1 Introduction The importance of lingual tonsil hypertrophy has long been recognized as a significant factor in obstructive sleep apnea (OSA), but only recently with the advent of transoral robotic surgery (TORS) do sleep surgeons have a tool that can…
This chapter reviews the role of the epiglottis in obstructive sleep apnea (OSA) and surgical management of its obstructive capacity. Although it has been well recognized for years that multiple levels of obstruction are responsible for OSA, most authors focus…
1 Introduction 1.2 Indications and Contraindications Obstruction of the airway at the retropalatinal and retropharyngeal airway is the key factor in the pathophysiology of obstructive sleep apnea syndrome (OSAS). Patient selection is crucial in successful surgery of the upper airway…
1 Introduction The genioglossus muscle originates from the genial tubercle, inserts posteriorly at the tip of the tongue and the dorsum of the tongue, and into the body of the hyoid bone ( Fig. 52.1 ). The fibers retract the…
1 Introduction The major contributing factors to retrolingual collapse in sleep apnea are macroglossia, hypotonia, retrognathia, and lingual tonsillar hyperplasia. Any or all of these may contribute to varying degrees in any given individual. All current low-morbidity options have limitations…
1 Introduction Obstructive sleep apnea (OSA) is a common sleep disorder. It is characterized by repetitive apneas and hypopneas during sleep. These events are due to partial or complete collapse of the upper airway, resulting in decreased oxygenation and sympathetic…
1 Introduction Obstructive sleep apnea (OSA) is a multi-factorial disorder where state-dependent loss of upper airway muscle tone and neuromuscular dysfunction result in cyclical upper airway obstruction during sleep. Hypoglossal neurostimulation is a new, functional approach to treating OSA that…
1 Introduction Upper airway stimulation is a novel approach to the management of obstructive sleep apnea (OSA). Hypoglossal nerve stimulation (HNS) therapy has been shown to improve objective respiratory and subjective quality-of-life outcomes and is well positioned as a new…
1 Introduction Sleep-disordered breathing results from a combination of factors affecting upper airway patency and the control of ventilation. Although the mechanisms underlying upper airway collapse are incompletely understood, a decline in pharyngeal neuromuscular activity during sleep appears to play…
1 Introduction For the clinician and surgeon treating patients with obstructed sleep apnea and related maladies, the retrolingual airway is of great importance. This area, often difficult to examine and identify as an area of concern, has recently been the…