ANATOMICAL ALTERATIONS OF THE NASO-OROPHARYNX AS THE ETIOLOGY OF SLEEP APNEA: A REVIEW OF PATHOPHYSIOLOGY AND SURGICAL APPROACHES TO THE SYNDROME
DOI:
https://doi.org/10.47820/recima21.v4i4.2999Keywords:
Anatomy, Surgeries, Pathophysiology, apnea, NasopharynxAbstract
Obstructive Sleep Apnea Syndrome is characterized by a sleep respiratory disorder, with recurrent episodes of partial or complete obstruction of the upper airways. Overweight, obesity, and male sex are some of the most widespread risk factors for OSA. Although they are extremely important, it is necessary to bring more space and notoriety to other factors: the anatomical ones. The pharynx is split into three segments: nasopharynx; oropharynx, that conducts air once inhaled; and laryngopharynx, responsible for blocking the passage to the esophagus when air is inhaled. Some craniofacial alterations (specifically in the oro-nasopharynx) are presented by several individuals with OSA. Individuals with greater resistance to airflow in fixed segments and greater sagging in the flexible segment are more predisposed to collapse of the upper airways, which is a primary risk factor for the development of OSA, regardless of obesity, neck circumference, and other craniofacial anomalies. Surgical treatment is indicated as primary therapy for OSA when a surgically correctable fixed obstruction of the airways is responsible for apnea. In recent decades, there has been a rise in surgical technology advancements, but further research is needed to better quantify changes in patient-centered outcomes as well as cardiac, metabolic, neurocognitive, and long-term mortality outcomes.
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