Influence of obesity on the correlation between laryngopharyngeal reflux and obstructive sleep apnea.

INTRODUCTION: The obstructive sleep apnea (OSA) is caused by recurrent episodes of partial or total obstruction of the upper airway lasting more than 10 seconds during sleep. Laryngopharyngeal reflux (LPR) is a variant of the disease Gastroesophageal Reflux that affects the larynx and pharynx. OBJECTIVES: Evaluate the influence of obesity on the relationship between RFL and OSAS in patients with OSA. MATERIALS AND METHODS: An observational retrospective cross. We reviewed care protocol for patients with OSA that includes validated questionnaires for RFL as Sympton Reflux Index (RSI) and Reflux Finding Score (RSI), and polysomnography nasolaringofibroscopia. RESULTS: 105 patients were divided into obese group (39 patients) and non-obese patients (66 patients). In the evaluation of the mean RSI group of non-obese was similar between patients with mild OSA (11.96) and moderate (11.43). In the obese group the mean RSI was 6.7 in patients with mild OSA and 11.53 in patients with moderate to severe OSA (p < 0.05). DISCUSSION: The subgroup of patients with OSA and RFL have several factors that promote inflammation of the upper airway. Patients with OSA should be screened and treated as the RFL increasing the quality of life. CONCLUSION: The RFL are positively correlated and OSAS in obese patients.

Influencia da obesidade na correlacao entre refluxo faringolaringeo e apneia obstrutiva do sono / Influence of obesity on the correlation between laryngopharyngeal reflux and obstructive sleep apnea

Introdução: A apneia obstrutiva do sono (AOS) é causada por episódios recorrentes de obstrução total ou parcial da via aérea superior com duração superior a 10 segundos durante o sono. Refluxo faringolaríngeo (RFL) é uma variante da doença do refluxo gastroesofágico que afeta a laringe e a faringe. Objetivos: Avaliar a influência da obesidade na relação entre RFL e AOS em pacientes com SAOS. Materiais e métodos: Estudo observacional transversal retrospectivo. Foram revisados protocolos de atendimento de pacientes com AOS que incluem questionários validados para RFL como Reflux Sympton Index (RSI) e Reflux Finding Score (RSI), nasolaringofibroscopia e polissonografia. Resultados: Cento e cinco pacientes foram divididos em grupo de obesos (39 pacientes) e não obesos (66 pacientes). Na avaliação das médias do RSI o grupo de não obesos foi semelhante entre pacientes com AOS leve (11,96) e moderada (11,43). No grupo de obesos a média do RSI foi de 6,7 em pacientes com AOS leve e de 11,53 em pacientes com AOS moderada a grave (p < 0,05). Discussão: O subgrupo de pacientes com AOS e RFL apresenta vários fatores que promovem a inflamação da via aérea superior. Pacientes com AOS devem ser pesquisados e tratados quanto a RFL, aumentando a qualidade de vida. Conclusão: O RFL e a AOS se correlacionam positivamente em pacientes obesos. .

Introduction: The obstructive sleep apnea (OSA) is caused by recurrent episodes of partial or total obstruction of the upper airway lasting more than 10 seconds during sleep. Laryngopharyngeal reflux (LPR) is a variant of the disease Gastroesophageal Reflux that affects the larynx and pharynx. Objectives: Evaluate the influence of obesity on the relationship between RFL and OSAS in patients with OSA. Materials and methods: An observational retrospective cross. We reviewed care protocol for patients with OSA that includes validated questionnaires for RFL as Sympton Reflux Index (RSI) and Reflux Finding Score (RSI), and polysomnography nasolaringofibroscopia. Results: 105 patients were divided into obese group (39 patients) and non-obese patients (66 patients). In the evaluation of the mean RSI group of non-obese was similar between patients with mild OSA (11.96) and moderate (11.43). In the obese group the mean RSI was 6.7 in patients with mild OSA and 11.53 in patients with moderate to severe OSA (p < 0.05). Discussion: The subgroup of patients with OSA and RFL have several factors that promote inflammation of the upper airway. Patients with OSA should be screened and treated as the RFL increasing the quality of life. Conclusion: The RFL are positively correlated and OSAS in obese patients. .

