ChicagoENT

New Treatment for Sleep Apnea

HNCSA — Tue, 10 Apr 2012 20:26:36 +0000

Free clinical snoring treatment with a new treatment option -PROVENT – ANNOUNCING A NEW STUDY

If you’ve seen our previous blog, you’ll know how excited the doctors at Chicago ENT have been with the results of the latest alternative to CPAP for the treatment of sleep apnea - Provent Nasal EPAP.

WHY TREAT SLEEP APNEA?

Sleep apnea (or more commonly called snoring) affects over 28 million Americans, and increases an individual’s risk of hypertension, stroke, heart attack, irregular heart rhythm, weight gain and impotence, not to mention daytime sleepiness, decreased mental function and productivity and an increase in the risk of auto accidents!

REMINDER – WHAT IS PROVENT?

Provent is an FDA-approved device that has been shown - through a number of large-scale clinical studies - to significantly reduce sleep apnea and snoring for a range of patients who have been unable to tolerate and is an alternative treatment than CPAP. As reported by Tara Parker-Pope of the New York Times (Health Blog 4/9/12), the Provent device has been in such hot demand of late that the manufacturers – Ventus Medical – have shipped over one million units in the past 12 months.

HOW PROVENT WORKS:

A small, unintrusive adhesive valve placed just inside each nostril allows unrestricted inward airflow, but restricts outward airflow through the nose. This build-up of pressure during expiration helps to splint the collapsible soft tissues of the upper airway open in readiness for the next breath in and thereby reduces the chance of apnea.

WHAT’S NEW?

The team at Chicago ENT has been hugely encouraged by our own and previously published results of Provent therapy. However, while effective for a large number of people, Provent is not for everyone. We therefore want to take things one step further, by better defining the group of patients for whom the Provent device works best.

To that end, a first-of-its-kind studyis about to be launched at our practice, which aims to assess the relationship between nasal patency (the size of the nasal passages and relative restriction of airflow within them) and the effectiveness of the Provent device.

This study will involve the use of the Provent device nightly for a period of one month, and all devices will be provided free of charge to participants.

Suitable candidates for this study should be over 18 years of age, have an existing diagnosis of sleep apnea with an apnea-hypopnea index (AHI) of between 15 and 60 events per hour, and have failed treatment of their sleep apnea by CPAP*.

Identifying the specific group of patients who benefit most from Provent, will assist us (and other physicians) in providing the most appropriate and focused treatment for individual patients suffering from sleep apnea and snoring related complaints.

*Additional inclusion and exclusion criteria for study participation will apply.

Works like CPAP… without the CPAP.

HNCSA — Fri, 30 Sep 2011 15:03:32 +0000

For patients with obstructive sleep apnea, CPAP is the gold standard treatment. The only problem is a lot of patients don’t like it. At Chicago ENT, we have recently begun to work with a newer device called Provent Nasal EPAP. “That’s it?” you might ask when you see what it looks like; a disposable sticker placed over each nostril prior to going to sleep. That’s it! But look a little closer…

Unlike CPAP which provides continuous positive airway pressure to keep the airway open during inspiration and expiration, Provent provides EPAP – positive airway pressure during expiration only.

How? Each sticker contains a central valve that stays open during inspiration allowing unobstructed airflow. The valve then closes during expiration leaving only a small hole to breathe out through. This expiratory resistance increases airway caliber towards the critical end-expiratory period in particular. Imagine trying to blow out a birthday candle on the other side of the room while breathing out through a drinking straw… same idea.

Why is the end-expiratory period critical? Because you’re just about to take another breath in! Without the externally provided positive pressure from CPAP or EPAP during this period, the upper airway is left prone to collapse as a result of negative pressure in the chest. Now imagine bending the drinking straw in the middle and trying to breathe in through it.

Like any new device, Provent takes some getting used to, but a number of studies conducted to date have shown excellent results for patients with mild right through to very severe sleep apnea.

