Wos İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4807
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Item Pharyngeal airway and hyoid bone position changes of skeletal anchored Forsus Fatigue Resistant Device and activator appliances(2021) Ince-Bingol, Sinem; Kaya, Burcak; https://orcid.org/0000-0002-7014-0784; 33449194Objectives To evaluate the effects of miniplate anchored Forsus Fatigue Resistant Device (MAF) and activator treatments in the pharyngeal airway dimensions and hyoid bone position. Materials and methods Thirty-eight patients with mandibular retrusion who were treated with either MAF or activator were selected retrospectively and compared with an untreated control group. The data of 114 lateral cephalograms, comprising those taken before treatment (T1) and at the end of functional treatment (T2), were evaluated with regard to their linear, angular, and area measurements. Results The mandibular length increased and the hyoid bone moved forward with both treatments (P < 0.05). The horizontal change in the hyoid bone position with MAF treatment was correlated with changes in the point B and ANB angle. Increases of 1.8 mm, 1.4 mm, and 1.8 mm in the pharyngeal airway dimensions were obtained at the levels of the second, third, and fourth cervical vertebra, respectively, with the MAF treatment. On the other hand, an increase of 1.9 mm was found at the level of the fourth cervical vertebra with the activator treatment. The greatest vertical movement in the Menton and the highest increase in the oropharyngeal area were observed in the MAF group (P < 0.05). Conclusion Both the MAF and activator treatments caused favorable maxillomandibular changes; however, the MAF treatment provided a greater increase in the oropharyngeal area according to both the increase in mandibular length and the change in the vertical position of the mandible. Clinical relevance Functional appliances were found to be useful in increasing the pharyngeal airway dimensions in the shortterm. The skeletal anchored fixed functional appliance caused a greater increase in the oropharyngeal airway area that may be beneficial for Class II patients who carry a risk of having respiratory problems.Item The relationship between clinical and laboratory findings and duration of sleep where oxygen saturation remains below 90-95% in obstructive sleep apnea(2016) Avci, Suat; Avci, Aynur Yilmaz; Yagbasan, Berna Devrim; Gunizi, HuseyinObjective: The aim of the present study was to determine correlations between CT90 and CT95 values and physical examination parameters, chronic metabolic diseases, smoking, mean platelet volume, cerebral magnetic resonance imaging (MRI), presence and number of hyperintense foci in obstructive sleep apnea (OSA). Methods: A total of 1154 patients who underwent polysomnography in our sleep laboratory between 2011 and 2014 were screened retrospectively. Among them, 72 cases who underwent ear, nose and throat examinations, cerebral MR, CBC and biochemical tests were included in the study. All patients underwent a detailed anamnesis together with (1) measurements of BMI (body mass index) (2) circumferences of neck and abdomen, (3) examination of oropharynx, (4) Muller maneuver with the aid of fiberoptic endoscope, (5) estimation of Epworth sleep scale scores, (6) and polysomnographic (PSG) tests. Results: According to the severity of OSA, the patients had simple snoring (22.2%), mild (19.4%) and severe OSA (38.9%). In multivariate regression analysis, body mass index (BMI) (p=0.026) and apnea/hypopnea index (AHI) (p=0.013) were seen as independent variables affecting CT90 (R-2=49%). Multivariate linear regression analysis demonstrated that independent variables of smoking (p=0.001), AHI (p=0.003) and number of hyperintense foci (p=0.013) affected CT95 (R-2=%47.9), while relationships between diabetes, BMI and CT95 were not statistically significant. Conclusion: Since CT95 values are affected by smoking without any statistically significant correlation with retropalatal and retroglossal Muller stages, we think that consideration of CT90 value will be more appropriate in the evaluation of the severity of chronic intermittent hypoxia in patients with obstructive sleep apnea. However, the correlation between CT90 value and AHI is closer to the value indicated in the literature, but not stronger.Item Three-dimensional analyses of palatal morphology and its relation to upper airway area in obstructive sleep apnea(2017) Kecik, Define; 27622701Objective: To evaluate