Association between allergic rhinitis and development of autoimmune thyroid diseases in Egyptian patients.

Background: Autoimmune thyroid diseases (AITD) and allergic rhinitis (AR) are prevalent conditions; however, limited research has investigated their association. This study aimed to evaluate whether AR can be considered a risk factor for developing AITD.

Methods: A retrospective cohort study analyzed the records of AITD patients who visited Alexandria University Students Hospital between January 2017 and December 2021.

Differentiation of Benign and Malignant Neck Neoplastic Lesions Using Diffusion-Weighted Magnetic Resonance Imaging.

The most difficult diagnostic challenge in neck imaging is the differentiation between benign and malignant neoplasms. The purpose of this work was to study the role of the ADC (apparent diffusion coefficient) value in discriminating benign from malignant neck neoplastic lesions. The study was conducted on 53 patients with different neck pathologies (35 malignant and 18 benign/inflammatory).

International expert consensus statement: surgical failure in obstructive sleep apnea.

Purpose: Upper airway (UA) surgery is commonly employed in the treatment of patients with obstructive sleep apnea (OSA). The intricate pathophysiology of OSA, variability in sites and patterns of UA collapse, and the interaction between anatomical and non-anatomical factors in individual patients may contribute to possible surgical failures. This clinical consensus statement aims to identify areas of agreement among a development group comprising international experts in OSA surgery, regarding the appropriate definition, predictive factors in patients, and management of surgical failure in OSA treatment.

Unraveling the Complexities of Oxidative Stress and Inflammation Biomarkers in Obstructive Sleep Apnea Syndrome: A Comprehensive Review.

Background: Obstructive sleep apnea syndrome (OSAS), affecting approximately 1 billion adults globally, is characterized by recurrent airway obstruction during sleep, leading to oxygen desaturation, elevated carbon dioxide levels, and disrupted sleep architecture. OSAS significantly impacts quality of life and is associated with increased morbidity and mortality, particularly in the cardiovascular and cognitive domains. The cyclic pattern of intermittent hypoxia in OSAS triggers oxidative stress, contributing to cellular damage.

Clinical Application of Pediatric Sleep Endoscopy: An International Survey.

Objectives: To investigate through an international survey the actual clinical application of drug-induced sleep endoscopy (DISE) in pediatric patients with obstructive sleep apnea (OSA) and to clarify the use, application, clinical indications, and protocol of pediatric DISE.

Methods: A specific survey about pediatric DISE was initially developed by five international otolaryngologists with expertise in pediatric sleep apnea and drug-induced sleep endoscopy and was later spread to experts in the field of sleep apnea, members of different OSA-related associations.

Results: A total of 101 participants who answered all the survey questions were considered in the study.

The Effects of Barbed Repositioning Pharyngoplasty in Positional and Non-Positional OSA Patients: A Retrospective Analysis.

Purpose: The aim of our retrospective study is evaluating the effectiveness of barbed repositioning pharyngoplasty (BRP) in a consecutive cohort of patients and assessing its impact on positional indexes in order to potentially identify specific obstructive sleep apnea (OSA) phenotypes for patients who might benefit more significantly from this intervention.

Methods: A single-center retrospective study with baseline and follow-up type III sleep tests evaluating the Apnea Hypopnea Index (AHI), supine AHI, non-supine AHI, oxygen desaturation index (ODI), mean SaO2, percentage of time spent at SaO2 below 90% (CT90), and lowest oxygen saturation (LOS) were performed. The patients were then divided into groups according to Sher's criteria and Amsterdam Positional OSA Classification (APOC).

Head-Of-Bed Elevation (HOBE) for Improving Positional Obstructive Sleep Apnea (POSA): An Experimental Study.

Purpose: Evaluate the effectiveness of the head-of-bed elevation position (HOBE) with a 30° elevation of the head and trunk, in improving obstruction of the upper airways in obstructive sleep apnea (OSA) patients. A prospective trial simultaneously performing drug-induced sleep endoscopy (DISE) and polysomnography (PSG) tests was performed. Methods: Forty-five patients were included in the prospective study protocol.

International palate surgery questionnaire.

Background: This international study aimed at determining current routine palate surgeries and surgical methods adopted by otolaryngologists who practice surgical management of obstructive sleep apnea (OSA).

Methods: An international online survey was developed with the collaboration of the YO-IFOS (Young Otolaryngologists-International Federation of Otorhinolaryngological Societies) to assess the current routines in palatal procedures. The surgeons were asked 33 multiple-choice questions.

Surgical correction of nasal obstruction in obstructive sleep apnea improves CPAP outcomes and compliance.

Background: Although continuous positive airway pressure (CPAP) therapy curtails most of the negative impacts of obstructive sleep apnea (OSA), its efficacy is limited by its low long-term adherence. Nasal obstruction contributes to OSA pathophysiology and necessitates high CPAP titration pressures which reduce CPAP compliance.

Aim: This study aims at elucidating the outcomes of surgical correction of nasal obstruction in patients intolerant to CPAP therapy.

