Article

Laser partial epiglottidectomy as a treatment for obstructive sleep apnea and laryngomalacia.

Department of Otolaryngology-Head and Neck Surgery, Rambam Medical Center and Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
The Annals of otology, rhinology, and laryngology (Impact Factor: 1.05). 01/2001; 109(12 Pt 1):1140-5. DOI: 10.1177/000348940010901211
Source: PubMed

ABSTRACT Obstructive sleep apnea (OSA) and laryngomalacia are two different entities. Occasionally, they may have a common etiology: an elongated, flaccid, and lax epiglottis that is displaced posteriorly during inspiration causing airway obstruction. Twenty-seven adults with a diagnosis of airway obstruction or OSA of various degrees, and 12 infants with severe stridor associated with frequent apneas due to laryngomalacia, who on fiberoptic examination were found to have a posteriorly displaced epiglottis, underwent partial epiglottidectomy with a CO2 laser. Their postoperative recovery was uneventful. Polysomnographic studies performed after operation in the adult patients demonstrated statistically significant improvement in 85% of the patients. In all the cases of laryngomalacia, stridor ceased permanently after surgery, together with complete cessation of the apneic episodes. This study demonstrates that similar pathophysiological mechanisms may be involved in both laryngomalacia and in OSA. Effective and relatively safe treatment can be achieved by partial resection of the epiglottis with a microlaryngoscopic CO2 laser.

1 Bookmark
 · 
146 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: La laryngomalacie est l’affection laryngée la plus fréquente du nourrisson. Dans 10 % des cas, elle est mal tolérée. Cette mauvaise tolérance conduit à la réalisation d’un bilan et à une prise en charge qui sera le plus souvent chirurgicale. La chirurgie est souvent une section des replis aryépiglottiques avec de très nombreuses variantes techniques décrites. Cette chirurgie, pratiquée dans un environnement adapté, permet le contrôle des signes subjectifs dans une grande majorité des cas avec une morbidité faible. Toutefois, les données concernant les évaluations objectives sont rares : il faut réaliser, si possible, une évaluation objective préopératoire et postopératoire de ces nourrissons. Certains nourrissons ont des pathologies intriquées ou ne répondent pas au traitement chirurgical : c’est la place de la ventilation non invasive.
    Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale. 02/2013; 130(1):15–21.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Nocturnal upper airway collapse is often multi-level in nature but typically will involve some degree of obstruction at the level of the tongue-base. Several surgical procedures have been developed in recent years to address this area in patients resistant to continuous positive airway pressure. This article outlines a novel way to treat obstructive sleep apnea lingual obstruction using the da Vinci robotic surgical system. This technique offers significant potential advantages over other established approaches and it should be included in the surgical armamentarium of sleep surgeons.
    Otolaryngologic Clinics of North America 01/2014; · 1.34 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Nocturnal upper airway collapse often involves obstruction at the level of the tongue base. A number of surgical procedures have been developed in recent years to address this area in patients non-compliant with CPAP therapy. This paper outlines a novel way to treat obstructive sleep apnea related to lingual obstruction, utilizing the da Vinci® robotic surgical system. This technique offers significant potential advantages over other established approaches, and should be included in the surgical armamentarium of sleep surgeons.
    Current Otorhinolaryngology Reports. 09/2013; 1(3).