Otorhinolaryngology is a surgical subspecialty within medicine that deals with conditions of the ear, nose, and throat (ENT) and related structures of the head and neck. Doctors who specialize in this area are called otorhinolaryngologists, otolaryngologists, ENT doctors, ENT surgeons, or head and neck surgeons. Patients seek treatment from an otorhinolaryngologist for diseases of the ear, nose, throat, base of the skull, and for the surgical management of cancers and benign tumors of the head and neck.
Sleep apnea, also spelled sleep apnoea, is a sleep disorder characterized by pauses in breathing or periods of shallow breathing during sleep. Each pause can last for a few seconds to a few minutes and they happen many times a night. In the most common form, this follows loud snoring. There may be a choking or snorting sound as breathing resumes. As the disorder disrupts normal sleep, those affected may experience sleepiness or feel tired during the day. In children it may cause problems in school, or hyperactivity.
The palatine uvula, usually referred to as simply the uvula , is a conic projection from the posterior edge of the middle of the soft palate, composed of connective tissue containing a number of racemose glands, and some muscular fibers. It also contains a large number of serous glands that produce a lot of thin saliva.
Snoring is the vibration of respiratory structures and the resulting sound due to obstructed air movement during breathing while sleeping. In some cases, the sound may be soft, but in most cases, it can be loud and unpleasant. Snoring during sleep may be a sign, or first alarm, of obstructive sleep apnea (OSA). Research suggests that snoring is one of the factors of sleep deprivation.
Adenoidectomy is the surgical removal of the adenoid for reasons which include impaired breathing through the nose, chronic infections, or recurrent earaches. The surgery is less commonly performed in adults in whom the adenoid is much smaller and less active than it is in children. It is most often done on an outpatient basis under general anesthesia. Post-operative pain is generally minimal and reduced by icy or cold foods. The procedure is often combined with tonsillectomy and recovery time can range from several hours to two or three days.
A thyroglossal cyst is a fibrous cyst that forms from a persistent thyroglossal duct. Thyroglossal cysts can be defined as an irregular neck mass or a lump which develops from cells and tissues left over after the formation of the thyroid gland during developmental stages.
Upper airway resistance syndrome is a common sleep disorder characterized by the narrowing of the airway that can cause disruptions to sleep. The primary symptoms include excessive fatigue and chronic insomnia. UARS can be diagnosed by polysomnography, and can be treated with lifestyle changes, dental devices, or CPAP therapy. UARS is similar to certain types of sleep apneas.
A mandibular splint or mandibular advancement splint is a device worn in the mouth that is used to treat orofacial disorders including: obstructive sleep apnea (OSA), snoring, and TMJ disorders. These devices are also known as mandibular advancement devices, sleep apnea oral appliances, oral airway dilators and sleep apnea mouth guards. The American Academy of Sleep Medicine (AASM) and the American Academy of Dental Sleep Medicine (AADSM) recommend that sleep physicians should prescribe sleep apnea oral appliances for the adult patients who need treatment for their primary snoring rather than no treatment and for the patients who have obstructive sleep apnea but are intolerant to the CPAP therapy, or for those who prefer alternate therapy.
Uvulopalatopharyngoplasty is a surgical procedure or sleep surgery used to remove tissue and/or remodel tissue in the throat. This could be because of sleep issues. Tissues which may typically be removed include:
The genioglossus is one of the paired extrinsic muscles of the tongue. The genioglossus is the major muscle responsible for protruding the tongue.
Maxillomandibular advancement (MMA) or orthognathic surgery, also sometimes called bimaxillary advancement (Bi-Max), or maxillomandibular osteotomy (MMO), is a surgical procedure or sleep surgery which moves the upper jaw (maxilla) and the lower jaw (mandible) forward. The procedure was first used to correct deformities of the facial skeleton to include malocclusion. In the late 1970s advancement of the lower jaw was noted to improve sleepiness in three patients. Subsequently, maxillomandibular advancement was used for patients with obstructive sleep apnea.
Genioglossus advancement (GA) also known as Genial Tubercle Advancement (GTA), is a surgical procedure or sleep surgery in which the base of the tongue is pulled forward, usually to increase airway size due to deformity or a sleep breathing disorder. This procedure is frequently performed with either uvulopalatopharyngoplasty or Maxillomandibular advancement surgeries.
Velopharyngeal insufficiency is a disorder of structure that causes a failure of the velum to close against the posterior pharyngeal wall during speech in order to close off the nose during oral speech production. This is important because speech requires sound and airflow to be directed into the oral cavity (mouth) for the production of all speech sound with the exception of nasal sounds. If complete closure does not occur during speech, this can cause hypernasality and/or audible nasal emission during speech. In addition, there may be inadequate airflow to produce most consonants, making them sound weak or omitted.
The Stanford Protocol is a combination of surgeries that are undertaken to treat obstructive sleep apnea. The Protocol involves two phases, the first of which involves UPPP and one or more of Genioglossus Advancement or Hyoid Suspension. The Second Phase of the operation involves maxillomandibular advancement.
Eric M. Genden is an American otolaryngological surgeon at the Icahn School of Medicine at Mount Sinai and Mount Sinai Health System in New York City.
TransOral Robotic Surgery (TORS) is a modern surgical technique used to treat tumors of the mouth and throat via direct access through the mouth. TransOral Robotic Sleep Apnea (TORSA) surgery utilizes the same approach to open the upper airway of patients with obstructive sleep apnea. In TORS and TORSA procedures, the surgeon uses a surgical robot to view and access structures in the oral cavity (mouth) and pharynx without any incisions through the neck, chin or lip. Current TORS techniques include radical tonsillectomy, resection of palate and base of skull tumors, hemiglossectomy and resection of tumors above and involving the larynx. The TORSA technique is used for uvulopalatopharyngoplasty, hemiglossectomy, and other airway procedures.
