HOW TO OVERCOME FAILURES IN SLEEP SURGERIES

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Anand Raju

Anand ENT Hospitals, India

: J Otol Rhinol

Abstract

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Obstructive sleep apnea (OSA) is a silent nightmare. It is a rising social problem. A variety of medical and surgical solutions are available in the field but still there is no 100% cure. There are many hidden causes for the failure: Lack of proper counseling, over-weight, improper diagnosis and unaddressed areas in surgery. Hypopharyngeal collapse in OSA is the main cause for failure. Hypopharynx is the area between upper borders of epiglottis to lower border of cricoid cartilage. In failure cases, a high level of suspicion about hypopharyngeal collapse must be thought. Structures like huge tongue base, floppy epiglottis, lingual tonsil and laryngeal mass can be the reasons for the Collapse. Apart from the routine workup Sleep Endoscopy is a very important tool to find out the cause. Surgeries like hyoid mobilization & suspension with mandible, midline glossectomy, Epiglottopexy and vocal cord surgeries-posterior cordectomy are being performed to correct the failures. Proper pre-operative assessment along with Drug Induced Sleep Endoscopy (DISE) is very important for accurate diagnosis and better outcome. Multilevel surgical intervention tailored according to each individual is mandatory. Keywords: hypopharyngeal airway, druginduced sleep, nasendoscopy

Biography

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Dr. Anand Raju is the director and Head of ENT department in Anand ENT Hospitals, an academic training institute, Coimbatore, India. He is a visiting professor in PSG MEDICAL COLLEGE. He is a member of various associations like World Sleep Association, International sleep surgery surgeon association, Cochlear implant group of India .he has presented several papers in India and international conferences and conducts cadaver hands-on dissection workshops in regular intervals. Now He is the Head of cochlear implant department in PSG MEDICAL COLLEGE a leading advanced center for pediatrics cochlear implant center.