"Obstructive sleep apnea syndrome (SAOS) or chronic snoring"
Principal investigators: Pedro Quesada Marín and Juan Lorente Guerrero.
The clear improvement in the apnea-hypopnea index (AHI) index after soft palate partial resection (RPP) objectively demonstrates the hypertrophy of the soft palate influence in the OSAS. However, an important number of patients (20-30%) do not profit according to the sleep polygraphic, recordings from this surgical technique. This indicates that in some cases upper airways obstruction is due to anatomic structures different to the soft palate. This data led us, together with the Neurophysiology and Pneumology Departments, to evaluate the tolerance to non-invasive positive pressure ventilation (NPPV) in those patients that do not benefit from RPP. We concluded that a soft palate partial resection did not increase CPAP intolerance.
“Effects of functional Septoplasty on the obstructive sleep apnea syndrome (SAOS)”
In SAOS and nasal respiratory insufficiency due to septal dysmorfia, functional septoplasty is the appropriate therapeutic option, since it diminishes nasal resistance and increases nasal air flux. This result led us, in collaboration with the Neurophysiology Department, to perform research in order to define the functional septoplasy effect on SAOS symptoms (IAH, oxygenation level during sleep, daytime sleepiness and others) in patients with l dysmorphic septum. We have reached the conclusion that functional septoplasy is the appropriate therapeutic choice, since it diminishes nasal resistance and increases nasal air flux, inducing SAOS improving. In those cases in which the improvement is not achieved it seems to increase the tolerance to nasal CPAP .
“Gastroesophagic reflux in SAOS patients”
In SAOS patients, respiratory difficulty associates with a decrease in supradiaphragm pressure which facilitates gastric acid content reflux due to a negative pressure suction phenomenon. Different reports suggest a link between gastroesophageal reflux disease (GERD) and SAOS, but GERD prevalence in SAOS and the influence of SAOS severity GERD is so far unknown. In collaboration with the HUVH Neurophysiology and Digestive Departments, we are studying gastroesophagic reflux prevalence in SAOS patients diagnosed by conventional sleep polygraphy, and to evaluate the efficiency of a designed questionnaire in gastroesophagic reflux diagnosis.
“Relationship between gastroesophagic reflux and otorhinolaryngological pathology”
Principal investigators: Pedro Quesada Marín and Juan Luis Quesada Martínez.
In otorhinolaryngology there are some pathologies thought to be GERD-related, such as posterior laryngitis, laryngotracheal stenosis, globus pharynx, obstructive apnea syndrome, or Laryngeal granuloma. Although different studies have been performed in order to reveal the presence of GERD associated to these conditions, there no data about efficacy of antireflux treatments. The aim of this line of research is to evaluate the result therapeutic interventions in these patients.
“Thallium-201 scintigraph in larynx carcinoma patients”
Principal investigators: Pedro Quesada Marín and Juan Lorente Guerrero
In collaboration with the Otorhinolaryngology and Nuclear Medicine Departments we have initiated a research project involving larynx carcinoma patients in order to establish a diagnostic correlation among lesion extension determined by ENT exploration, surgery in surgical cases, CT scanning and Thallium 201. Our goal is to validate the later as imaging diagnostic method for monitoring and controlling possible post-treatment local relapses.
“99mTc-depreotide performance in initial staging and recurrence of larynx cancer”
NeoSpect proved utility for lung cancer, which shares similar aspects with larynx epithelial tumors, lead us to propose its efficiency in initial staging and recurrence detection for these types of neoplasias with two specific aims:
- To obtain data regarding sensibility, specificity and predictive value for the 99mTc-depreotide in the diagnosis and initial staging in larynx cancer. As reference standard, CT/MN R and year two monitoring will be used.
-To obtain data regarding sensibility, specificity and predictive value for the diagnosis of recurrence at six months after initial treatment.
- Clinical and radiological monitoring will last at least for two years since the end of initial treatment.
“Genetic transcription factors and NOS in upper airways inflammation”
Principal investigators: Jose Oriol Bulbena Moreu and Juan Lorente Guerrero.
In collaboration with the Barcelona Biomedical Research Institute, CSIC is carrying out a research project studying cellular and molecular mechanisms in chronic inflammation at the respiratory mucosa. We are studying NF-kB/inducible nitric oxide synthase (iNOS) pathway in epithelial cells from polyps and nasal mucosa.