicated that the addition of either nasal surgery (odds ratio = 1.21, 95% CI = 1.10-1.34, P < .001) or tongue/hypopharyngeal surgery (odds ratio = 1.15, 95% CI = 1.00-1.32, P = .048) to UPPP was associated with increased odds of postoperative continuous positive airway pressure. Conclusions UPPP alone is currently the predominant form of sleep surgery in the United States. Multilevel surgery had greater odds of postoperative bleeding and positive airway pressure equipment supply than UPPP alone. Dedicated studies formally evaluating single- versus multilevel sleep surgery and the impact of possible surgeon/patient selection bias should be a priority.
[Mh] Termos MeSH primário: Palato Mole/cirurgia
Qualidade de Vida
Apneia Obstrutiva do Sono/diagnóstico
Apneia Obstrutiva do Sono/cirurgia
Úvula/cirurgia
[Mh] Termos MeSH secundário: Adulto
Bases de Dados Factuais
Feminino
Seguimentos
Glossectomia/métodos
Seres Humanos
Hipofaringe/cirurgia
Masculino
Meia-Idade
Análise Multivariada
Procedimentos Cirúrgicos Nasais/métodos
Razão de Chances
Faringostomia/métodos
Polissonografia/métodos
Análise de Regressão
Estudos Retrospectivos
Medição de Risco
Índice de Gravidade de Doença
Apneia Obstrutiva do Sono/psicologia
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170816
[Lr] Data última revisão:
170816
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170322
[St] Status:MEDLINE
[do] DOI:10.1177/0194599817696503


  7 / 1583 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
[PMID]:28231365
[Au] Autor:Mutlu M; Vuralkan E; Akin I; Firat H; Ardic S; Akaydin S; Miser E
[Ad] Endereço:Department of Otorhinolaryngology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey. muradmutlu78@yahoo.com.
[Ti] Título:Alteration of serum levels of inflammatory cytokines and polysomnographic indices after uvulopalatal flap surgery in obstructive sleep apnea.
[So] Source:Ear Nose Throat J;96(2):65-68, 2017 Feb.
[Is] ISSN:1942-7522
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The aim of the current study was to compare the changes in polysomnographic indices and serum levels of C-reactive protein (CRP), cystatin C, tumor necrosis factor-α (TNF-α), and intercellular adhesion molecule-1 (ICAM-1) in patients with obstructive sleep apnea (OSA) who were treated surgically via a uvulopalatal flap (UPF) technique. Twenty-five patients (14 men, 11 women), average age 46.2 ± 9.3 years, who underwent UPF surgery were included in this study. Serum biochemical analyses and polysomnographic examinations were performed before and 6 months after the surgery. Pre- and postoperative values of apnea hypopnea index (AHI), oxygen desaturation index (ODI), and minimum oxygen concentrations, as well as serum levels of CRP, cystatin C, TNF-α, and ICAM-1 were compared. Comparison of variables before and after UPF surgery demonstrated that AHI (p = 0.001), ODI (p < 0.001) and oxygen saturation (p < 0.001) were significantly improved. In addition, serum levels of CRP (p = 0.036), cystatin C (p = 0.005), TNF-α (p < 0.001), and ICAM-1 (p < 0.001) were significantly reduced 6 months after surgery. Our results suggest that UPF is an effective surgical method that alleviates the severity of OSA. Moreover, it may have the potential to prevent the development of atherosclerosis by attenuating the inflammatory process induced by activation of inflammatory mediators such as CRP, TNF-α, ICAM-1, and cystatin C.
[Mh] Termos MeSH primário: Citocinas/sangue
Palato/cirurgia
Índice de Gravidade de Doença
Apneia Obstrutiva do Sono/sangue
Retalhos Cirúrgicos
Úvula/transplante
[Mh] Termos MeSH secundário: Adulto
Proteína C-Reativa/análise
Cistatina C/sangue
Feminino
Seres Humanos
Molécula 1 de Adesão Intercelular/sangue
Masculino
Meia-Idade
Polissonografia/estatística & dados numéricos
Período Pós-Operatório
Período Pré-Operatório
Apneia Obstrutiva do Sono/fisiopatologia
Apneia Obstrutiva do Sono/cirurgia
Resultado do Tratamento
Fator de Necrose Tumoral alfa/sangue
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (CST3 protein, human); 0 (Cystatin C); 0 (Cytokines); 0 (Tumor Necrosis Factor-alpha); 126547-89-5 (Intercellular Adhesion Molecule-1); 9007-41-4 (C-Reactive Protein)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170224
[St] Status:MEDLINE


