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…
1 Introduction Obstructive sleep apnea syndrome (OSA) results from a complex scenario initiated with airway collapse and obstruction, loss of compensatory wake and sleep reflexes, increased ventilatory effort, arousal, hypoventilation, and asphyxia during sleep. In adults, a structurally small upper…
As we trace the advancements of obstructive sleep apnea (OSA) surgery, it is important to realize that tongue base surgery has remained a challenge. Traditional hypopharyngeal/tongue base procedures for OSA are usually aggressive, time consuming, and technically advanced. Some previously…