Abstract
Background: Sleep disordered breathing, speci�耀 cally obstructive sleep apnea (OSA) is due to constriction of the oropharyngeal airway during sleep and has major public health implications. By conservative estimates, 3% of the adult population are su�耀 ering from OSA characterized by sleep deprivation, fatigue during the day and somnolence. �怀 e most common treatment for sleep apnea is continuous positive airway pressure (CPAP). However, CPAP does not eliminate the cause of OSA. Methods: �怀 e goal of this prospective pilot study was to evaluate the changes of the total airway volume and most constricted area of the oropharyngeal airway using a non-ablative laser procedure. Cone beam computed tomography (CBCT) scans were obtained from seven patients enrolled in the study. Airway volume measurements were calculated before and after laser treatment using 3D volumetric software. Results: �怀 e photothermic e�耀 ects of a non-ablative laser procedure increased the mean total airway volume from 10.23 ± 0.94 mL to 12.54 ± 1.01 mL (p=0.0179), and the minimum cross-sectional area from 109.7 ± 20.6 mm 2 to 142.4 ± 29.2 mm 2 (p=0.0484) approximately 12 weeks post-laser treatment. Conclusions: Non-ablative laser therapy may be a promising non-surgical treatment modality for increasing the oropharyngeal airway volume, especially the most constricted area. Clinical implications: �怀 e results of this pilot study demonstrate that photothermal energy applied to the pharyngeal and palatal soft tissues may prove to be bene�耀 cial in the non-surgical management of sleep disordered breathing, especially the CPAP intolerant individual.
Highlights
Sleep disordered breathing affects thousands of adults and children in the United States [1,2]
Clinical implications: The results of this pilot study demonstrate that photothermal energy applied to the pharyngeal and palatal soft tissues may prove to be beneficial in the non-surgical management of sleep disordered breathing, especially the continuous positive airway pressure (CPAP) intolerant individual
The data clearly demonstrate that the oropharyngeal airway volume was significantly increased as a result of the photothermc effects from the non-ablative laser procedure (Figures 2A and 2B)
Summary
Sleep disordered breathing affects thousands of adults and children in the United States [1,2]. Anatomic structures involved may include the soft palate, tonsils, uvula, base of tongue and lateral pharyngeal walls [4]. In these patients, the airway caliber is decreased by soft tissue excess and negative airway pressure. The goal is to decrease the amount of soft tissues in the pharynx [5] This can be accomplished by non-surgical interventions, such as weight reduction, avoiding the use of alcohol and sedatives at night, continuous positive airway pressure (CPAP), and use of oral mandibular appliances to move the tongue base anteriorly. Obstructive sleep apnea (OSA) is due to constriction of the oropharyngeal airway during sleep and has major public health implications.
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