If you’re not a fan of CPAP, there’s a lot more to be gained than to be lost by trying Provent. In fact, Dr Friedman and the team at Chicago ENT are so convinced of its potential, they’re about to start a study of their own.

Transnasal Esophagoscopy

HNCSA — Tue, 20 Sep 2011 21:16:10 +0000

Transnasal Esophagoscopy is a diagnostic study that allows your physician to examine your esophagus without the need for sedation or anesthesia. How does Transnasal Esophagoscopy (TNE) differ from classic Esophagoscopy?

1. Sedation: Classic esophagoscopy requires sedation. The patient needs to be accompanied for transportation and typically the sedation wears off quickly. Residual sedation persists for most of the day though. TNE is performed in the MD office with topical anesthetic spray. It requires NO SEDATION, and patients do not need to be accompanied to the appointment. Patients typically return to work right after they have been seen by the doctor.

2. Size of the Scope: TNE is done with a smaller caliber scope with high end optics. The length of the scope is the same.

Results of the tests? Both classic esophagoscopy and TNE have been shown to be accurate diagnostic tools.

Costs of the tests? Classic Esophagoscopy costs approximately $8,000 including facility fees. TNE cost is under $1,000.

The purpose of the procedures is for diagnosis of gastro esophageal reflux disease (GERD). Diagnosis of GERD is important even when the symptoms are minimal. Uncontrolled reflux can lead to severe medical problems including Esophageal Cancer.

Chicago ENT introduced Transnasal esophagoscopy to the Chicago Community as an option for diagnosis and treatment of gastro esophageal reflux disease and for the screening esophageal cancer.

Dr. Oz talks about esophageal cancer, click here

Michael Friedman MD, is an Otolaryngologist- Head and Neck Surgeon and serves as the Medical Director for ChicagoENT.

What Happens When CPAP Fails?

HNCSA — Wed, 14 Sep 2011 18:57:42 +0000

Continuous Positive Airway Pressure (CPAP) is an excellent option for treatment of sleep apnea but it is not for everyone. Approximately 50 percent of people suffering with moderate to severe sleep apnea cannot accept using CPAP. Although CPAP is the best option for treatment, Dr. Michael Friedman tells his patients there are many other options available and the only bad option is no treatment at all. Most patients with mild sleep apnea will not even consider CPAP as an option. They often choose to fore go treatment even though studies have shown that mild sleep apnea increases the risk of serious consequences such as fatigue, weight gain, hypertension and impotence. Women can often suffer from sleep apnea without snoring and still risk the problems of fatigue, weight gain, loss of libido, and depression. They also need options besides CPAP. And what about bed partners who suffer while their sleep is disturbed by the snoring sounds of patients with mild disease? In a study on the impact of snoring, the average sleep loss of the bed partner was 25% of their sleep time. For those patients with mild to moderate disease, office-based minimally invasive nonsurgical procedures have been shown to be highly successful in eliminating snoring and reducing apneic events. Treatments such as palatal stiffening have been used successfully in thousands of patients. Often these techniques are combined with other nonsurgical treatments such as radio-frequency, which allows nonsurgical shrinkage of tonsils, tongue base or obstructing nasal tissue. In some cases simple improvement of the nasal airway alone by an Otolaryngologist can improve or correct the problem. Click HERE and watch a Fox News segment Featuring ChicagoENT and Dr. Michael Friedman on tonsil shrinkage. In patients with severe disease, dental appliances can often offer relief of symptoms. Many of these patients may require surgical correction of the obstructing tissue. Modern day multilevel approaches have improved the success rate and reduced the morbidity. With multilevel treatment, over 60% of the patients achieved cures, and 80% achieved improvement. A recent innovation allows for precise tissue reduction by using the da Vinci robot , which helps conduct a minimally invasive surgery that allows for improved precision. There are more than 20 different treatment protocols available to patients suffering from snoring and sleep apnea. It is important to consult with your physician to determine which course of action. This article was published in the Spring 2011 issue of Chicago Health- Top Doctors and Hospitals