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52. Head-Of-Bed Elevation (HOBE) for Improving Positional Obstructive Sleep Apnea (POSA): An Experimental Study

Author

Iannella, Giannicola, primary, Cammaroto, Giovanni, additional, Meccariello, Giuseppe, additional, Cannavicci, Angelo, additional, Gobbi, Riccardo, additional, Lechien, Jerome Rene, additional, Calvo-Henríquez, Christian, additional, Bahgat, Ahmed, additional, Di Prinzio, Giuseppe, additional, Cerritelli, Luca, additional, Maniaci, Antonino, additional, Cocuzza, Salvatore, additional, Polimeni, Antonella, additional, Magliulo, Giuseppe, additional, Greco, Antonio, additional, de Vincentiis, Marco, additional, Ralli, Massimo, additional, Pace, Annalisa, additional, Polimeni, Roberta, additional, Lo Re, Federica, additional, Morciano, Laura, additional, Moffa, Antonio, additional, Casale, Manuele, additional, and Vicini, Claudio, additional

Published
2022
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53. New diagnostic tools to screen and assess a still too underestimated disease: the role of the wrist-worn peripheral arterial tonometry device—a systematic review.

Author

Moffa, Antonio, Giorgi, Lucrezia, Carnuccio, Luca, Mangino, Carmen, Lugo, Rodolfo, Baptista, Peter, and Casale, Manuele

Abstract

Purpose: Home sleep apnea testing devices aim to overcome the drawbacks of polysomnography (PSG). Among these, the WatchPAT (WP) (Itamar Medical Ltd., Caesarea, Israel) has recently been introduced on the market for diagnosis of Obstructive Sleep Apnea (OSA). The aim of this review was to provide a comprehensive overview of the studies validating the WP for the diagnosis of sleep-disordered breathing through comparison with PSG. Methods: A systematic review was performed to identify all clinical studies concerning WP validation compared with PSG as diagnostic tools. A qualitative analysis of the data was conducted. Results: In this review, 18 studies were included for a total of 1049 patients, aged 8 to 70 years old, with 74 of these being pediatric patients. In most studies, patients completed an overnight PSG and simultaneously wore WatchPAT in a sleep laboratory, while others compared the results obtained on two different nights. Both protocols showed good results in terms of AHI, ODI, RDI, and SO2. Moreover, some studies calculated the sensitivity and specificity of the WP ranging from 87 to 96% and from 66 to 80%, respectively. Excellent results were found also in pediatric patients. Conclusion: The WP represents an effective and convenient tool for OSA diagnosis compared to standard reference systems. [ABSTRACT FROM AUTHOR]

Published
2023
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59. Does Frenotomy Modify Upper Airway Collapse in OSA Adult Patients? Case Report and Systematic Review.

Author

Correa, Eduardo J., O'Connor-Reina, Carlos, Rodríguez-Alcalá, Laura, Benjumea, Felipe, Casado-Morente, Juan Carlos, Baptista, Peter M., Casale, Manuele, Moffa, Antonio, and Plaza, Guillermo

Subjects
SLEEP apnea syndromes, SLEEP quality, AIRWAY (Anatomy), ADULTS, SPEECH therapy
Abstract

Ankyloglossia (tongue-tie) is a condition of the oral cavity in which an abnormally short lingual frenulum affects the tongue's mobility. Literature on the correlation between ankyloglossia and obstructive sleep apnea (OSA) is scarce. The main objective of this study was to report our preliminary experience in adult OSA patients before and after ankyloglossia treatment, using drug-induced sleep endoscopy (DISE) to evaluate the upper airway modifications resulting after treatment, and to present a systematic review of the impact of ankyloglossia and its treatment on OSA adults. We found that, after frenotomy, regarding the DISE findings, and according to the VOTE classification, two of the three patients showed an improvement in tongue level, from 2A-P (complete anteroposterior collapse) to 1ap (partial anteroposterior collapse). The third patient showed no changes in his UA after frenotomy, neither worsening nor showing improvement. Thus, the results of this study suggest that frenotomy in OSA patients with ankyloglossia could reduce tongue collapse, probably by allowing the tongue to take into the physiological position in the oral cavity. These patients should undergo speech therapy and oropharyngeal exercises prior to any surgical procedure, in order to avoid glossoptosis and to improve the quality of life and sleep apnea results. [ABSTRACT FROM AUTHOR]

Published
2023
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65. Hypoglossal Nerve Stimulation in the Treatment of Obstructive Sleep Apnea: Patient Selection and New Perspectives

Author

Baptista,Peter M, Costantino,Andrea, Moffa,Antonio, Rinaldi,Vittorio, and Casale,Manuele

