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By David J. Terris
Delivering a complete evaluate and replace on contemporary advances, that types a useful reference for practitioners attracted to the most recent operative recommendations, this state of the art textual content stories present and rising issues within the surgical administration of sleep apnea and noisily snoring, inclduing tools for sufferer assessment, avoidance of problems, and postoperative care. With greater than 30 illustrative chapters and targeted figures that provide transparent presentation of the options mentioned, the publication comprehensively delineates the anatomy and body structure of sleep apnea and addresses contemporary and proven surgical methods to the administration of obstructive sleep apnea and noisily snoring.
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Oropharyngeal wall thickening is also noted (41). These studies support the hypothesis that the oropharynx is the anatomic site of SDB. If all the proposed anatomic changes evolved to facilitate speech and caused SDB, why was there no negative selection pressure preventing the changes? SDB does not The anatomy of sleep disordered breathing 49 manifest in humans until the fourth and fifth decades of life, which is beyond man’s procreative peak and until the last century, beyond man’s life expectancy.
4 Oropharyngeal Tongue The oropharyngeal tongue of H. sapiens is well described in anatomy books and scientific literature. Crelin (13) notes that man is the only animal whose tongue resides partially in the pharynx. In all other animals, including the nonhuman primates, the tongue resides exclusively in the oral cavity. Negus (14) opines that the tongue is primarily designed for mastication and that a smaller, shorter tongue would suffice for this purpose. The human oral cavity is far smaller than that of a similar-sized nonhominid primate, yet the tongue remains approximately the same volume.
Many suffer partial to total nasal obstruction when asleep and the oral cavity becomes a major part of the upper respiratory tract. Man’s nasopharynx is held open, as it is in animals, by a bony skeleton including the pterygoid bones laterally, the basisphenoid above, and the occipital bone and cervical spine posteriorly. Air must pass from the nasopharynx through the oropharynx to the laryngeal introitus. The oropharynx is a floppy, distensible tube and is partially supported by bone. This area can be filled with soft tissue including the tonsils, tongue, and soft palate.