Sleep-Related Breathing Disorders

Transcription

1 Sleep-Related Breathing Disorders

2 Advances in Oto-Rhino-Laryngology Vol. 80 Series Editor Patrick J. Bradley Nottingham

3 Sleep-Related Breathing Disorders Volume Editor Hsin-Ching Lin Kaohsiung 45 figures, 19 in color, and 14 tables, 2017 Basel Freiburg Paris London New York Chennai New Delhi Bangkok Beijing Shanghai Tokyo Kuala Lumpur Singapore Sydney

4 Hsin-Ching Lin Department of Otolaryngology, Sleep Center Kaohsiung Chang Gung Memorial Hospital 123, Ta-Pei Road, Niao-Sung District Kaohsiung City 833, Taiwan (ROC) Library of Congress Cataloging-in-Publication Data Names: Lin, Hsin-Ching, editor. Title: Sleep-related breathing disorders / volume editor, Hsin-Ching Lin. Other titles: Sleep-related breathing disorders (Lin) Advances in oto-rhino-laryngology ; v Description: Basel : New York : Karger, Series: Advances in oto-rhino-laryngology, ISSN ; vol. 80 Includes bibliographical references and indexes. Identifiers: LCCN ISBN (hard cover : alk. paper) ISBN (electronic version) Subjects: MESH: Sleep Apnea Syndromes--surgery Classification: LCC RC737.5 NLM WF 143 DDC 616.2/09--dc23 LC record available at Bibliographic Indices. This publication is listed in bibliographic services, including Current Contents and Index Medicus. Disclaimer. The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publisher and the editor(s). The appearance of advertisements in the book is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements. Drug Dosage. The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Copyright 2017 by S. Karger AG, P.O. Box, CH 4009 Basel (Switzerland) Printed on acid-free and non-aging paper (ISO 9706) ISSN e-issn ISBN e-isbn

5 Contents VII Preface Lin, H.-C. (Kaohsiung) VIII Introduction Advances in Sleep-Related Breathing Disorders Bradley, P.J. (Nottingham) X Introduction Advances in the Surgical Treatment of Obstructive Sleep Apnea Friedman, M. (Chicago, IL) 1 A Succinct History of Sleep Medicine Huon, L.-K.A.; Guilleminault, C. (Redwood City, CA) 7 Advanced Concepts in the Pathophysiology of Obstructive Sleep Apnea White, D.P. (Boston, MA) 17 The History of Sleep Surgery Yaremchuk, K.; Garcia-Rodriguez, L. (Detroit, MI) 22 Advances in the Diagnosis of Obstructive Sleep Apnea: Drug-Induced Sleep Endoscopy Revesloot, M.J.L. (Amsterdam); Benoist, L. (Edegem); van Maanen, P. (Amsterdam); Kezirianl, E.J. (Los Angeles, CA); de Vries, N. (Amsterdam) 28 Novel Positional Devices for the Treatment of Positional Obstructive Sleep Apnea, and How This Relates to Sleep Surgery Revesloot, M.J.L. (Amsterdam); Benoist, L. (Edegem); van Maanen, P. (Amsterdam); de Vries, N. (Amsterdam) 37 Updated Concepts on Treatment Outcomes for Obstructive Sleep Apnea Certal, V. (Porto); Capasso, R. (Stanford, CA) 41 Updated Friedman Staging System for Obstructive Sleep Apnea Friedman, M.; Salapatas, A.M. (Chicago, IL); Bonzelaar, L.B. (Maywood, IL) 49 Advancements of CPAP Therapy for Obstructive Sleep Apnea Chen, N.-H. (Taoyuan) 57 Advances in Oral Appliances for Obstructive Sleep Apnea Jacobowitz, O. (New York, NY) 66 Updated Nasal Surgery for Obstructive Sleep Apnea Johnson, D.M.; Soose, R.J. (Pittsburgh, PA) V

