Otolaryngologic clinics of North America
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Otolaryngol. Clin. North Am. · Aug 1990
ReviewEvaluating the patient with a difficult airway for anesthesia.
Patients with difficult airways present a challenge when they must undergo anesthesia. This article examines the problems inherent in evaluating patients with difficult airways for surgery. The authors believe that these patients are best evaluated in a Difficult Airway Clinic. The structure and organization of such clinics are examined.
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Otolaryngol. Clin. North Am. · Aug 1990
ReviewNeurologic aspects of sleep apnea and related respiratory disturbances.
Several types of neurologic diseases can contribute to disturbed respiration during sleep. Abnormal function of respiratory and upper airway muscles can occur with neuromuscular diseases and lead to upper airway obstruction and alveolar hypoventilation during sleep. Central nervous system disorders that cause dysarthria and dysphagia can also lead to obstructive and central sleep apnea, even in the absence of the usual anatomic deformities associated with OSA. Appropriate treatment requires an understanding of the effect of the underlying disease process on upper airway and respiratory function.
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Otolaryngol. Clin. North Am. · Aug 1990
Review Comparative StudyObstructive sleep apnea and obesity.
OSA affects approximately 1 per cent of the adult male population and is more common among obese patients. The mechanism for the relationship between obesity and OSA may be mechanical obstruction or hypoxemia. Patients with obesity often have other medical problems that can exacerbate or complicate OSA. ⋯ Weight loss methods include behavior modification with diet, very low calorie diets with behavior modification, and bariatric surgery. In morbidly obese patients, more dramatic means such as bariatric surgery or very low calorie diets seem to be preferable because of the significant reduction in the length of time it takes for patients to lose weight. Because of a tendency for obese patients to regain weight, it is important to follow the patients long term to prevent the regaining of weight.