An important review on obstructive sleep apnea for the oral and maxillofacial surgeon! Topics include epidemiology, pathophysiology and clinical features of obstructive sleep apnea; systematic evaluation of the OSA patient; upper airway imaging in the evaluation and surgical management of OSA; management of OSA by continuous positive airway pressure; oral appliances in the treatment of OSA; algorithms for surgical management of obstructive sleep apnea; surgery of the palate, tonsils and tongue; treatment of OSA by distraction osteogenesis; surgical management of OSA in the pediatric patient; anesthetic and postoperative management of the OSA patient, and much more! Sleep-related problems affect over 50 million Americans of all ages and are therefore a significant public health concern. One of the most common sleep disorders is obstructive sleep apnea (OSA), which is characterized by repetitive complete or partial collapse of the upper airway during sleep. The ensuing reduction in airflow leads to hypoxia and subsequent arousals from sleep, producing sleep deprivation. Major risk factors for OSA include being male, obese, and over 40 years of age, but anyone can be affected, even children. The effect that OSA has on general health and quality of life has been well documented. Untreated OSA is associated with a significant number of medical conditions, including hypertension, myocardial infarction, and stroke. Additionally, sleep deprivation may lead to impaired cognitive function, which can hurt job performance and lead to more motor vehicle crashes. OSA is considered to be a chronic disorder that often requires lifelong management. Unfortunately, the majority of individuals with OSA are undiagnosed and therefore remain untreated. Because of the complexity of the disease and the associated medical conditions, a broad spectrum of clinicians play important roles in the treatment of OSA. These clinicians include sleep medicine specialists, surgeons, dentists, primary care physicians, and pediatricians. Therefore, the evaluation and management of OSA are best performed using a multidisciplinary team approach. Oral and maxillofacial surgeons are integral members of the team, particularly in regard to surgical management of both adults and children with OSA. The overarching goal of this issue is to provide contemporary guidelines for the evaluation and management of OSA in this rapidly evolving area of clinical practice. This publication is organized in an integrated fashion, so the articles are presented in a manner that generally parallels the sequence of patient care. Experts from a variety of specialties were recruited to contribute articles, thereby facilitating comprehensive coverage of the subject. Each author has done an admirable job of covering his or her topic using a blend of evidence-based review of the literature and personal experience.
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