• The Journal of the Korea Contents Association
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• v.10 no.2
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• pp.35-42
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• 2010

The increasing regular medical check up rate for early diagnosis in disease has increasing sleep endoscopy rate because of reduction with discomfort. The purpose of this study was to determine the number of recovery bed as increasing sleep endoscopy rate using check up time, waiting time & recovery time at a general hospital in Seoul. This study was analyzed using ARENA 10.0 program. At present and as increasing of sleep endoscopy rate 10%, 20% was increased recovery time, waiting time & the rate of bed inflection. So at present, the number of recovery bed has to increase for client's safety and as increasing of sleep endoscopy rate 10%, 20% has to increase 3 and then waiting time decreased in 2 minutes.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.2
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• pp.149-165
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• 1999

The pathomechanism of obstructive sleep apnea(OSA) is not clearly elucidated. The possible mechanisms are pathologic reduction of pharyngeal muscular tonus during sleep, abnormal anatomical stenosis of nasopharyx or a combination of the above two mechanisms. It is very important to find the cause(anatomical location or pathologic dynamic change) of OSA in order to treat it. Cephalometric analysis in patients with obstructive sleep apnea is a good method for evaluating anatomical morphologic change but it cannot give any information about the dynamic changes occurring during sleep. On the contrary, nasopharyngeal endoscopy offer 3 dimensional image and information about the dynamic changes. Accordingly, these two diagnostic tools can be utilize in the diagnosis and treatment planning of OSA Cephalometric analysis of craniofacial skeletal and soft tissue morphology in 53 patients with OSA and 43 controls was performed and cephalometric analysis and nasopharygeal endoscopy were performed in 9 patients with OSA in order to come up with individualized therapy plans. Following results were obtained ; Patients with OSA showed 1. body weight gain 2. clockwise mandibular rotation 3. increased anterior lower facial height 4. inferiorly positioned hyoid bone 5. increased length of soft palate 6. decreased sagittal dimension of nasopharyx 7. increased vertical length of inferior collapsable nasopharyx 8. increased length of tongue Through cephalometric analysis and nasopharygeal endoscopy(mutually cooperative in diagnosis), 9. one can find the possible origin of OSA and make a adequate individualized therapy plan and predict accurate prognosis. Cephalometric analysis and nasopharygeal endoscopy are highly recommended as a diagnostic aid in OSA patients

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.1
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• pp.71-76
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• 2017

Drug-induced sleep endoscopy (DISE) is used to identify areas of upper airway obstruction, which occurs when patients with obstructive sleep apnea (OSA) snore. DISE enables effective diagnosis and appropriate treatment of the obstruction site. Among surgical treatment methods for OSA, maxillomandibular advancement surgery (MMA) is performed to move a jaw forward; the surgery has a high success rate for OSA treatment. In DISE, anesthetics such as propofol and midazolam must be administered to induce snoring while the patient is deeply sedated for an accurate diagnosis to be made. When inducing deep sedation in a patient with OSA, airway obstruction may increase, causing oxygen saturation to drop; airway interventions are necessary in such cases. Effective DISE and MMA surgery can be performed by administering propofol through target-controlled infusion while monitoring the bispectral index (BIS).

• Journal of Clinical Otolaryngology Head and Neck Surgery
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• v.29 no.2
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• pp.190-197
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• 2018

Background and Objectives : Positional OSAS is characterized by an apnea-hypopnea index (AHI) score >5, which, while sleeping in the supine position, is double that in non-supine position. This study was performed to compare the clinical characteristics of positional OSAS and non-positional OSAS patients, and the effects of the modified jaw thrust maneuver during drug-induced sleep endoscopy (DISE) between positional OSAS and non-positional OSAS patients. Materials and Methods : 68 positional OSAS patients and 19 non-positional OSAS patients were included. They all underwent full-night polysomnography and DISE. The modified jaw thrust maneuver was introduced during DISE. Airway structural changes induced by the modified jaw thrust maneuver were evaluated and documented. Results : There were no statistically significant differences in Friedman stage or tonsil grade, body mass index, Epworth sleepiness scale (ESS) score, blood pressure, AHI, or obstructive pattern between the positional and non-positional OSAS patients. However, mean arterial oxygen saturation (SaO2), lowest SaO2, and total arousal index values were more severe in the non-positional OSAS patients. After introduction of the modified jaw thrust maneuver, retrolingual level obstruction showed a tendency toward a higher rate of airway opening in positional OSAS patients than in non-positional OSAS patients. Conclusions : The effects of a mandibular advancement device (MAD) can be estimated by carrying out a modified jaw thrust maneuver during DISE. The tendency toward a higher rate of airway opening in positional OSAS patients than non-positional OSAS patients in retrolingual level obstruction after jaw thrust maneuver introduced during DISE may be clinically important for MAD.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.39
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• pp.27.1-27.5
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• 2017

The prevalence of obstructive sleep apnea (OSA) is estimated to be 1-5% of the adult population world-wide, and in Korea, it is reported at 4.5% of men and 3.2% of women (Age 40 to 69 years old). Active treatment of OSA is associated with decrease in insulin resistance, cardiovascular disease, psychosocial problems, and mortality. Surgical treatment of OSA has evolved in the era of neuromodulation with the advent of hypoglossal nerve stimulation (HGNS). We share this review of HGNS with our maxillofacial surgical colleagues to expand the scope of surgical care for OSA.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.3
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• pp.267-275
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• 2005

Obstructive sleep apnea syndrome (OSAS) is characterized by sleep-induced obstruction of the upper airway that results in cessation of airflow. Obstruction can occur at a number of points in the airway, but frequently in the oropharynx. A diagnostic evaluation includes cephalometry, computed tomography, magnetic resonance imaging, acoustic reflection technique, polysomnography and fibroptic endoscopy. Cephalometric measurements of the patients with obstructive sleep apnea have revealed that posterior airway anatomy has strong relations with the symptoms of them. A lateral cephalogram is routinely obtained in the radiologic evaluation of sleep apnea patients. The purpose of this study is to provide a the lateral cephalometric korean norms for the diagnosis and treatment of the patients with obstructive sleep apnea by analyzing the abnormal occlusion of Korean adults.