Sleep Apnea Syndromes: Siegert R

Verse T, de la Chaux R, Dreher A, Fischer Y, Grundmann T, Hecksteden K, Hörmann K, Hohenhorst W, Ilgen F, Kühnel T, Mahl N, Maurer JT, Pirsig W, Roth B, Siegert R, Stuck BA, Anonymous00280. · Klinik für HNO-Heilkunde, Asklepios Klinik Harburg, Hamburg. · Laryngorhinootologie. · Pubmed #17464894 No free full text.

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Mahl N, Schuff S, Mattheis S, Siegert R. · Prosper-Hospital Recklinghausen, Klinik für HNO-Heilkunde, Kopf- und Hals-Chirurgie, Recklinghausen. · Laryngorhinootologie. · Pubmed #17464895 No free full text.

Abstract: OBJECTIVE: Besides operation the mandibular advancement splint (MAS) is one of the main options for treatment of snoring. Especially the MAS by Hinz, which exclusively blocks mandibular retrusion, has been established as an effective alternative. The aim of this study is to examine the effectiveness of this MAS and to evaluate the role of obstruction at the level of the tongue base as a successful pretherapeutic predictor by using the sleep nasal endoscopy. SUBJECTS AND METHODS: From August 2001 until August 2006 we have examined over 450 patients with sleep disorders at our hospital. All patients have had an ENT examination, a standardized polysomnography and a sleep nasal endoscopy with therapy simulation. The application of a MAS is indicated if an obstruction at the level of the tongue base is detected and the RDI (respiratory disturbance index) is below 10/h. 10 patients are examined by PSG and partly by sleep nasal endoscopy before and after adjustment of the MAS. The patient group is classified in three velum- (n = 3), isolated tongue base-snorers, five combined tongue base-/velum- and two tongue base-/epiglottis-snorers. RESULTS: The subjective sleep recovery and the snoring-intensity can be improved by the MAS in eight of ten patients. In addition the long-term acceptance of this therapy is very high. CONCLUSIONS: According to our experiences the MAS by Hinz is an effective treatment option for patients with an obstruction level at the tongue base confirmed by sleep nasal endoscopy.

Magritz R, Siegert R. · Klinik für HNO-Heilkunde, Kopf- und Hals-Chirurgie, Prospe-Hospital, Akademisches Lehrkrankenhaus der Ruhruniversität Bochum, Recklinghausen. · Laryngorhinootologie. · Pubmed #12624842 No free full text.

Abstract: BACKGROUND: For the implementation of an uvulopalatopharyngoplasty (UPPP) it is nowadays common practice to operate in a manner which is gentle on the tissue and which retains as much muscle as possible. However, even when the greatest possible care is taken during the operation, serious complications such as persistent velopharyngeal insufficiency can arise. PATIENT AND METHOD: Based on a case report of a 55 year old man with a persistent severe velopharyngeal insufficiency after UPPP performed at another institution and serious OSA, we suggest a so-called push back technique, adapted from the cleft-palate surgery, for the extension of the soft-palate. With regard to the operative technique, it is thus possible to produce an effective extension of the soft-palate by means of a dorsocaudal displacement of a wide and on the palatal vascular fascicle pedicled mucoperiosteum flap of the mucous membrane of the hard palate, as well as similar mobilisation of the soft-palate from the os-palatinum. RESULT: Only 3 weeks after the operation, our patient showed a clinically sufficient velopharyngeal functioning. After 3 months, a complete restoration of the nasal CPAP-acceptance was evident. As a result, a complete social rehabilitation was possible for our patient. CONCLUSION: The modified push back technique of the palate retrodisplacement which is described above offers an efficient possibility of anatomically and functionally correcting the persistent and serious velopharyngeal insufficiency after UPPP.

Hollandt JH, Klaiber S, Gäbler R, Siegert R. · Klinik für Hals-, Nasen- und Ohrenheilkunde Universitätsklinikum Lübeck Ratzeburger Allee 160, 23538 Lübeck. · HNO. · Pubmed #12243035 No free full text.

This publication has no abstract.