Ambulatory blood pressure monitoring in children with obstructive sleep apnea and primary snoring.

OBJECTIVE: To evaluate the systemic blood pressure (BP) during daytime and nighttime in children with sleep breathing disorders (SBD) and compare parameters of BP in children with diagnosis of obstructive sleep apnea syndrome (OSA) to those one with primary snoring (PS). METHODS: Children, both genders, aged from 8 to 12 years, with symptoms of SBD realized an overnight polysomnography followed by a 24h recording of ambulatory BP. RESULTS: All subjects presented with a history of snoring 7 nights per week. Children who have apnea/hipoapnea index ≥ four or a apnea index ≥ one presented a mean BP of 93±7mmHg and 85±9mmHg diurnal and nocturnal respectively whereas children who have a apnea/hipoapnea < four or a apnea index < one presented 90±7mmHg and 77±2mmHg. Eight children out of fourteen, from OSA group, lost the physiologic nocturnal dipping of the blood pressure. Among OSA children 57% were considered non-dippers. Two (16%) have presented absence of nocturnal dipping among children with primary snoring. The possibility of OSA children loosing physiologic blood pressure dipping was 6.66 higher than the possibilities of patients from PS group. DISCUSSION: Our results indicate that children with sleep apnea syndrome exhibit a higher 24h blood pressure when compared with those of primary snoring in form of decreased degree of nocturnal dipping and increased levels of diastolic and mean blood pressure, according to previous studies in literature. OSA in children seems to be associated to the development of hypertension or other cardiovascular disease.

Prevalence of broncopulmonary and otorhinolaryngologic symptoms in children under investigation for gastroesophageal reflux disease: retrospective analysis.

UNLABELLED: Gastroesophageal reflux disease (GERD) is a common ailment in children, adding up to the evidence that gastroesophageal reflux is an important cofactor in upper airway disorders, especially in the pediatric population. It is very common for it to impact the upper and lower airways. Our goal was to assess the presence of otorhinolaryngological symptoms in children aged between one and twelve years in whom gastroesophageal reflux is suspected. MATERIALS AND METHODS: We assessed data from the charts of patients up to 12 years of age submitted to 24 hour pH measuring of one of two channels, placed at 2 and 5 cm from the LEE in order to confirm the diagnosis of Gastroesophageal Reflux Disease. RESULTS: We studied 143 charts from children who underwent 24 hour pH measuring to investigate GERD; however, only 65 were included. The most prevalent symptoms in the children were bronchopulmonary, found in 89.2%, of sinonasal symptoms (72.3%), otologic (46.1%) and repetition UAW infections (44.6%). When we compared the presence of each group of symptoms of the results from the pH measuring, no significant differences were found between the symptoms and the pH measuring results. CONCLUSION: GERD can manifest in different ways and otorhinolaryngological symptoms are frequent in children.

Prevalence of broncopulmonary and otorhinolaryngologic symptoms in children under investigation for gastroesophageal reflux disease: retrospective analysis / Prevalência de achados broncopulmonares e otorrinolaringológicos em crianças sob investigação de doença do refluxo gastroesofágico: análise retrospectiva

