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Governance Lead

28/2/2013

 
I have recently been appointed Governance lead for the department of surgery and anaesthetics at Warrington & Halton Hospitals. It is a privilege to take on this role and I look forward to continue to build on the excellent provision of high quality, safe healthcare delivered by the trust. 

Patient Outcomes Can Measure Success of Obstructive Sleep Apnea Surgery

19/2/2013

 
This is an interesting article from ENT Today looking at outcome measures of snoring and OSA surgery. One can measure hard sleep study data or look at patient-reported outcomes. Either way, surgery for OSA is worth considering for cases where CPAP does not deliver a solution

There is an interesting table comparing the Pros and Cons of patient-reported and physician-recorded data:
POLYSOMNOGRAPHY / SLEEP STUDY (PSG)

+
Hard AHI data to compare surgery to baseline

Can show reductions in mortality risks eg if AHI drops from 100 to 50



-
Does not capture full clinical picture eg symptom improvement, presence or absence of adverse effects or patient satisfaction with procedure
PATIENT REPORTED OUTCOME MEASURES (PROMs)

+
Represents patient's general perception of well-being

Captures symptom improvement

Reports patient's satisfaction with surgery

-
Does not yield objective data to compare post-op results with baseline

Cannot predict reduction in mortality risk
http://www.enttoday.org/details/article/4330421/Patient_Outcomes_Can_Measure_Success_of_Obstructive_Sleep_Apnea_Surgery.html

A new treatment for snoring and OSA

19/2/2013

 
Obstructive sleep apnoea is a common condition that can cause excessive daytime tiredness as well as increasing the risk of blood pressure, stroke, heart attack and road traffic accidents. The mainstay of treatment has been CPAP - a type of mask worn at night or a mandibular advancement splint which is like a gum shield. Both of these work well but patients often find them uncomfortable or cannot use them during the night. 

I have recently published a paper in the Journal of Clinical Sleep Medicine outlining some research I did when I was in Australia. This paper analyses a modified type of palatal (throat) surgery known as a uvulopalatopharyngoplasty combined with Coblation to the base of the tongue (which is a type of heat energy). The aim of this surgery is to open up the space behind the tongue and behind the palate (dangly bit at the back of the throat) to reduce snoring and OSA.

The results are pretty good - the AHI (which is a measure of severity of OSA) fell from 23.1 to 5.6 which is effectively normal and the Epworth Sleepy Score fell from 10.5 to 5 (anything less than 8 is normal).

Obviously this type of surgery is not for everyone but if you do suffer from OSA or snore then do ask your GP to be referred for an assessment.


Jonathan Hobson - HobsonENT

email

hobsonent@gmail.com


Locations

Wythenshawe Hospital
M23 9LT

Spire Cheshire
WA4 4LU

Spire Manchester
M20 2AF

Calderbank Medical Chambers
M20 3QD




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