6 74 Updated Palate Surgery for Obstructive Sleep Apnea Li, H.-Y. (Taoyuan) 81 Updated Hypopharyngeal Surgery for Sleep Apnea Woodson, B.T. (Milwaukee, WI) 90 Updated Minimally Invasive Surgery for Sleep-Related Breathing Disorders Kotecha, B. (London) 99 Advances in Box Surgery for Obstructive Sleep Apnea: Genioglossus Advancement, Hyoid Suspension, and Maxillomandibular Advancement Goh, Y.H.; Tan, W. (Singapore); Abdullah, V.J. (Hong Kong); Kim, S.W. (Seoul) 109 Multilevel Obstructive Sleep Apnea Surgery Li, H.-C. (Kaohsiung); Weaver, E.M. (Seattle, WA); Lin, H.-S. (Detroit, MI); Friedman, M. (Chicago, IL) 116 Innovative Surgery for Obstructive Sleep Apnea: Nerve Stimulator Sommer, J.U.; Hörmann, K. (Mannheim) 125 Robotic Obstructive Sleep Apnea Surgery Toh, S.T.; Hsu, P.P. (Singapore) 136 Pediatric Obstructive Sleep Apnea: Where Do We Stand? Huang, Y.-S. (Taoyuan); Guilleminault, C. (Redwood City, CA) 145 Future Perspectives in Sleep Medicine Huon, L.-K.A.; Guilleminault, C. (Redwood City, CA) 148 Future Perspectives in Sleep Surgery Friedman, M.; Salapatas, A.M. (Chicago, IL); Bonzelaar, L.B. (Maywood, IL) 155 Author Index 156 Subject Index VI Contents

7 Preface Sleep medicine is a relatively young medical specialty in the history of medicine. However, sleep has such a huge impact on our lives, both while sleeping and awake. Sleep-related breathing disorders, especially obstructive sleep apnea, obviously originate from upper airway abnormalities. The diagnosis, treatment, and research of these disorders includes multidisciplinary specialties. Significant advances have been achieved in this field in recent years. Organized into 20 important chapters, this book incorporates the efforts and expertise of more than 30 outstanding experts, working alongside the editorial staff at Karger. The aim is to provide concise, practical, and comprehensive advanced knowledge. This will allow the physicians and researchers who are interested in the field of sleep medicine to catch up with current clinical knowledge and stay abreast of important developments that could be readily applied in daily practice and help meet the demands of our profession in this ever-evolving era. Finally, I would like to thank all the authors for their great contributions, and the book series editor-in-chief Prof. Patrick Bradley and my mentor Prof. Michael Friedman for their tremendous dedication to the creation of this book. I hope all readers will enjoy this book and expand their knowledge. We definitely hope many will join us on the journey of sleep medicine. Hsin-Ching Lin, Kaohsiung City Preface VII

8 Introduction Advances in Sleep-Related Breathing Disorders What I knew, as a head and neck oncologic surgeon, could have been written on a postage stamp, and I have memories of 2 patients presenting with sleep-related breathing difficulties, which on investigation were due to an underlying malignancy! During my early years of training in the 1970s, all snoring problems were solved by some form of nasal septal surgery with or without surgery to the oropharynx! Sleep-related breathing disorders encompass a wide range of conditions, in which there is recurrent partial or complete cessation of breathing, and includes simple snoring, upper airway resistance syndrome, central sleep apnea-hypopnea syndrome, obesity-related sleep hypoventilation syndrome, and obstructive sleep apnea-hypopnea syndrome. Sleep-related breathing disorders, more so obstructive sleep apnea-hypopnea, can increase the risk of cardiac arrhythmias, pulmonary and systemic hypertension, myocardial infarction, type 2 diabetes mellitus, cerebrovascular accidents, impaired cognition, and road traffic accidents. The pathophysiology of sleep-related breathing disorders is complex, and the explanations usually involve several anatomical and other factors; obesity, increased neck circumference, craniofacial abnormalities and other variations (retrognathia, macroglossia, nasal obstructive pathologies), hypothyroidism, acromegaly, family history, excessive alcohol intake, or sedative ingestion. Many of the advances in the diagnosis and the formulation of modern treatment strategies have been developed through collaborative work in a multiprofessional and multidisciplinary environment. While a number of large textbooks have been published on sleep and breathing disorders and obstructive sleep apnea, this volume edited by Prof. Philip Lin (Hsin-Ching), Chairman of the Department of Otorhinolaryngology, and Director of Laryngology and Sleep Surgery, at Kaohsiung Chang Gung Memorial Hospital, Taiwan, has drawn upon his professional colleagues, friends and acquaintances from around the world to contribute chapters summarizing and updating knowledge on the new and innovative ob- VIII Introduction

