Projects & Grants
| The role of epiglottopexy in the treatment of obstructive sleep apnea | |
|---|---|
| Project Id | SGS11_2021 |
| Main solver | MUDr. Michaela Masárová |
| Period | 1/2021 - 12/2021 |
| Provider | Specifický VŠ výzkum |
| State | finished |
| Anotation | The upper airway morphology plays a major role in the pathogenesis of obstructive sleep apnea (OSA). Determining the areas in the airways where obstruction occurs in sleep is a major diagnostic and therapeutic problem. Currently, the main diagnostic method for determining the sites of obstruction is considered to be drug-induced sleep endoscopy (DISE), which is indicated before planned OSA surgery. In patients with severe and moderate OSA, conservative positive airway pressure (CPAP) therapy is indicated and patients do not routinely undergo DISE prior to initiation. However, a relatively large proportion of patients (up to 50-60%) do not tolerate CPAP for various reasons. The role of the larynx in the formation of OSA has been known for many years. Prior to the introduction of DISE into routine clinical practice, it was estimated that the epiglottis (its collapse, retroflexion) contributed to the development of OSA in approximately 12%. In recent years, however, DISE has shown that epiglottis is a much more common cause of OSA. It can also cause intolerance of CPAP treatment in up to 15%. With increasing CPAP pressure it can aggravate obstruction. In cases where the cause of OSA is insufficiently rigid epiglottis, surgical treatment is indicated. Epiglottopexy is a surgical procedure, the essence of which is the fixation of the free part of the epiglottis to the root of the tongue. The aim of this surgical technique is to prevent the suction of an insufficiently rigid epiglottis to the posterior wall of the pharynx while inspiring while maintaining the anatomy and physiology of the larynx. This procedure is also associated with a lower risk of bleeding. Because insufficiently rigid epiglottis causing airway obstruction can only be diagnosed in sleep, the indication for surgery is based on DISE. |
