Læknablaðið : fylgirit - 01.06.2005, Blaðsíða 16

ABSTRACTS / XXIX CONGRESS OF THE NORDIC ASSOCIATION OF OTOLARYNGOLOGY
tions to this widely variable disease. Majority of the patients have
multilevel obstruction. The surgical techniques employed are
quite varied and involves site-specific alterations of the upper
airway to more directly address the disease process. Different
techniques have been developed to widen the pharynx. A valu-
able contribution to the surgical arsenal has been tissue reduction
using radiofrequency energy, which has been shown to be effec-
tive, minimally invasive and suitable for multilevel surgery. Nasal
airway reconstruction may aid in the treatment of OSA, because
increased nasal resistance and obstruction increases the negative
pressure of the upper airway, leading to collapse of the velopha-
ryngeal, base-of-tongue, and hypopharyngeal regions. Functional
nasal passages is a prerequisite for successful CPAP therapy. The
effectiveness of the different procedures to treat airway obstruc-
tion in OSA patients needs to be clarified. Evidence to compare
procedures or combinations of procedures requires relatively
large studies. Multi-centre studies of surgical treatments for sleep
apnea would help to clarify the strengths and weaknesses of dif-
ferent approaches and determine the reproducibility of surgical
outcomes in the hands of different surgical teams.
Abstract no.: 018
Treatment of Snoring and mild OSAS by Low frequency
Radio waves
Tvinnereim M, Bergen Sleep Center & EuroSleep Ltd., Bergen, Norway
A variety of UvuloPalatoPharyngoPlasty(UPPP) procedures has
been developed, for widening of the pharynx by removing or
reducing the pharyngeal soft tissue volume to treat snoring and
sleep apnea, Different success rates (30-80 %) are reported in the
literature.
A fairly new bipolar series of low frequency radio wave
instruments(Coblation), possessing the abilities of effective
combinating low pain volumetric tissue reduction with excision
possibilities, has recently been introduced.
100 otherwise healthy patients suffering from snoring and
moderate sleep apnea( AHI<20) and also having their main level of
obstruction (> 50%) in the upper pharyngeal region, were selected.
This was obtained by performing complete ENT examination
including endoscopies as well as whole night monitoring,
with recordings of pharyngeal and mid-esophageal pressure
fluctuations (ApneaGraph). The whole group were treated
by The Coblation Assisted Upper-airway Procedures(CAUP)
selected for problems in the upper pharyngeal region.
One year follow up results have shown the classification and
treatment to be utmost satisfactory, with proper results for almost
9 out of 10 patients. Unwanted side effects are hardly seen.
Further results will be presented.
Conclusion: Classification of Snorers and OSAS-patients accom-
panied by stepwise treatment with bipolar low frequency radio
wave equipment (CAUP) in local anaesthesia as an outpatient
procedure, seems to give acceptable results.
Together with long time follow up, this offers a complete and
logical line for reflected step by step treatment of Snoring and
mild Obstructive Sleep Apnea.
The method will be further described and results presented.
Abstractno.: 019
Obstructive Sleep Apnea in lceland - traditions and facts
Pórarinn Gíslason, Professor. Dept. of Allergy, Respiratory Medicine
and Sleep. Landspítali University Hospital (E7), 105 Reykjavik, Iceland.
thorarig@landspitali.is
There has been increasing interest in Obstructive sleep apnea
(OSA) Sleep related breathing disturbances has achived an
increasing interest in the last two decades - even in Iceland.
When published 18 years ago, that OSA was probably affecting
at least 1.3% of the middle aged male population, these news
where received by most Icelandic doctors as they where being
told a fairy tale on elves or trolls - 'these guys might very well be
out there, but I have not seen them’ - especially the obstructive
sleep apnea syndrome (OSAS). Simplified diagnostic technics,
effective therapy together with scientific interest are also reflected
by at least 100.000 cases of OSAS in the Nordic countries alone.
Although the search term sleep apnea syndrome yields more
than 11.000 publications on PubMed there is still not a general
agreement as how to define obstructive sleep apnea syndrome
(OSAS), although there is little argument as long as we are fac-
ing the typical OSAS patient: an overweight middle-aged man or
woman, complaining about habitual snoring and daytime sleepi-
ness and with hundreds of apnea episodes during sleep, associ-
ated with a reduction in blood oxygen saturation. Since autumn
1987 until December 2004 altogether 4611 patients with OSAS
have been diagnosed in Iceland (total population 290.000), 1365
females and 3204 males. There is a gender difference at younger
age with more males diagnosed but no longer a significant differ-
ence after 65 years. Among the total Icelandic male population
50-69 years altogether 6.4% of males has been diagnosed with
OSAS and 2.8% of females. OSAS patients where often referred
for uvulopalatopharyngealplastic (UPPP) until the mid nineties.
There is still a lack of effective therapy although some 70-80%
accept continuous positive airway pressure (CPAP). In December
2004 altogether 1.175 males where CPAP treated and 428 females
(2.4% of the total male Icelandic population 50-69 years and 0.9%
of females).
Epilog: OSA is today recognized as one of the most common
chronic disorders - one that can be easily diagnosed and usu-
ally effectively treated. Cardiovascular co-morbidity is commonly
encountered and OSAS is now characterized by sympathetic
activation, insulin resistance and increased oxidative stress. There
is an urgent need for better aimed treatment alternatives - whom
to treat? and how?
Abstract no.: 020
OSAS and GERD
S0ren Berg, MD PhD, ENT-dept. University Hospital of Lund, Sweden &
Scansleep, Denmark
Association between gastro-oesophageal reflux (GER) and
pulmonary disease has been recognized more than 30 years ago.
More recently, there has been an increasing interest in the pos-
sible role of GER in such specific respiratory disease as asthma
and sleep apnea. The latter association is particularly intriguing
16 Læknablaðið/Fylgirit 51 2005/91