The Effects of Expansion Sphincter Pharyngoplasty on the Apnea Hypopnea Index and Heart Rate Variability

Publication date: Available online 10 June 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Ahmet Emre Süslü, Gözde Pamuk, Ahmet Erim Pamuk, Serdar Özer, Shamkhal Jafarov, T.Metin Önerci
PurposeHeart rate variability (HRV) is a non-invasive and sensitive method used to evaluate autonomic function of the heart based on specific polysomnographic parameters. This study aimed to determine the effect of expansion sphincter pharyngoplasty (ESP) on HRV and the apnea hypopnea index (AHI) in patients with obstructive sleep apnea (OSA).Materials and MethodsThis retrospective cohort study included patients that presented to Hacettepe University Hospital, Department of Otorhinolaryngology, were diagnosed as OSA, and underwent ESP. Patient medical records, including demographic data, polysomnography findings, and HRV parameters were reviewed. The predictor variable was the effect of ESP on the AHI and the primary outcome variables were HRV parameters. Descriptive and bivariate statistics were computed using the chi-square test, t-test, and Mann-Whitney U test.ResultsMean age of the 28 patients (20 male and 8 female) was 43 ± 9.9 years. Surgical success (AHI <20 and a 50% decrease in the AHI) was achieved in 16 (57.1%) patients. The AHI decreased in 22 (78.6%) patients, versus increased in 6 (21.4%) patients following ESP. The LF/HF ratio decreased significantly in the successful surgery patients and in those in which the AHI decreased postsurgery (P = 0.02 and P = 0.001, respectively). With respect to change in the LF/HF ratio, 19 patients had a decrease in sympathetic activity, whereas 9 had an increase in sympathetic activity following ESP. A decrease in sympathetic activity post ESP was significantly associated with surgical success and a decrease in the AHI (P = 0.033 and P = 0.001, respectively).ConclusionESP is an effective surgical option for the treatment of OSA and lowers the AHI. Successful ESP plays a role in decreasing sympathetic activity of the heart, which might be associated with a reduction in the risk of cardiovascular disease.



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“Deep extrinsic Muscle Involvement” is a Fallacy in the American Joint Committee on Cancer 7th Edition Tumor staging of the oral cavity cancers

Publication date: Available online 10 June 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Samskruthi P. Murthy, Krishnakumar Thankappan, Sandya Chirukandath Jayasankaran, Karippaliyil Milind, Chaya Prasad, Deepak Balasubramanian, Subramania Iyer
PurposeThe T staging in the 7^th edition, American Joint Committee on Cancer (AJCC) includes extrinsic muscle involvement to define T4a tongue carcinomas. The anatomical location of the extrinsic muscles predisposes them for early involvement even in superficial tumours. The purpose of this paper was to bring out a fallacy in this staging system, with regards to the extrinsic muscle involvement.Materials and methodsProspective cohort study of 87 oral tongue squamous cell carcinoma patients. MRI parameters, namely, 1) distance of the extrinsic muscles from the surface measured on the normal side in mm (range, mean and standard deviation). 2) maximum transverse, cranio-caudal and antero-posterior tumour dimensions (range, mean and standard deviation).3) tumor involvement of the muscles recorded on the involved side, in terms of number and percentage of each muscle involved. Histopathological depth of invasion was also recorded.Results67 patients were male and 20 patients were female. Age of the patients ranged between 18-74 years with mean age of cohort being 51 years. The mean distance of the most superficial part of muscle to the normal surface on MRI for genioglossus (antero-ventral), hyoglossus, styloglossus was 3.98, 2.13 and 0.66, respectively. The pattern of involvement of extrinsic muscle involvement showed hyoglossus, styloglossus and genioglossus involvement in 79 (90.8%), 58 (66.76%) and 31 (35.6%), respectively. In patients with pathological depth of invasion less than 10mm, involvement of hyoglossus, styloglossus and genioglossus was seen in 80, 35, and 15 %, respectively.ConclusionThe extrinsic muscles of the tongue are not deep. Even superficial thin tumors can involve the muscles. AJCC 8^th edition which has considered the tumor thickness into the staging system is in the process of being implemented. This present study would be one that will justify the removal of the extrinsic muscle involvement in defining the T4 stage of oral cavity.



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GORHAM-STOUT VANISHING BONE DISEASE: A REVIEW OF 2 CASES

Publication date: July 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 124, Issue 1
Author(s): M. HANSEN, S. BARGHAN, D. KASHTWARI, M.K. NAIR




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DARK ROOM TO AUGMENTED REALITY: APPLICATION OF HOLOLENS TECHNOLOGY FOR ORAL RADIOLOGICAL DIAGNOSIS

Publication date: July 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 124, Issue 1
Author(s): A.Z. SYED, A. ZAKARIA, S. LOZANOFF




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Table of Contents

Publication date: July 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 124, Issue 1





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FIFTEEN CASES OF ORAL BISPHOSPHONATE-RELATED OSTEONECROSIS OF THE JAWS (BRONJ)

Publication date: July 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 124, Issue 1
Author(s): T. GHEORGHE, L. LEE




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Information for Readers

Publication date: July 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 124, Issue 1





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