Navegando por Palavras-chave "airway obstruction"

Agora exibindo 1 - 2 de 2
  • Nenhuma Miniatura disponível
    Item
    Somente Metadadados
    Effect of Sleeping Position on Upper Airway Patency in Obstructive Sleep Apnea Is Determined by the Pharyngeal Structure Causing Collapse
    (Oxford Univ Press Inc, 2017) Marques, Melania; Genta, Pedro R.; Sands, Scott A.; Azarbazin, Ali; de Melo, Camila [UNIFESP]; Taranto-Montemurro, Luigi; White, David P.; Wellman, Andrew
    Objectives: In some patients, obstructive sleep apnea (OSA) can be resolved with improvement in pharyngeal patency by sleeping lateral rather than supine, possibly as gravitational effects on the tongue are relieved. Here we tested the hypothesis that the improvement in pharyngeal patency depends on the anatomical structure causing collapse, with patients with tongue-related obstruction and epiglottic collapse exhibiting preferential improvements. Methods: Twenty-four OSA patients underwent upper airway endoscopy during natural sleep to determine the pharyngeal structure associated with obstruction, with simultaneous recordings of airflow and pharyngeal pressure. Patients were grouped into three categories based on supine endoscopy: Tongue-related obstruction (posteriorly located tongue, N = 10), non-tongue related obstruction (collapse due to the palate or lateral walls, N = 8), and epiglottic collapse (N = 6). Improvement in pharyngeal obstruction was quantified using the change in peak inspiratory airflow and minute ventilation lateral versus supine. Results: Contrary to our hypothesis, patients with tongue-related obstruction showed no improvement in airflow, and the tongue remained posteriorly located while lateral. Patients without tongue involvement showed modest improvement in airflow (peak flow increased 0.07 L/s and ventilation increased 1.5 L/min). Epiglottic collapse was virtually abolished with lateral positioning and ventilation increased by 45% compared to supine position. Conclusions: Improvement in pharyngeal patency with sleeping position is structure specific, with profound improvements seen in patients with epiglottic collapse, modest effects in those without tongue involvement and-unexpectedly-no effect in those with tongue-related obstruction. Our data refute the notion that the tongue falls back into the airway during sleep via gravitational influences.
  • Nenhuma Miniatura disponível
    Item
    Somente Metadadados
    Systematic Evaluation of the Upper Airway in the Adult Population of São Paulo, Brazil
    (Sage Publications Ltd, 2012-05-01) Stefanini, Renato [UNIFESP]; Tufik, Sergio [UNIFESP]; Mattos Soares, Maria Claudia [UNIFESP]; Martinho Haddad, Fernanda Louise [UNIFESP]; Azeredo Bittencourt, Lia Rita [UNIFESP]; Santos-Silva, Rogerio [UNIFESP]; Gregório, Luiz Carlos [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objectives. To study the prevalence of otorhinolaryngologic symptoms and findings of physical examination of the upper airway (UA) of a representative sample of the adult population of São Paulo, Brazil, and the association between these findings.Study Design. Cross-sectional survey.Setting. Population sample.Methods. A total of 1101 randomly selected volunteers representing the adult population of São Paulo according to sex, age, and socioeconomic class were included in this study. Otorhinolaryngological evaluation included investigation of nasal complaints, physical examination of the UA, and a facial inspection.Results. A total of 993 volunteers (53.9% women), with a mean age of 41.8 +/- 0.89 years, underwent otorhinolaryngologic examination. the most prevalent symptoms were the following: symptoms suggestive of rhinitis (44.9%), snoring (42.8%), mouth breathing (39.3%), and nasal obstruction (33.3%). in physical examination, the most common findings were a web palate (redundant posterior pillar; 62.9%), septum deviation (56.9%), and inferior turbinate hypertrophy (37.7%). Significant associations were found between nasal obstruction and septum deviations, inferior turbinate hypertrophy, high-arched palate, and class II dental occlusion; between symptoms of rhinitis and inferior turbinate hypertrophy; and between snoring and obstructive deviated septum, modified Mallampatti grades III and IV, increased neck circumference, and age greater than or equal to 50 years.Conclusions. the prevalence of otorhinolaryngologic symptoms and alterations in physical examination of the UA were high in the adult population of São Paulo, Brazil. the snoring and nasal symptoms were significantly associated with findings from UA physical examination and inspection of the facial skeleton.