VALERIA MENDES
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Resumo IPEN-doc 29997 Lasers não-ablativos de alta intensidade na apneia obstrutiva do sono2022 - MENDES, VALERIA; AZEVEDO, LUCIANE H.; ZEZELL, DENISE M.INTRODUÇÃO: O ronco primário e apneia grave representam as diferentes gravidades do mesmo distúrbio fisiopatológico, que afeta em torno de um bilhão de pessoas em todo o mundo. É mais frequentemente em homens e idosos. O ruído é causado pela vibração dos tecidos moles na área mais constrita das vias aéreas superiores. As opções terapêuticas usuais apresentam limitações e as publicações em literatura sobre os efeitos clínicos do uso de laser no manejo do ronco e AOS são escassas e pouco exploradas. OBJETIVOS: Após determinar as melhores condições de irradiação, este estudo tem como objetivo, avaliar o tratamento do ronco com irradiação de alta intensidade, sequencial e não-ablativa de dois lasers pulsados: Nd:YAG e Er:YAG (Lightwalker, Fotona). Os resultados obtidos com o tratamento são comparados às condições em linha de base. METODOLOGIA: Um estudo longitudinal, intervencionista e prospectivo está em andamento com a aprovação do comitê de ética em pesquisa. Até o momento, 32 de 40 voluntários que transitam entre ronco primário e apneia obstrutiva do sono moderada foram tratados em três sessões de irradiação laser não-ablativa. O intervalo entre as sessões foi de14 dias. O volume do espaço orofaríngeo foi analisado por registro fotográfico, de acordo com o índice Mallampati modificado. Saturação de oxigênio, gravidade do ronco e qualidade do sono também serão avaliados. RESULTADOS ESPERADOS: O principal resultado clínico obtido será a expansão da luz da via aérea superior pela diminuição da complacência tecidual. Com isso, redução ou eliminação do ronco.Dissertação IPEN-doc 29487 Non-ablative treatment of sleep breathing disorders with the association of two high-intensity pulsed lasers2022 - MENDES, VALERIAPrimary snoring and obstructive sleep apnea (OSA) represent different severity degrees of the same chronic, complex and progressive disease, which affects about one billion people worldwide. It is more prevalent in elderly men. Historically, snoring is seen as a social problem, being considered the most benign form of sleep breathing disorders (SBD). Because of this, treatment is not prescribed. Snoring noise occurs as a result of soft tissue vibration in the region of upper airway (UA) greater constriction during sleep. Therapeutic options may involve medical treatments, use of devices, and surgical procedures. As for the results, all of them have limitations. Adherence to treatment and cases of relapse over time represent the greatest challenge in disease control. Increased cardiovascular risk, emergence of chronic diseases and use of medications result from worsening and disease progression. A dysregulation of palatopharyngeal muscle tone plays a significant role in this disorder. After determining the best irradiation conditions, this study aims to evaluate the treatment of SBD with high intensity non-ablative irradiation with two pulsed lasers: Nd:YAG laser (1064 nm) followed by Er:YAG laser (2940 nm), both from Fotona LightWalker platform, comparing results before and after the intervention. A controlled, randomized, double-blind clinical trial was performed with approval of the research ethics committee. Thirty volunteers that transitioned between primary snoring and moderate obstructive sleep apnea were treated in three sessions of non-ablative laser irradiation, with a 14-day interval between them. The upper airway lumen for airflow passage was analyzed by photographic record, according to modified Mallampati index. Oxyhemoglobin desaturation parameters, severity of snoring (noise amplitude and sleep time with snoring) as well as aspects of sleep quality were also evaluated. The main clinical result obtained is the expansion of the upper airways lumen by reduction of tissue compliance in an outpatient procedure. Therefore, improvement of sleep breathing disorder.Resumo IPEN-doc 29205 High-intensity non-ablative lasers in sleep-disordered breathing2022 - MENDES, V.; AZEVEDO, L.H.; ZEZELL, D.M.Primary snoring and severe apnea are considered sleep-disordered breathing and represent different degrees of severity of the same disorder which affects around one billion people worldwide. It is more common in men and the elderly. The noise is caused by the soft tissues's vibration in the regions of greatest constriction of the upper airways. Increased cardiovascular risk, emergence of chronic diseases and use of medications are due to the progression and evolution of the disease. After determining optimal irradiation conditions, this study aimed to evaluate the treatment of snoring with sequential high-intensity non-ablative irradiation with two pulsed lasers Nd:YAG and Er:YAG comparing the results before and after treatment. A randomized, double-blind, controlled clinical trial is underway with the approval of the research ethics committee. To date, 32 of 40 volunteers transitioning between primary snoring and moderate obstructive sleep apnea have been treated in three sessions of nonablative laser irradiation, 14 days apart. The volume of the oropharyngeal space for air passage was analyzed by photographic record according to the modified Mallampati index. Oxygen saturation, snoring severity and sleep quality will also be evaluated. The primary clinical outcome obtained was the expansion of the upper airway lumen by reducing tissue compliance and, therefore, reducing or eliminating snoring, in an outpatient procedure. The reduction of snoring is due to the decrease in tissue compliance.