Complications of ventilation tubes: - Dr. Nassem Talaat

Snoring & sleep apnea
Def: * snoring sound produced during sleep due to partial air way obstruction.
*Sleep apnea: cessation of respiration during sleep, at nostril & mouth > 10
seconds it is 3 types
- obstructive : no air flow in spite of respiratory effort ( commonest )
- central: no air flow with no respiratory effort
- Mixed : start as central then trial of respiratory effort
* Sleep apnea syndrome (OSAS): 5 episodes of apnea / night h. sleep or
30 episodes of apnea / night sleep
* Apnea index periods of apnea / 1 h. night sleep
Aet : any condition causing narrowing of the air way
A)Naso pharyngeal
1-Large naso pharyngeal tumor
2-Huge adenoids
3-Ant. & large post packs in children
B) Oro pharyngeal
1-Marked adenotonsillar hypertrophy
2-Large lax uvula & soft palate with excess mucosal folds
3-Large oropharyngeal tumors
C) Hypo pharyngeal:
1-Macro glossia 2-Micro gnathia
3-Hypo pharyngeal tumors 4-oedema due to radio therapy
Exacerbating factors: 1-Nasal obstruction e.g. D.S, polypi , rhinitis or neoplasm
Incid : more in male , at older age
Pathogenesis :
2-obesity 3-Alcohol & sedatives
Partial narrowing of the upper air way ……...increased – ve intrathoracic pressure
…….acceleration of air currents……….vibrations of soft tissue………snoring.
During sleep muscle tone decrease……..collapse
Clinical picture: results from: oxygen desaturation & high negative intrathorathic
pressure
Symptoms: Snoring: disrupted sleep: frequent movement, nocturnal choking, day
time sleep, memory loss
Obstructive episodes