Subjects
Nature and Science of Sleep
Abstract

Peter M Baptista,1 Andrea Costantino,2 Antonio Moffa,3,4 Vittorio Rinaldi,3 Manuele Casale3 1Department of ORL, Clínica Universidad de Navarra, Pamplona, Spain; 2Otorhinolaryngology Unit, Humanitas Clinical and Research Center-IRCCS, Milan, Italy; 3Department of Otolaryngology, Integrated Therapies in Otolaryngology, University Campus Bio-Medico, Rome, Italy; 4Department of Otolaryngology, University of Foggia, Foggia, ItalyCorrespondence: Peter M BaptistaDepartment of ORL, Clinica Universidad de Navarra, Pamplona, SpainEmail pmbaptista@unav.esAbstract: Hypoglossal nerve stimulation (HNS) is an increasingly widespread OSA treatment. It is a non-anatomical modifying surgery able to achieve an adequate objective and subjective result with a reasonable complication rate. HNS exploits the neurostimulation to reduce upper airway collapsibility providing a multilevel upper airway improvement within a single procedure. Proper patient selection has a fundamental role in determining an adequate long-term clinical outcome. All patient candidates for HNS undergo a standard comprehensive sleep medicine assessment and upper airway surgical examination. Several features should be assessed preoperatively in order to predict patients’ response to HNS treatment. In particular, the assessment of OSA severity, BMI > 32 Kg/m2, collapse pattern during drug-induced sleep endoscopy (DISE), and many other parameters, is central for a good patient selection and customization of OSA treatment. HNS is indeed one of the most promising tools in the widespread context of personalized sleep medicine. HNS is an adjustable medical device that could be titrated in order to improve HNS effectiveness, maintaining patient comfort. Moreover, HNS provides the opportunity for patients to play an active role in their own care, with a potential improvement in therapy adherence and efficacy. This review summarizes the current evidence in patient selection for HNS, highlighting the reasons behind the optimistic future of this OSA treatment in the context of personalized medicine.Keywords: obstructive sleep apnea, hypoglossal nerve, upper airway, stimulation, personalized medicine

Published
2020

66. Topical Ectoine: A Promising Molecule in the Upper Airways Inflammation—A Systematic Review

Author

Casale, Manuele, Moffa, Antonio, Carbone, Samanta, Fraccaroli, Francesca, Costantino, Andrea, Sabatino, Lorenzo, Lopez, Michele Antonio, Baptista, Peter, Cassano, Michele, and Rinaldi, Vittorio

Subjects
Article Subject
Abstract

To date, topical therapies guarantee a better delivery of high concentrations of pharmacologic agents to the mucosa of the upper airways (UA). Recently, topical administration of ectoine has just been recognized as adjuvant treatment in the Allergic Rhinitis (AR) and Rhinosinusitis (ARS). The aim of this work is to review the published literature regarding all the potential therapeutic effects of ectoine in the acute and chronic inflammatory diseases of UA. Pertinent studies published without temporal limitation were selected searching on MEDLINE the following terms: “ectoine” and “nasal spray,” “oral spray,” “upper respiratory tract infections,” “rhinosinusitis,” “rhinitis,” “rhinoconjunctivitis,” “pharyngitis,” and “laryngitis.” At the end of our selection process, six relevant publications were included: two studies about the effect of ectoine on AR, one study about ARS, one study about rhinitis sicca anterior, and two studies about acute pharyngitis and/or laryngitis. Due to its moisturizing and anti-inflammatory properties, topical administration of ectoine could play a potential additional role in treatment of acute and chronic inflammatory diseases of UA, in particular in the management of sinonasal conditions improving symptoms and endoscopic findings. However, these results should be viewed cautiously as they are based on a limited number of studies; some of them were probably underpowered because of their small patient samples.

Published
2019
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71. Nasal Delivery Devices: A Comparative Study on Cadaver Model

Author

Moffa, Antonio, primary, Costantino, Andrea, additional, Rinaldi, Vittorio, additional, Sabatino, Lorenzo, additional, Trecca, Eleonora Maria Consiglia, additional, Baptista, Peter, additional, Campisi, Paolo, additional, Cassano, Michele, additional, and Casale, Manuele, additional

Published
2019
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73. Could Music Minimize Discomfort and Pain During Office-Based ENT Surgery?

Author

Casale, Manuele, primary, Sabatino, Lorenzo, additional, Moffa, Antonio, additional, Oliveto, Giuseppe, additional, Rinaldi, Vittorio, additional, Costantino, Andrea, additional, Vella, Paola, additional, Ianni, Andrea, additional, Petitti, Tommasangelo, additional, Baptista, Peter, additional, and Salvinelli, Fabrizio, additional

Published
2018
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77. Hyaluronic acid: Perspectives in dentistry. A systematic review

Author

Casale, Manuele, primary, Moffa, Antonio, additional, Vella, Paola, additional, Sabatino, Lorenzo, additional, Capuano, Francesco, additional, Salvinelli, Beatrice, additional, Lopez, Michele Antonio, additional, Carinci, Francesco, additional, and Salvinelli, Fabrizio, additional

Published
2016
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80. Protección del agua en pacientes pediátricos con Tubos de Ventilación: Mito o realidad? Una revisión sistemática

Author

Moffa, Antonio, Giorgi, Lucrezia, Fiore, Valeria, Baptista, Peter, Cassano, Michele, and Casale, Manuele

