Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P310

P310		
Otolaryngology-Head and Neck Surgery 163(1S)
Presentation schedule is subject to change. The Official Program Abstracts supplement does not reflect changes made after August 10, 2020.
Methods: Patients with mild, moderate, and severe OSA
were included in the study. The diagnosis was confirmed by
means of home sleep test or polysomnography. Patients with
primary snoring without obstructions and healthy volunteers
served as a control group. In addition to clinical parameters,
various landmarks were sonographically evaluated (eg, distance between lingual arteries, horizontal and vertical tongue
thickness, thickness of the pharyngeal wall, and intima
media thickness [IMT] of the common carotid artery).
Results: In each group, more than 25 patients could be
enrolled. Evaluation of clinical parameters revealed differences
in body mass index and neck circumference. The evaluation of
the sonographic parameters showed higher values with increasing severity of OSA regarding distance between the lingual
arteries, the horizontal and vertical thickness of the tongue, the
thickness of the lateral pharyngeal wall, and the IMT (all P <
.05). These measurements correlated with the apnea-hypopnea
index.
Conclusions: Sonographic assessment of landmarks relevant to OSA revealed correlations between anatomical measures and IMT as a surrogate parameter for the risk of
cardiovascular disease with the severity of OSA. In further
investigations, these results should provide further insight
into the pathogenesis of OSA and enable a more targeted
therapy.

Sleep Medicine

Total Intravenous Anesthesia Versus
Sevoflurane Gas in Treatment of
Obstructive Sleep Apnea
Matthew J. Stewart (Presenter); Leonard Estephan;
Kevin Connors; Patrick Hunt, MD; Maurits Boon, MD;
Colin T. Huntley, MD
Objectives: Currently, there is no standard of care for anesthesia method for patients who receive surgery with comorbid
obstructive sleep apnea (OSA). Here, we compare total intravenous anesthesia (TIVA) to sevoflurane gas anesthesia
related to emergence time, phase I, and total recovery times
among patients receiving palate surgery, nasal surgery, and
upper airway stimulation.
Methods: This is a retrospective review of 165 patients who
received surgery from January 2019 to December 2019.
Results: Upper airway stimulation therapy experienced a
45-minute reduction in total recovery time (195 vs 240 minutes, P = .003) and a 38-minute reduction in phase I (142 vs
180 minutes, P = .002). Nasal surgery experienced an average
39-minute reduction in total recovery time (155 vs 194 minutes, P ≤ .0001) and an average 29-minute reduction in phase
I (112 vs 141 minutes, P = .018). The sample size for palate
surgery (uvulopalatopharyngoplasty and tonsillectomy and
adenoidectomy) was small and yielded no significant results.
Overall, patients who received TIVA had a faster recovery
(by 27 minutes) than those who had sevoflurane (184 vs
211 minutes, P = .003). Controlling by time spent in surgery
did not significantly change the results. The emergence times
between methods were similar. There was no significant

difference in complications, readmissions, or emergency
department admissions between groups.
Conclusions: Compared with sevoflurane anesthesia, patients
with OSA who receive TIVA experience significantly reduced
recovery times with no change in outcomes for their procedure. It may be appropriate to use TIVA for patients with OSA
to reduce recovery time and overall time spent in the hospital,
potentially leading to decreased cost and presumably increased
patient satisfaction.
Variation in Sleep Stability With Differences
in Severity of Sleep-Disordered Breathing in
Children
Min Young Seo (Presenter)
Objectives: The aim of this study was to analyze the association between the severity of obstructive sleep apnea (OSA)
and various cardiopulmonary coupling (CPC) parameters in
children with OSA.
Methods: A total of 117 children (aged 7.96 ± 3.54 years; 86
male) with suspected sleep-disordered breathing (SDB) were
enrolled in the present retrospective study and underwent allnight polysomnography (PSG) and CPC. We analyzed the
association between various CPC and PSG findings.
Results: The apnea-hypopnea index was negatively correlated with high-frequency coupling (HFC; r = −0.374; P <
.001) and very low-frequency coupling (VLFC; r = −0.192;
P = .038) and positively correlated with low-frequency coupling (LFC; r = 0.503; P < .001), elevated low-frequency coupling (e-LFC; r = 0.475; P < .001), and narrowband and
broadband e-LFC (e-LFCNB and e-LFCBB; r = 0.221; P =
.016 and r = 0.468; P < .001, respectively). The arousal index
was negatively correlated with HFC (r = −0.466; P < .001)
and positively correlated with LFC, e-LFC, e-LFCNB, and
e-LFCBB (r = 0.543, 0.460, 0.239, and 0.445, respectively; all
P < .001). In addition, we also found a significant difference
in various CPC values according to OSA severity.
Conclusions: CPC parameters accurately reflect sleep fragmentation and OSA severity in children. Thus, we can verify
objective sleep quality using CPC analysis, which is a simple
method of analyzing sleep stability in children with SDB.
Variation in Urologic Health in Male and
Female Patients With Obstructive Sleep
Apnea
Martin L. Hopp, MD, PhD (Presenter); Michela Borrelli;
Stephen Freedland, MD; Lenore Ackerman, MD;
Jennifer Anger, MD; Daryoush Saadat, MD; Arash Shamsian
Objectives: Obstructive sleep apnea (OSA) has been suspected to be a risk factor for urinary dysfunction (UD) and erectile dysfunction in men and nocturia and overactive bladder
syndrome in women. This study evaluates both the incidence
and correlation of UD in male and female patients with OSA.
Methods: The 25-Item Symptoms of Nocturnal Obstruction
and Related Events (SNORE-25), a validated quality-of-life
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts

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