  8 / 1583 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28219167
[Au] Autor:Zhu M; Bai X
[Ad] Endereço:Department of Otorhinolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
[Ti] Título:[Therapeutic effectiveness of the soft palate fold surgery in patients with obstructive sleep apnea hypopnea syndrome].
[So] Source:Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi;52(2):99-102, 2017 Feb 07.
[Is] ISSN:1673-0860
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To evaluate the relationships between anatomical changes and treatment outcomes after modified velopharyngeal surgery in obstructive sleep apnea hypopnea syndrome (OSAHS) patients with the soft palate drooping. From November 2011 to November 2015, 44 OSHS patients (AHI 5-30 times/h) with the soft palate drooping determined by Muller test and drug-induced sleep endoscopy (DISE) were randomly selected. Treatment group included 23 patients who underwent modified velopharyngeal surgery, in which uvula was preserved and soft palate was shortened and advanced. Control group included 21 patients who received conventional UPPP surgery.Compared the differences in preoperative and postoperative Epworth Sleepiness Scale (ESS), Numeric Rating Scale (NRS), lowest arterial blood oxygen saturation (LSaO(2)), and apnea hypoventilation index (AHI) between the two groups. Each data rows normality test. The two groups' preoperative and postoperative data row intra-group comparison and matching t test. Used the independent sample t test after homogeneity of variance test to compare the two groups. The difference was statistically significant when <0.05. There were statistically significant differences in AHI , LSaO(2) and ESS score between before and after surgery in individual groups. There were not significant differences in preoperative AHI and LSaO(2) between the two groups, but with a higher ESS in treatment group compared to control group. There were no statistically significant differences in postoperative AHI, LSaO(2) or ESS between the two groups. Compared with control group, treatment group had a lower postoperative pain scale score (4.3±1.3 vs 6.3±0.8, =0.000) and a shorter time to resume normal eating ((6.7±1.6) d vs (15.5±3.5) d, =0.000). OSAHS patients (AHI 5-30 times/h) with the soft palate drooping are more likely to have favorable anatomical changes after revised velopharyngeal surgery.
[Mh] Termos MeSH primário: Palato Mole/cirurgia
Apneia Obstrutiva do Sono/cirurgia
[Mh] Termos MeSH secundário: Estudos de Casos e Controles
Feminino
Seres Humanos
Masculino
Tratamentos com Preservação do Órgão
Polissonografia
Período Pós-Operatório
Resultado do Tratamento
Úvula
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170802
[Lr] Data última revisão:
170802
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170222
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.1673-0860.2017.02.005