Abstract

Antecedentes : La miringotomìa acompañada de la inserción de Tubos de Ventilación (TV) es uno de los procedimientos mas realizados en niños y adolecentes a nivel mundial. Los TV normalmente permanecen sobre la membrana timpánica entre 6 a 12 meses y durante este periodo una de las complicaciones mas frecuentes es la presencia de otorrea. Durante muchos años, se les ha indicado a los padres sobre la necesidad de evitar el contacto con agua de aquellos niños que tienen TV, ya que la exposición al agua puede producir una Otitis Media Aguda. Sin embargo, existe una creciente evidencia sobre la imposibilidad de que el agua pueda penetrar a través del tubo de ventilación a menos que exista una presión significativa, por lo tanto, estas precauciones resultan innecesarias. A pesar de estas recomendaciones muchos otorrinolaringólogos y pediatras siguen indicando tapones de oídos durante el baño o la natación e inclusive la prohibición de deportes acuáticos. Actualmente en la literatura existen dos revisiones sobre este tema: el primero utilizo criterios de selección estrictos e incluyó 2 estudios de alta calidad mientras que el segundo presentó evidencia solo hasta el año 2005. El objetivo de esta revisión es identificar, resumir y evaluar críticamente la evidencia actual sobre las precauciones con el agua en los niños con TV.

Published
2021
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81. Cervical spine disorders and its association with tinnitus: The 'triple' hypothesis

Author

Antonio Moffa, Federica Bressi, Silvia Sterzi, Sandra Miccinilli, Rocco Papalia, Manuele Casale, Vincenzo Denaro, Fabrizio Salvinelli, Alberto Di Martino, Bressi, Federica, Casale, Manuele, Papalia, Rocco, Moffa, Antonio, Di Martino, Alberto, Miccinilli, Sandra, Salvinelli, Fabrizio, Denaro, Vincenzo, and Sterzi, Silvia

Subjects
0301 basic medicine, Dorsal cochlear nucleus, Cochlear Nucleus, Tinnitu, medicine.medical_specialty, Serotonin, Models, Neurological, Audiology, Somatosensory system, Serotonergic, Synaptic Transmission, Cochlear nucleus, 03 medical and health sciences, Tinnitus, 0302 clinical medicine, Neuroplasticity, medicine, otorhinolaryngologic diseases, Animals, Humans, Hemodynamic, Trigeminal Nerve, Trigeminal nerve, Neurons, Neuronal Plasticity, Animal, Hemodynamics, General Medicine, Models, Theoretical, Neuron, 030104 developmental biology, medicine.anatomical_structure, Acoustic Stimulation, Disinhibition, Positron-Emission Tomography, Cervical Vertebrae, medicine.symptom, Cochlear Nucleu, Nerve Net, Psychology, Neuroscience, 030217 neurology & neurosurgery, Human, Signal Transduction
Abstract

Subjective tinnitus and cervical spine disorders (CSD) are among the most common complaints encountered by physicians. Although the relationship between tinnitus and CSD has attracted great interest during the past several years, the pathogenesis of tinnitus induced by CSD remains unclear. Conceivably, CSD could trigger a somatosensory pathway-induced disinhibition of dorsal cochlear nucleus (DCN) activity in the auditory pathway; furthermore, CSD can cause inner ear blood impairment induced by vertebral arteries hemodynamic alterations and trigeminal irritation. In genetically-predisposed CSD patients with reduced serotoninergic tone, signals from chronically stimulated DCNs could activate specific cortical neuronal networks and plastic neural changes resulting in tinnitus. Therefore, an early specific tailored CSD treatments and/or boosting serotoninergic activity may be required to prevent the creation of 'tinnitus memory circuits' in CSD patients. (C) 2016 Elsevier Ltd. All rights reserved.

Published
2017

82. Coblator Assisted-Barbed Relocation Pharyngoplasty (Co-BRP) in Obstructive Sleep Apnea Surgical Treatment.

Author

Bahgat A, Vicini C, Bahgat Y, Magliulo G, Greco A, De Virgilio A, Pace A, Maniaci A, Lechien J, De Vito A, Cammaroto G, Caranti A, Casale M, Moffa A, Cocuzza S, Olszewska E, Perrone T, and Iannella G

Abstract

Barbed reposition pharyngoplasty (BRP) is a new technique to manage velo-pharyngeal obstruction and collapse in OSA patients. Tonsillectomy is a preliminary step of BRP surgery. Dissection of the PPM with monopolar or hot instruments is an essential step of the BRP technique. Tonsillectomy and muscle manipulation should be managed with careful attention due to the risk of muscle fibers rupture and surgical failure. We describe the coblator assisted BRP. The aim of this paper is to report the use and advantages of coblator technology in tonsillectomy and the velo-pharyngeal dissection before the PPM relocation with barbed sutures. In this operative technique study 100 OSA patients underwent Co-barbed technique. The CO-BRP technique has been considered fast, safe and minimally invasive with a low postoperative pain (mean value 3.63 ± 0.7). Postoperatively, a significant decrease in mean AHI from 35.63 ± 10.57 to 17.06 ± 5.92 ( P  < .005) emerged., Competing Interests: None., (© 2025 The Author(s). OTO Open published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngology‐Head and Neck Surgery Foundation.)

Published
2025
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