Advertisement

Contents

        Preface: Sleep Surgery: From Reconstruction to Restoration and Re-education xi

        Stanley Yung-Chuan Liu

        Sleep Surgery in the Era of Precision Medicine 1

        Stanley Yung-Chuan Liu, Robert Wayne Riley, Anthony Pogrel, and Christian Guilleminault
        How to approach a patient seeking surgery for obstructive sleep apnea?1
        Why do we need an updated algorithm? 1
        What is precise about the updated algorithm? 2
        How to optimize PAP or oral appliance therapy? 3
        How to address the soft palate and tongue? 3
        When is skeletal surgery considered? 4
        What is the new definition of success? 4

        Drug-Induced Sleep Endoscopy 7

        Michael Awad, Tyler S. Okland, and Vladimir Nekhendzy
        Video content accompanies this article at http://www.oralmaxsurgeryatlas.theclinics.com.
        Introduction: nature of the problem 7
        Surgical technique 7
        Preoperative Planning 7
        Preparation and patient positioning 7
        Anesthetic approach/sedation agent 8
        Surgical procedure 8
        Potential complications 8
        Immediate postoperative care 9
        Pearls and pitfalls 9
        Clinical results in the literature 9
        Summary 9

        Nasal Surgery for Sleep-Disordered Breathing 11

        Jayini S. Thakker, Christopher Vuong, Katina Nguyen, and Jared C. Inman
        Introduction 11
        Identifying the site of nasal obstruction 11
        Surgical technique 11
        Anesthesia and analgesia 11
        Incision 12
        Elevating the mucoperichondrial flap 12
        Removing the obstruction 13
        Closure 14
        Endoscopic approach 14
        Inferior turbinate reduction 14
        Complications 15
        Early complications 15
        Late complications 15
        Other complications 15
        Discussion 15
        Summary 16

        Tonsillectomy and Pharyngoplasty: Tissue-Preserving Techniques 17

        Michael Awad, Christopher Gouveia, Robson Capasso, and Stanley Yung-Chuan Liu
        Introduction 17
        Surgical technique: preoperative planning 17
        Surgical approaches 17
        Surgical technique 18
        Potential complications 21
        Postoperative care/rehabilitation and recovery 21
        Clinical results 21
        Summary 21

        Genioglossus and Genioplasty Advancement 23

        Allen Cheng
        Introduction 23
        Preoperative planning 23
        Indications 23
        Computer surgical planning 24
        Surgical approach 24
        Surgical procedure 25
        Genioglossus advancement/anterior mandibular osteotomy 25
        Genioglossus advancement with genioplasty 26
        Closure 26
        Potential complications 26
        Pearls and pitfalls 27
        Immediate postoperative care 27
        Rehabilitation and recovery 28
        Summary 28

        Maxillomandibular Advancement: Contemporary Approach at Stanford 29

        Stanley Yung-Chuan Liu, Michael Awad, and Robert Wayne Riley
        Video content accompanies this article at http://www.oralmaxsurgeryatlas.theclinics.com.
        Introduction: nature of the problem 29
        Surgical technique 30
        Preoperative planning 30
        Preparation and patient positioning 30
        Anesthetic approach/sedation agent 31
        Surgical procedure 31
        Surgical steps 32
        Potential complications 34
        Intraoperative 34
        Early postoperative 35
        Late postoperative 35
        Clinical results in the literature 35
        Summary 35

        Maxillomandibular Advancement: The Canadian Experience 37

        Mélinda Paris, Simon Jean, and Carl Bouchard
        Introduction 37
        The Canadian health care system 37
        The CHU de Qúebec-Université Laval-Hôpital de l'Enfant-Jésus experience and surgical technique 38
        Preoperative planning 38
        Patient preparation 39
        Surgical technique and approaches 39
        Immediate postoperative care 40
        Potential complications 41
        Results 41

        Bilateral Temporomandibular Joint Reconstruction and Maxillomandibular Advancement for Concomitant Temporomandibular Joint Degeneration and Obstructive Sleep Apnea 43

        Rishi Jay Gupta, Rebeka Silva, and Stephen T. Connelly
        Introduction 43
        Surgical technique 44
        Diagnostic workup 44
        Preoperative planning 44
        Preparation and patient positioning 44
        Surgical procedure 46
        Potential complications 48
        Pearls and pitfalls 49
        Immediate postoperative care 50
        Rehabilitation and recovery 50
        Clinical results in the literature 51
        Summary 51

        Upper Airway (Hypoglossal Nerve) Stimulation for Treatment of Obstructive Sleep Apnea 53

        Rishi Jay Gupta, Deepak Kademani, and Stanley Yung-Chuan Liu
        Introduction 53
        Surgical technique 54
        Diagnostic work-up 54
        Preparation and patient positioning 54
        Surgical procedure 54
        Potential complications 56
        Surgical procedure 56
        Device related 56
        Pearls and pitfalls 56
        Immediate postoperative care 57
        Rehabilitation and recovery 57
        Clinical results in the literature 57
        Summary 57

        Transoral Robotic Surgery for the Tongue Base 59

        Ghali E. Ghali and Andrew T. Meram
        Introduction 59
        Indications 59
        Contraindications 60
        Relevant anatomy 60
        Surgical technique 60
        Patient preparation and positioning 60
        Surgical procedure 61
        Potential complications 62
        Pearls and pitfalls 64
        Immediate postoperative care 64
        Rehabilitation and recovery 65
        Clinical results in the literature 65
        Summary 65

        Pediatric Sleep Surgery: Skeletal Procedures 67

        Cory M. Resnick
        Video content accompanies this article at http://www.oralmaxsurgeryatlas.theclinics.com.
        Introduction 67
        Robin sequence 67
        Syndromic craniosynostosis 71
        Summary 75

        Pediatric Tongue Base Surgery 77

        Gi Soo Lee and Umakanth Katwa
        Introduction: nature of the problem 77
        Diagnostic modalities 77
        Polysomnography (sleep study) 77
        Imaging studies 77
        Airway upper airway endoscopy 78
        Surgical technique 78
        Preoperative planning 78
        Preparation and patient positioning 78
        Surgical approach 79
        Surgical procedure 79
        Potential complications 79
        Pearls and pitfalls 80
        Immediate postoperative care 80
        Rehabilitation and recovery 80
        Clinical results in the literature 80
        Summary 80