Surgeon, ENT Specialty Centre, India
Title: Hypo pharyngeal collapse in obstructive sleep apnea: How to address it?
Biography: R Anand,
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. Hypo-pharyngeal collapse in OSA is the main cause for failure. Hypo-pharynx is the area between upper borders of epiglottis to lower border of cricoid cartilage. In failure cases, a high level of suspicion about hypo-pharyngeal 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.