Airway camera reveals causes of sleep apnea
By Graciela Gutierrez
Sleep apnea is a potentially dangerous condition that is caused by an obstruction to the airway, and now doctors at Baylor College of Medicine are using tiny video cameras to determine just what is causing that obstruction.
Obstructive sleep apnea, in which tissues in the back of the throat collapse during sleep, results in the cessation of breathing, restless sleep, daytime fatigue, loud snoring, as well as frequently waking up gasping for breath.
"In the past, most doctors assumed it was always the soft palate and uvula (soft tissue in the back part of the roof of the mouth) that was collapsing, and they would trim portions of it out," said Dr. Mas Takashima, assistant professor of otolaryngology. "However, as surgical outcomes have shown, this procedure doesn't have a 100 percent cure rate."
Airway obstructions
Takashima says that's because there are many things other than the soft palate that can obstruct the airway, such as large tonsils, large tongue base, skeletal abnormalities or the epiglottis (the structure that prevents food from entering the trachea during swallowing). Getting an up-close view of these areas with the camera while the patient is asleep helps doctors determine exactly what areas to target.
Patients are sedated, and a drug-induced sleep is obtained so the patient can breath on his or her own. While asleep, an endoscope, a small flexible device with a camera on the end, is inserted into the back of the nose to view the throat. Doctors are able to watch what happens inside the throat as the person sleeps.
Treatment options
By exactly diagnosing the cause of the obstruction, a more precise and directed surgical therapy can be planned.
"Of course you are not going to get a good result if surgery is addressed on your soft palate but the main cause of your sleep apnea is your tongue," said Takashima.
There are nonsurgical options, like wearing a breathing mask that blows a continuous stream of air into the throat to keep the airway open when you sleep.
"As long as sleep apnea is treated, whether or not a person wants to undergo surgery is up to them," Takashima said. "Having the video helps us to understand what surgical options are available, which in turns improves our patient counseling and, more importantly, helps prevent unnecessary surgery."