the relationship between palatal morphology and pharyngeal airway morphology in patients who have obstructive sleep apnea (OSA) and compare with a nonsnoring and nonapneic control group. Materials and Methods: Three-dimensional maxillary dental cast measurements from 25 OSA patients (6 women, 19 men) with a mean age of 41.5 (4.8) years, and 25 control group participants (14 women, 11 men) without any symptom of OSA with a mean age of 38.3 (3.7) were correlated with an analysis of pharyngeal area evaluated with lateral cephalograms. Intermolar and intercanine widths and palatal volumes were calculated on the dental casts, and the upper airway area measurements were performed on lateral cephalograms. Results: OSA patients had smaller oropharyngeal volume and upper airway when compared with controls (P <.001). Palatal area measurements were significantly smaller in OSA (P <.001). OSA patients had significantly narrower maxilla with smaller intermolar and intercanine widths (P <.001). A positive correlation was found between the palatal morphology and pharyngeal dimensions. Conclusions: A significant correlation exists between palatal morphology and pharyngeal airway.Item The Quantitative Analysis of Uvulopalatal Flap Surgery(2017) Erdamar, Aykut; Bayrak, Tuncay; Firat, Hikmet; Mutlu, Murad; Ardic, Sadik; Eroglu, Osman; 0000-0001-8588-480X; AAA-6844-2019Objective: In this work, a new methodology based on signal processing techniques for the quantitative analysis of uvulopalatal flap surgery is proposed. Clinical assessment studies of uvulopalatal flap surgery are based on not only the physician's examination, but also the patient's subjective feedback. Quantitative and objective evaluation studies are still lacking in the literature. Materials and Methods: Full night sleep records were analyzed for 21 patients before and after the surgery. The proposed algorithm consists of two independent parts. In the first part, the heart rate variability and complexity of the electrocardiogram were calculated. The second part includes calculating the electroencephalogram sub-band energy. Afterwards, the statistical methods were applied in order to determine the correlation of clinical and experimental parameters. Results: The low frequency/high frequency ratio and the sub-band energy of beta wave were significant for the patients having low postoperative delta sleep duration. Moreover, the sub-band energies of both alpha and beta waves, and theta wave were significant for the patients who had high post-operative delta sleep duration and blood oxygen saturation (SaO(2))-parameter. Complexity was significant for the patients with low postoperative respiratory disturbance index and SaO(2) parameter, and respiratory disturbance is correlated with snoring index. Conclusion: Respiratory disturbance index, which is not significant according to the pre- and post-operative clinical findings, was found to be directly related to the complexity feature. The most important result of this work is that the pre-operative complexity feature is correlated with respiratory disturbance and snoring index. This means that complexity feature can be a predictor prior to surgery.Item Results of Polysomnographies and Treatment Strategies in Elderly Patients with Symptoms of Obstructive Sleep Apnea Syndrome(2017) Ugurlu, Aylin Ozsancak; Balcan, Baran; 0000-0003-3598-3986; 29404173; A-4721-2018; AAA-2925-2020OBJECTIVES: In this study, we evaluated data regarding the management of geriatric patients with symptoms of obstructive sleep apnea syndrome (age, >65 years) who were admitted to our sleep clinic. MATERIAL AND METHODS: Symptoms and sleep data of the patients were retrospectively evaluated, and the patients were reevaluated after treatment. RESULTS: A total of 85 patients with a median age of 69 years were included. Snoring and fatigue were the most common symptoms. Cardiovascular diseases were the most frequently listed comorbidity. The median Epworth sleepiness scale was 10, and based on Berlin sleep questionnaire findings, 63.5% of the participants were in the high-risk group. Eighty-seven percent were diagnosed with obstructive sleep apnea (2/3 of them were positional), and moderate-to-severe obstructive sleep apnea was observed more in women than in men. Only one patient was diagnosed with central sleep apnea. There were positive and linear correlations between increased age and the apnea-hypopnea index, arousal index, Epworth sleepiness scale, and being in a high-risk group according to the