  9 / 1583 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28201808
[Au] Autor:Camacho M; Nesbitt NB; Lambert E; Song SA; Chang ET; Liu SY; Kushida CA; Zaghi S
[Ad] Endereço:Otolaryngology-Head and Neck Surgery, Division of Sleep Surgery and Medicine, Tripler Army Medical Center, Honolulu, HI.
[Ti] Título:Laser-Assisted Uvulopalatoplasty for Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis.
[So] Source:Sleep;40(3), 2017 Mar 01.
[Is] ISSN:1550-9109
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Study Objectives: Laser-assisted uvulopalatoplasty (LAUP) has been used as treatment for obstructive sleep apnea (OSA). The objective of this study was to perform a systematic review and meta-analysis for LAUP alone as treatment for OSA in adults. Methods: Three authors searched five databases (including PubMed/MEDLINE) from inception through October 30, 2016 for peer-reviewed studies, with any design/language. A study quality assessment tool was used. The PRISMA statement was followed. A meta-analysis was performed. Results: Twenty-three adult studies (717 patients) reported outcomes (age: 50 ± 9 years, body mass index: 29 ± 4 kg/m2). The pre- and post-LAUP means (M) ± standard deviations (SDs) for apnea-hypopnea index (AHI) were 28 ± 13 and 19 ± 12 events/h (32% reduction). Random effects modeling for 519 patients demonstrated an AHI mean difference (MD) of -6.56 [95% CI -10.14, -2.97] events/h. Individual patient data analyses demonstrate a 23% success rate (≥50% reduction in AHI and <20 events/h) and an 8% cure rate. Additionally, 44% of patients had worsening of their AHI after LAUP. Lowest oxygen saturation (LSAT) improved from a M ± SD of 80 ± 8% to 82 ± 7%. A limitation is that most studies were case series studies and only two were randomized controlled trials. Conclusions: In this meta-analysis, LAUP reduced AHI by 32% among all patients; while the LSAT only changed minimally. Individual data demonstrated a success rate of 23%, cure rate of 8%, and worsening of the AHI among 44% of patients. We recommend that LAUP be performed with caution or not performed at all given the unfavorable results of currently published studies.
[Mh] Termos MeSH primário: Terapia a Laser
Palato/cirurgia
Apneia Obstrutiva do Sono/cirurgia
Úvula/cirurgia
[Mh] Termos MeSH secundário: Seres Humanos
Palato/fisiopatologia
Apneia Obstrutiva do Sono/fisiopatologia
Úvula/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170627
[Lr] Data última revisão:
170627
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170216
[St] Status:MEDLINE
[do] DOI:10.1093/sleep/zsx004


  10 / 1583 MEDLINE  
              first record previous record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28116979
[Au] Autor:Tang JA; Salapatas AM; Bonzelaar LB; Friedman M
[Ad] Endereço:1 Chicago ENT: Advanced Center for Specialty Care, Chicago, Illinois, USA.
[Ti] Título:Long-Term Incidence of Velopharyngeal Insufficiency and Other Sequelae following Uvulopalatopharyngoplasty.
[So] Source:Otolaryngol Head Neck Surg;156(4):606-610, 2017 Apr.
[Is] ISSN:1097-6817
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objective The aim of this study is to (1) assess incidence of long-term velopharyngeal insufficiency (VPI) and (2) determine other sequelae following classic and modified uvulopalatopharyngoplasty (UPPP and mUPPP) for treatment of obstructive sleep apnea (OSA). Data Sources Medline, PubMed, Cochrane Library database. Review Methods A systematic review was performed following standard Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Original research articles reporting on sequelae of UPPP and mUPPP for treatment of OSA, at a mean of 1 year follow-up, were included. Articles were retrieved using keywords UPPP complications and UPPP questionnaire. A random-effects model was used for pooling data. Results A total of 24 studies were included in this review. Complications included VPI (24 studies, n = 191), difficulty swallowing (7 studies, n = 83), taste disturbances (4 studies, n = 10), voice changes (7 studies, n = 46), foreign body (9 studies, n = 427), and dry pharynx (7 studies, n = 150). When pooling all studies together, VPI was the least common sequelae reported in 8.1% of the cases. Foreign body sensation was the most commonly reported sequelae at 31.2%, with difficulty swallowing (17.7%), dry pharynx (23.4%), voice changes (9.5%), and taste disturbances (8.2%) being the most to least likely. Conclusions The long-term effectiveness of UPPP and mUPPP is limited by the number of studies reporting short-term follow-up only. Despite this, long-term data suggest that complications such as VPI are more common than previously reported. Other sequelae, such as foreign body sensation, may be one of the most frequently expected complications after UPPP surgery.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos Otorrinolaringológicos/efeitos adversos
Palato Mole/cirurgia
Faringe/cirurgia
Complicações Pós-Operatórias/epidemiologia
Apneia Obstrutiva do Sono/cirurgia
Insuficiência Velofaríngea/etiologia
[Mh] Termos MeSH secundário: Seres Humanos
Incidência
Úvula/cirurgia
Insuficiência Velofaríngea/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170728
[Lr] Data última revisão:
170728
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170125
[St] Status:MEDLINE
[do] DOI:10.1177/0194599816688646



página 1 de 159 ir para página                         
   


Refinar a pesquisa
  Base de dados : MEDLINE Formulário avançado   

    Pesquisar no campo  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde