Tailoring surgical interventions to treat obstructive sleep apnoea: one size does not fit all.
| Title: | Tailoring surgical interventions to treat obstructive sleep apnoea: one size does not fit all. |
|---|---|
| Authors: | Sethukumar P; Otolaryngology, Head and Neck Surgery, Queen's Hospital, Romford, UK.; Kotecha B; Otolaryngology, Head and Neck Surgery, Queen's Hospital, Romford, UK.; Royal National Throat, Nose and Ear Hospital, UCLH, London, UK. |
| Source: | Breathe (Sheffield, England) [Breathe (Sheff)] 2018 Sep; Vol. 14 (3), pp. e84-e93. |
| Publication Type: | Journal Article; Review |
| Language: | English |
| Journal Info: | Publisher: European Respiratory Society Country of Publication: England NLM ID: 101231007 Publication Model: Print Cited Medium: Print ISSN: 1810-6838 (Print) Linking ISSN: 18106838 NLM ISO Abbreviation: Breathe (Sheff) Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Original Publication: Sheffield, United Kingdom : European Respiratory Society |
| Abstract: | While continuous positive airway pressure (CPAP) remains the gold standard treatment of choice in patients with moderate or severe obstructive sleep apnoea (OSA), surgery has been established as a means to improve compliance and facilitate the use of CPAP, both of which are potential pitfalls in the efficacy of this treatment modality. In a minority of cases, with obvious oropharyngeal anatomical obstruction, corrective surgery may completely alleviate the need for CPAP treatment. In this review, we summarise clinical assessment, surgical options, discuss potential new treatments, and outline the importance of investigating and addressing the multiple anatomical levels that can contribute to OSA. Research into effectiveness of these procedures is rapidly accumulating, and surgery can be an effective treatment. However, given the myriad of options available and multiple levels of anatomical pathology that can present, it is imperative that correctly selected patients are matched with the most appropriate treatment for the best outcomes.; Key Points: OSA is an increasingly prevalent disorder which has significant systemic effects if left untreated.Anatomical abnormalities can be corrected surgically to good effect with a growing and robust evidence base.Drug-induced sleep endoscopy is a key tool in the otolaryngologist's armamentarium to tailor specific surgery to address specific anatomical concerns, and to facilitate appropriate patient selection.Multilevel surgical approaches are often indicated instead of a "one size fits all" model.; Educational Aims: To discuss how to assess patients presenting with OSA in clinic, from an otorhinolaryngology perspective.To discuss the indications for intervention.To provide an overview of nonsurgical interventions for treating OSA, with evidence.To discuss the different surgical modalities available for treatment of OSA, with evidence. |
| Competing Interests: | Conflict of interest: None declared. |
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| Entry Date(s): | Date Created: 20181027 Latest Revision: 20241114 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC6196320 |
| DOI: | 10.1183/20734735.020118 |
| PMID: | 30364490 |
| Database: | MEDLINE |
Journal Article; Review