Berlin sleep scale; however, there was no correlation between increased age and the number of hypopnea and apnea events. There were also positive and linear correlations between the apnea-hypopnea index and the Epworth sleepiness scale, being in a high-risk group according to the Berlin sleep questionnaire, an increased number of known medical conditions, and increased body mass index. We were able to contact 72 of the 85 patients via phone calls. Patients who adjusted to treatment had positive feedbacks. CONCLUSION: Sleep disorders are observed more in the elderly, and an increasing age is an independent factor for sleep disorders. Besides the usual signs and symptoms of sleep disorders, it should be considered in elderly who have cognitive dysfunction and dementia.Item Coronary flow reserve is impaired in patients with obstructive sleep apnea(2017) Bozbas, Serife Savas; Eroglu, Serpil; Ozyurek, Berna Akinci; Eyuboglu, Fusun Omer; 0000-0002-7230-202X; 0000-0002-5525-8207; 0000-0003-3055-7953; 29118860; ABG-1582-2021; AAI-8064-2021; AAR-4338-2020STUDY OBJECTIVES: Obstructive sleep apnea (OSA) is common in adult populations. Accumulating data indicate that it is independently associated with a variety of cardiovascular diseases and has prognostic importance in affected cases. In this study, we aimed to evaluate coronary flow reserve (CFR) in patients with OSA and controls. METHODS: Sixty-one patients undergoing an overnight polysomnography were enrolled in this study. Patients with an apneauhypopnea index (AHI) 5 were accepted as OSA group (n = 45) and those with an AHI <5 were taken as controls (n = 16). Using Doppler echocardiography at baseline and following dipyridamole infusion, coronary peak flow velocities were obtained. CFR was calculated as the ratio of peak diastolic flow to baseline diastolic flow. A CFR value <2 was accepted as impaired coronary microvascular function. RESULTS: The mean age was 50.8 10.8 years, of which 16 (26.2%) were female. Both groups had similar features with regard to demographic and clinical variables. The mean value of CFR was significantly lower in patients with OSA compared to those controls (2.24 0.46 vs. 2.74 0.62, respectively, P = 0.001). An abnormal CFR value was observed in 12 (26.7%) patients with OSA and in 1 (6.3%) participant in control group. CONCLUSIONS: The findings of this study indicate that CFR, an indicator of coronary microvascular function, is significantly impaired in patients with OSA. Coronary microvascular function, an early sign of atherosclerosis, can be evaluated noninvasively in these patients might be used as a predictor of cardiovascular risk.Item Importance of laboratory parameters in patients with obstructive sleep apnea and their relationship with cardiovascular diseases(2018) Kulaksizoglu, Sevsen; Kivanc, Tulay; Lakadamyali, Huseyin; Eyuboglu, Fusun; 0000-0002-7613-2240; 0000-0002-5525-8207; 28345811; AAI-8932-2021; AAR-4338-2020BackgroundOstructive sleep apnea (OSA) is an independent risk factor for the development of cardiovascular events. Platelet activation and inflammation are the mechanisms involved in the association between OSA and cardiovascular disease (CVD). The markers of platelet activation and inflammation are the mean platelet volume (MPV), platelet-lymphocyte ratio (PLR), red cell distribution width (RDW), neutrophil- lymphocyte ratio (NLR). We aimed to define the association of NLR, PLR, RDW, and MPV with the severity of disease and the presence of CVD. MethodsThis study consisted of 300 patients who were admitted to the sleep laboratory. The patients were classified according to their apnea- hypopnea index (AHI) scores as OSA negative (Group A: AHI<5), mild (Group B: AHI: 5-15), moderate (Group C: AHI=15-30), and severe OSA (Group D: AHI >30). ResultsThere were no significant differences in the NLR, PLR, and MPV among the groups (P>.05); only RDW differed significantly (P=.04). RDW was significantly higher in patients with than without risk factors for CVD [15.6% (15.4-15.7) vs 15.3% (15.1-15.3), respectively; P=.02]. ConclusionsNLR, PLR, MPV, and RDW are widely available and easily obtained from a routinely performed hemogram. Among these laboratory parameters, only RDW can demonstrate the reverse consequences of OSA-associated comorbidities, because vascular damage due to systemic inflammation is an important underlying mechanism in these diseases. RDW might be used as a marker of the response and patient compliance with continuous positive airway pressure treatment.