Cardiopulmonary Sequelae Research Articles

Expansion hyoidplasty: A potential surgical procedure designed for selected patients with obstructive sleep apnea syndrome. Experimental canine results

Some patients with "idiopathic" obstructive sleep apnea syndrome have an inspiratory, circumferential, passive collapse of the hypopharyngeal lumen as the mechanism of airway obstruction. Permanent tracheotomy has offered documented dramatic resolution of the airway obstruction with reversal of the associated cardiopulmonary sequelae. Tracheotomy is not, however, without psychological and physical complications detracting from its use. In hope of developing a surgical alternative, the expansion hyoidplasty was conceived. The hyoid bone is transected just medial to each lesser cornu. The trisected hyoid bone is then held in an expanded position by a permanent stainless steel brace. The greater cornua with attached middle constrictor and hyoglossus are moved laterally, while the body of the hyoid with attached geniohyoid and genioglossus shift the base of tongue anteriorly. The procedure is potentially reversible. Twenty dogs were studied pre and posthyoid expansion. Superior hypopharyngeal pressure-volume and closing pressures were obtained on 10 dogs. The pressure-volume studies demonstrate a consistent expansion of the superior hypopharynx. The average drop in pressure varied from 2.9 to 12.4 cm H2O in different animals. All posthyoid expansion dogs showed an average increase in closing pressure ranging from -4.4 to -28.3 cm H2O. Deglutition and laryngeal competence were not grossly effected. These results support the continued experimentation towards implementation of the expansion hyoidplasty in humans.

Phenol toxicity during face peels.

CHAIRMAN'S COMMENTS: This review by Koopmann summarizes the physiology and metabolism of phenol and useful guidelines to avoid phenol toxicity. The cosmetic surgeon should be aware of the serious, but fortunately rare, fatal cardiopulmonary sequelae that can result from the injudicious use of phenol during face peel surgery.

Cardiac Pharmacology and Cardiomyopathy in Friedreich's Ataxia

Friedreich's ataxia is almost always associated with a cardiomyopathy. The cardiomyopathy and its attendant cardiopulmonary sequelae is the usual cause of death in this disease. The author reviews the known pharmacology of the heart, particularly as it applies to hypertrophic cardiomyopathy. The important role played by calcium and the possible role of taurine is stressed. Therapeutic possibilities are mentioned.

Retrognathia and Sleep Apnea

The association of sleep apnea with daytime hypersomnolence without obesity, and its potentially lethal cardiopulmonary sequelae, make it crucial that this condition be distinguished from narcolepsy. A patient with retrognathia who had been diagnosed as a narcoleptic for 15 years had the primary complaint of excessive daytime sleepiness. Sleep laboratory evaluation showed severe hypoxemia and a mean of 366 upper airway obstructions per night. The patient was treated with a tracheotomy; this resulted in relief of the sleep-related upper airway obstructions, hypoxemia, and hypersomnolence.

VARIANTS OF CARDIOPULMONARY MANIFESTATIONS OF MANSON'S SCHISTOSOMIASIS: REPORT OF TWO CASES.

Excerpt Chronic visceral schistosomiasis may lead to two distinct cardiopulmonary sequelae: [1] cor pulmonale due to obstructive hypertensive pulmonary vascular disease and [2] a cyanotic syndrome ...