Endoskopische Untersuchung des mesopharyngealen Isthmus im Wachzustand und in propofolinduzierter Sedierung unter Einfluss der Unterkieferprotrusion und des Zungenrepositionsmanövers bei gesunden Erwachsenen

Scharfe, Sebastian

dc.contributor.advisor	Engelke, Wilfried Prof. Dr. Dr.
dc.contributor.author	Scharfe, Sebastian
dc.date.accessioned	2017-03-17T15:04:19Z
dc.date.available	2017-05-05T22:50:06Z
dc.date.issued	2017-03-17
dc.identifier.uri	http://hdl.handle.net/11858/00-1735-0000-0023-3DDF-3
dc.identifier.uri	http://dx.doi.org/10.53846/goediss-6194
dc.language.iso	deu	de
dc.rights.uri	http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subject.ddc	610	de
dc.title	Endoskopische Untersuchung des mesopharyngealen Isthmus im Wachzustand und in propofolinduzierter Sedierung unter Einfluss der Unterkieferprotrusion und des Zungenrepositionsmanövers bei gesunden Erwachsenen	de
dc.type	doctoralThesis	de
dc.title.translated	Endoscopic examination of the mesopharyngeal isthmus in wakefulness and in propofol-induced sedation under influence of the mandibular advancement and of the tongue repositioning maneuver in healthy adults	de
dc.contributor.referee	Russo, Sebastian G. Pd Dr.
dc.date.examination	2017-04-25
dc.description.abstracteng	Background: Early studies report on different calibers of the mesopharyngeal opening in the states of wakefulness and sedation. Objektives: Is it possible to manipulate the widening of the mesopharyngeal isthmus by particular maneuvers in the states of wakefulness and sedation? Methods: The mesopharyngeal isthmus of 50 healthy subjects was examined endoscopically in wakefulness and under sedation. The intraoral negative pressure was controlled by a vacuum activator. The following maneuvers were performed and widening of the isthmus was documented pictorially: spontaneous breathing with closed lips (SB), mandibular advancement (MA), tongue repositioning maneuver (TRM), and mandibular advancement combined with TRM (MA, TRM). While performing the tongue repositioning maneuver with closed lips, the tongue is adapted closely to the row of teeth and also to the hard and soft palate. Results: In wakefulness, 123 endoscopic pictures were analyzed, 35 with SB, 34 with MA, 35 with TRM, 19 with TRM and MA. In sedation there were 125 pictures, 35 with SB, 32 with MA, 34 with TRM, 24 with TRM and MA. The results represent that in sedation the TRM has a significant widening effect on the opening of the mesopharyngeal isthmus compared to SB without TRM (p<0.05). Compared to SB in sedation, the combined maneuver of TRM and MA had an additional effect on the widening of the mesopharyngeal isthmus (p<0.05). Conclusions: In sedation, the mesopharyngeal isthmus is stabilized by the TRM and the combined maneuver with MA and TRM because of the forward displacement of the tongue out of the pharynx with closed contact to the hard palate and apposition of the velum to dorsum of the tongue.	de
dc.contributor.coReferee	Rödel, Ralph Prof. Dr.
dc.subject.ger	Zungenrepositionsmanöver, Unterkiefervorverlagerung, Medikamentös induzierte Schlafendoskopie, Schlafendoskopie, Velopharynx	de
dc.subject.eng	Tongue repositioning maneuver, Mandibular advancement, Drug induced sleep endoscopy, Sleep nasendoscopy, Velopharynx	de
dc.identifier.urn	urn:nbn:de:gbv:7-11858/00-1735-0000-0023-3DDF-3-6
dc.affiliation.institute	Medizinische Fakultät	de
dc.subject.gokfull	Zahn-, Mund- und Kieferheilkunde - Allgemein- und Gesamtdarstellungen (PPN619876360)	de
dc.description.embargoed	2017-05-05
dc.identifier.ppn	882346229