Farideh Madani

Epidemiology, Pathophysiology, and Clinical Features of Obstructive Sleep Apnea

The normal cycle of respiration includes a unique balancing force between many upper airway structures that control its dilation and closure. Alteration of this delicate equilibrium, possibly by an increased airflow resistance, can cause various degrees of obstructive sleep apnea (OSA). OSA is now recognized as a major illness, an important cause of medical morbidity and mortality affecting millions of people worldwide, and a major predisposing factor for several systemic conditions, such as hypertension, cardiovascular disease, stroke, diabetes, and even sexual dysfunction. Initial evaluation for possible OSA may be done by dental professionals who can provide guidance for its comprehensive evaluation and management. Because of the complexity of the disease, factors contributing to its development must be identified. Some factors caused by the patients anatomic structures are slightly easier to rectify, whereas others may relate to the patients age, sex, habits, or associated illnesses, including obesity. In this article, various epidemiologic, pathophysiologic, and clinical features of OSA are discussed.

Normal Variations of Oral Anatomy and Common Oral Soft Tissue Lesions: Evaluation and Management

Examination of the oral cavity can provide significant diagnostic information regarding the general health of the patient. The oral cavity is affected by a multitude of pathologic conditions of variable cause and significance; however, there are numerous normal variations of oral soft tissue structures that may resemble a pathologic state. Understanding these variations assists practitioners to discriminate between normal versus abnormal findings and determine the appropriate course of management, if necessary.

Reoperative Treatment of Obstructive Sleep Apnea

Over the last several decades, various surgical treatments have been advocated and used to treat obstructive sleep apnea. Treatments ranging from aggressive procedures, such as tracheostomy, to the least-invasive procedures, such as radioablation, have not yielded satisfactory results. One of the major causes for surgical failures and lower success rates lies in the inadequate understanding and appreciation of the anatomic and pathophysiologic factors that contribute to upper airway obstruction. In some cases, combinations of various surgical techniques may help improve the conditions. This article reviews several major types of surgical procedures, their complications, and the recommended approaches for retreatments.

Psychological Issues in Sleep Apnea

The overlap of sleep disorders with various psychiatric problems is so great that one would suspect that both types of problems may have common biologic roots. An estimated 65% to 90% of adults with major depression experience some kind of sleep problem. Sleep problems also increase the risk for developing depression. Since the early days of research on disturbed sleep, clinical studies have suggested the existence of a relationship between depression and obstructive sleep apnea.

The occurrence of a fibro-osseous lesion and multiple dental anomalies in a patient with the Greig cephalopolysyndactyly syndrome.

The Greig cephalopolysyndactyly syndrome is an uncommon dysmorphic syndrome characterized by preaxial and postaxial polysyndactyly and minor craniofacial anomalies. It has an autosomal dominant inheritance. A review of the literature has failed to show documentation of any dental or oral abnormalities. Therefore, we report on a patient with Greig syndrome who had a maxillary fibro-osseous lesion and multiple dental and oral abnormalities.