Cindhuja, P (2022) A Study about Pre and Post Operative Evaluation of Apnea Hypopnea Index in Polysomnography in Adult Obstructive Sleep Apnea-Hypopnea Syndrome Patients. Masters thesis, Madurai Medical College, Madurai.
|
Text
220400322cindhuja.pdf Download (1MB) | Preview |
Abstract
INTRODUCTION: Obstructive sleep apnoea (OSA) can be regarded as a condition characterized by repetitive upper airway obstruction leading to sleep fragmentation, cardiovascular stimulation and oxygen desaturation during sleep. These together lead to symptoms such as snoring, unrefreshing sleep, excessive daytime sleepiness (EDS) and the increased risk of cardiovascular disease, hypertension, insulin resistance and road traffic accidents. Any individual with time may oscillate within a spectrum of sleep disordered breathing, from intermittent simple snoring, to chronic heavy snoring, to upper airway resistance syndrome (UARS), to mild OSA, to moderate OSA, to severe OSA or to obesity hypoventilation syndrome (OHS). ❖ OSA is characterized by complete breath-holds (apnoeas) and partial breath-holds (hypopnoeas) – With the present obesity epidemic, ear, nose and throat (ENT), hypertension, obesity, diabetes and sleep specialists are witnessing a large increase in the prevalence of OSA in their practice. The medical management of OSA, especially associated comorbidities, diagnosis and continuous positive airway pressure (CPAP), all relevant to the work environment of ENT specialists. Eventhough the OSA patients are classically treated with lifestyle modifications and medical management, poor compliance in these patients warranting surgical management. ❖ In our study after vigorous investigations in OSA patients, various surgeries has been done addressing the level of obstruction and improvement after surgery both in terms of subjective and objective results were analysed. AIM AND OBJECTIVES: 1. To study about the pre and post operative apnea hypopnea index in polysomnography in adult obstructive apnea hypoapnea syndrome patients 2. To study the effectiveness of various surgeries for obstructive sleep apnea. MATERIALS AND METHODS: STUDY PLACE: Government Rajaji Hospital, Madurai – 625020. Department of Otorhinolaryngology. STUDY DESIGN: Prospective study. STUDY PERIOD: One year. STUDY POPULATION: All patients with snoring and OSA who reported to the department of otorhinolaryngology of Madurai Medical College during the study period with the fulfillment of inclusion criteria. INCLUSION CRITERIA: 1) Age > 18 years. 2) Both sexes (male and female). 3) BMI < 40. 4) Patient with excessive daytime sleepiness. 5) Wittnesed apnea snoring. EXCLUSION CRITERIA: 1) Age below 18 yrs and above 55 yrs. 2) Hypothyroidism and other metabolic disorders. 3) BMI > 40. 4) Associated craniofacial abnormalities. METHODOLOGY: This is a prospective study conducted Department of Otorhinolaryngology, Madurai Medical College from June 2020to December 2021. All patients who attend our op with the complaints of snoring, frequent awakening at night, excessive day time sleepiness, choking in sleep are further evaluated. All the patients underwent clinical examination followed by blood investigations especially thyroid function test and BMI evaluation. Then polysomnography level1is done. CONCLUSION: ❖ Obstructive sleep apnea which is an entity of sleep disordered breathing leads on to various systemic consequences, if left untreated. Thus in the study conducted in our institution patients of OSA were clinically evaluated and admitted in ward and perform pre op AHI in polysomnography. After identifying the site of obstruction, patients were channelized to different surgeries addressing velum, tonsil and uvula, turbinate, septum, sinuses. Significant proportion of patients improved both subjectively and objectively as determined by reduction in AHI from 37.42 to 12.72, reduction in ESS from 12.41+ 3.09 to 5.14±3.41 and reduction in snoring. Since the complications of surgeries were anticipated preoperatively and managed accordingly. ❖ Thus nasal pathologies were produce significant O2 desaturation and significant AHI so addressing the nasal pathology by surgery in selected single level obstruction patient it may improve nasal patency and help to improve nasal resistance. ❖ Level 2 obstruction produce more obstruction so effective with proper preoperative investigations, appropriate surgery, anticipation and management of complications was needed. Lifestyle modifications should be consider to achieve better results.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | 220420101508 |
| Uncontrolled Keywords: | Pre and Post Operative Evaluation, Apnea Hypopnea Index, Polysomnography, Adult Obstructive Sleep Apnea-Hypopnea Syndrome Patients. |
| Subjects: | MEDICAL > Otolaryngology > MEDICAL > Otolaryngology |
| Depositing User: | Subramani R |
| Date Deposited: | 10 May 2021 16:17 |
| Last Modified: | 17 Dec 2023 10:22 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/16362 |
Actions (login required)
 |
View Item |
