Snoring and Obstructive Sleep Apnea.pptVIP

Tongue Surgery Lingual tonsillectomy. Laser midline glossectomy LMG . Lingualplasty. RFTA of the tongue. Tongue base suspension suture. Tracheotomy Indications: morbid obesity. significant cardiac arrhythmias associated with apneic events. severe apnea with oxygen desaturation below 40% to 50%. cor pulmonale. disabling somnolence. Portable Monitoring Devices Type2: minimum of seven channels, EEG. Type3: minimum of four channels, at least two channels of respiratory movement. Type4: one or two parameters. Oximetry Minimally invasive palatal procedures. sensitivity 100%. specificity 98%. Gyulay 1993 : SaO2 90% was less than 1% of the sleep time, clinically significant apnea is practically excluded. Polysomnography EEG. Electrooculogram EOG . Electrocardiogram ECG . Electromyogram EMG , both submental and anterior tibialis. Oxyhemoglobin saturation. Nasal or oral airflow. Thoracic/abdominal movement. Sleep position. Blood pressure. *Esophageal pressure. Polysomnography Sleep latency the length of time to falling asleep . Sleep efficiency total sleep time/time in bed . RDI. Types of respiratory disturbances average and maximum length of each event type . Sleep architecture. Volume and presence of snoring. Effect of position on the respiratory disturbances. Whether the respiratory disturbances occur more often in particular sleep stages. Number and severity of the oxygen desaturation events, total amount of time with an abnormal oxygen saturation level. Polysomnography RDI. Lowest SaO2. Length of time with an oxygen saturation 88%. ECG findings. Multiple Sleep Latency Test Nap study. Four or more opportunities to nap throughout a day at 2-hour intervals. Latency to sleep onset and REM sleep. Document sleepiness with a normal polysomnogram. Trucking or aviation industries. Pre-OP Evaluation All factors that may predispose or exacerbate upper airway obstruction should be addressed in the preoperative period. Cardiac arrhythmias, congestive heart failu