Gastroesophageal reflux disease (GERD) is a common ailment in children, adding up to the evidence that gastroesophageal reflux is an important cofactor in upper airway disorders, especially in the pediatric population. It is very common for it to impact the upper and lower airways. Our goal was to assess the presence of otorhinolaryngological symptoms in children aged between one and twelve years in whom gastroesophageal reflux is suspected. MATERIALS AND METHODS: We assessed data from the charts of patients up to 12 years of age submitted to 24 hour pH measuring of one of two channels, placed at 2 and 5 cm from the LEE in order to confirm the diagnosis of Gastroesophageal Reflux Disease. RESULTS: We studied 143 charts from children who underwent 24 hour pH measuring to investigate GERD; however, only 65 were included. The most prevalent symptoms in the children were bronchopulmonary, found in 89.2 percent, of sinonasal symptoms (72.3 percent), otologic (46.1 percent) and repetition UAW infections (44.6 percent). When we compared the presence of each group of symptoms of the results from the pH measuring, no significant differences were found between the symptoms and the pH measuring results. CONCLUSION: GERD can manifest in different ways and otorhinolaryngological symptoms are frequent in children.

A Doença do Refluxo Gastroesofágico (DRGE) é uma afecção comum na infância, aumentando as evidências de que o refluxo gastroesofágico seja um cofator importante que contribui para as desordens de vias aéreas, principalmente na população pediátrica. É muito comum serem observadas manifestações em vias aéreas superiores e inferiores. Nosso objetivo é avaliar a presença de sintomas otorrinolaringológicos em crianças com idade de um a 12 anos e suspeita de doença do refluxo gastroesofágico. MATERIAIS E MÉTODO: Foram avaliados dados de prontuários de pacientes de até 12 anos submetidos à pHmetria de 24 horas de um ou dois canais, locados a 2 e 5 cm do EEI para confirmação de diagnóstico de Doença do Refluxo Gastroesofágico. RESULTADOS: Foram analisados 143 prontuários de crianças que realizaram pHmetria de 24 horas para investigação de DRGE; porém 65 foram incluídas. Os sintomas mais prevalentes nas crianças eram os broncopulmonares, encontrados em 89,2 por cento, de sintomas nasossinusais (72,3 por cento) , otológicos (46,1 por cento) e de infecções de VAS de repetição (44,6 por cento). Quando comparada a presença de cada grupo de sintomas com o resultado da pHmetria, não foi encontrada diferença significativa entre os sintomas e o resultado da pHmetria. CONCLUSÃO: DRGE pode se manifestar de diversas maneiras e os sintomas otorrinolaringológicos são frequentes em crianças.

Laryngeal dystonia: case report and treatment with botulinum toxin.

Laryngeal dystonia or spasmodic dysphonia is characterized by involuntary and inappropriate spasms of vocal muscles, having the adductor type as the most common one. It is characterized by strain-strangled voice with pitch breaks. Diagnosis is made by means of videolaryngostroboscopic exam. The treatment of choice is done with botulinum toxin directly injected in the muscles responsible for the mismatched movement. The aim of this study is to report on an adductor- type dysphonia patient and to discuss the advantages and observations about this treatment reported in the literature.

Distonia laríngea: relato de caso e tratamento com toxina botulínica / Laryngeal dystonia: case report and treatment with botulinum toxin

Distonia laríngea, ou disfonia espasmódica, é caracterizada por contrações involuntárias e inapropriadas da musculatura responsável pela fonação, sendo a do tipo adutora a mais comum. Caracteriza-se por quebras fonatórias, sendo seu diagnóstico confirmado por videolaringoestroboscopia. O tratamento de escolha é feito com a aplicação direta de toxina botulínica nos músculos responsáveis pelo movimento incoordenado. O objetivo desse trabalho é relatar o caso de uma paciente com diagnóstico de distonia laríngea do tipo adutora, tratada com toxina botulínica e discutir as vantagens e observações descritas na literatura a respeito desse tratamento.

Laryngeal dystonia or spasmodic dysphonia is characterized by involuntary and innapropiate spasms of vocal muscles, having the adductor type as the most common one. It is chacterized by strain-strangled voice with pitch breaks. Diagnosis is made by means of videolaryngostroboscopic exam. The treatment of choice is done with botulinum toxin directly injected in the muscles responsible for the mismatched movement. The aim of this study is to report on an adductor- type dysphonia patient and to discuss the advantages and observations about this treatment reported in the literature.