9 structive sleep apnea surgery and sleep medicine, as well as reviewing traditional knowledge on surgical and nonsurgical patient management. This volume is a credit to the professionals and clinicians from many disciplines involved in all sleep-related breathing disorder clinics, who are to be congratulated on the progress that has been made over the past decades in unravelling this major health disorder. It has been a great pleasure for me to have invited and worked with Prof. Philip Hsin-Ching Lin in the maturation, development, and final publication of this volume. Patrick J. Bradley, Nottingham Introduction IX

10 Introduction Advances in the Surgical Treatment of Obstructive Sleep Apnea The future of sleep medicine and sleep surgery, like any other medical problem, is based on research, clinical studies, hard work, and commitment. After all, obstructive sleep apnea (OSA) is one of the most controversial, challenging, and ever-evolving specialties that otolaryngologists treat. The past few decades have seen a significant increase in research focusing on the pathophysiology, diagnosis, and surgical treatment of OSA. Great strides have been made in understanding how to treat OSA, and doctors must recognize that invasive and noninvasive treatments are crucial for the progress of the field. We must remember to resort to surgery only when patients have failed noninvasive treatment. A surgeon whose expertise includes both invasive and noninvasive options is in the ideal position to offer the most comprehensive treatment for OSA. These 2 treatment methods are not, however, mutually exclusive. Some patients may require an invasive treatment to enhance the efficacy of their long-term noninvasive treatment. Sleep surgery is, and will likely always be, a suboptimal alternative to continuous positive airway pressure (CPAP). Arguments against sleep surgery are based on the low rate of surgical cures, but we must recognize that most diseases have low or nonexistent cure rates. Hypertension, diabetes, morbid obesity, and asthma are almost never cured, yet we do not deny palliative treatments to alleviate symptomatology and reduce the risk of long-term sequelae. Even though surgery is less effective than CPAP, we should present all options and allow our patients to make informed decisions. Despite continuous improvements, CPAP compliance rates are not likely to reach 100%. A large percentage, and perhaps the majority, of patients with OSA have mild disease, and most of these patients defer testing and diagnosis because they are reluctant to accept CPAP therapy. Sleep surgery may be a beneficial and important treatment option for these patients. This book represents the efforts of Philip Hsin- Ching Lin in all these aspects of sleep medicine X Introduction

11 and sleep surgery. Hsin-Ching s interest first began when he devoted his post-doc work to specific studies in sleep surgery. He was already a faculty member at Kaohsiung Chang Gung Memorial Hospital, but decided to leave his country and his family for a year in order to come to Chicago and study sleep medicine. Since then, he has made tremendous efforts to spend time with the giants of sleep medicine. In fact, he most recently travelled to Philadelphia to further his training in transoral robotic surgery. His hard work is clearly evident he has over 80 peer-reviewed publications and has delivered close to 200 presentations worldwide. Among the 11 international awards he has received is the coveted International Guest Scholarships Award from the American College of Surgeons. Dr. Lin is a dynamic speaker and brilliant teacher, and is indeed well respected by all leaders in sleep medicine. The future of sleep medicine and sleep surgery is dependent on people who are dedicating their lives to clinical work, research, and teaching and Philip Hsin-Ching Lin definitely embodies all these qualities. Michael Friedman, Chicago, IL Introduction XI

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