Effectiveness of drug-induced sleep endoscopy in improving outcomes of barbed pharyngoplasty for obstructive sleep apnea surgery: a prospective randomized trial.

Purpose: To observe the effectiveness of preoperative drug-induced sleep endoscopy in improving surgical results of patients undergoing single-level barbed pharyngoplasty surgery for OSA, using a prospective randomized model.

Methods: A single-center randomized controlled trial with two prospective arms was carried out to compare functional results in patients treated with barbed reposition pharyngoplasty (BRP) surgery without a preoperative drug-induced sleep endoscopy (DISE) evaluation vs patients treated with BRP surgery performed after DISE evaluation of sites/patterns of collapse.

Results: We compared 50 patients who underwent BRP without a preoperative DISE evaluation (Group A) and 42 patients (Group B) treated with BRP surgery but preoperatively selected by means of a preoperative DISE.

Postoperative amyloidosis of tongue base: Extremely rare complication after multilevel sleep surgery.

Amyloidosis is to be considered in the differential diagnosis of postoperative edema of tongue base after its ablation. It might be triggered by surgical trauma. After establishment of diagnosis, cause of secondary amyloidosis should be excluded.

Effect of Cooling Irrigating Saline in Tongue Base Ablation in Obstructive Sleep Apnea.

Objective: Plasma is formed by creating a high-density energy field within an electrically conductive fluid such as saline. Sometimes ablated bits of tissue get stuck between the electrodes of the wand, obstructing the suction channel. The purpose of this study is to investigate the effect of cooling the irrigating saline during ablation of the hypertrophied tongue base in patients with obstructive sleep apnea.

Assessment of the New L Pharyngeal Flap for Velopharyngeal Insufficiency.

Objective: To assess the results of the new L pharyngeal flap for treatment of velopharyngeal insufficiency (VPI).

Methods: This study included 60 patients who were diagnosed as persistent VPI (for > 1 year without response to speech therapy for 6 months at least). L-shaped superiorly based pharyngeal flap was tailored from oropharynx and inserted into the soft palate through a transverse full-thickness palatal incision 1 cm from the hard palate, then the distal horizontal part of the flap was spread 1 cm anteroposterior direction and 1 cm horizontally into the soft palate.

Manipulation of Lateral Pharyngeal Wall Muscles in Sleep Surgery: A Review of the Literature.

Background: Obstructive sleep apnea syndrome (OSAS) occurs due to upper airway obstruction resulting from anatomical and functional abnormalities. Upper airway collapsibility, particularly those involving the lateral pharyngeal wall (LPW), is known to be one of the main factors contributing to the pathogenesis of OSAS, leading the authors of the present study to propose different strategies in order to stiffen the pharyngeal walls to try to restore normal airflow.

Methods: An exhaustive review of the English literature on lateral pharyngeal wall surgery for the treatment of OSAS was performed using the PubMed electronic database.

Role of dynamic sleep MRI in obstructive sleep apnea syndrome.

Purpose: To identify obstruction sites of the upper airway during sleep in patients with obstructive sleep apnea syndrome (OSAS) under dynamic conditions and improve knowledge to guide surgical treatment and advancements.

Materials And Methods: The study included 15 patients (5 females and 10 males) who were diagnosed as having OSAS. Overall mean age was 40.

Robo-Cob technique; transoral endoscopic coblation tongue base resection in obstructive sleep apnea patients.

Background: Another transoral tongue base surgical procedure for obstructive sleep apnea (OSA) is described. The procedure was named as the "Robo-Cob" technique because it is similar to transoral robotic surgery (TORS) but using a coblation technology to manage tongue base hypertrophy in patients with OSA especially in countries where TORS is not an available option for such benign conditions.

Methods: The technique is described step by step.

Transoral Endoscopic Coblation Tongue Base Surgery in Obstructive Sleep Apnea: Resection versus Ablation.

Background: A new transoral tongue base surgical procedure for the treatment of snoring and obstructive sleep apnea (OSA) is described. It is named "Robo-Cob" technique because it is similar to transoral robotic surgery (TORS) but it is performed by means of coblation technology in order to resect the tongue base in countries where TORS is not an available option for such benign conditions.

Methods: In this prospective, randomized, controlled trial, the new Robo-Cob technique was carried out in 25 adult OSA patients with confirmed tongue base hypertrophy at preoperative drug-induced sedation endoscopy.

Intravitreal aflibercept versus intravitreal ranibizumab for the treatment of diabetic macular edema.

Purpose: The purpose of this study was to compare the efficacy of intravitreal aflibercept and ranibizumab in the treatment of diabetic macular edema (DME) in eyes with moderate visual loss.

Patients And Methods: This study is a randomized prospective study. Seventy eyes with DME were divided into two groups (each containing 35 eyes).

Hemostatic Options for Transoral Robotic Surgery of the Pharynx and Base of Tongue.

Surgery with transoral robotic surgery (TORS) offers significant advantages compared with traditional open surgical approaches and potentially minimizes the long-term side effects of organ preservation therapy with chemoradiation. Angled telescopes and wristed instruments allow visualization and access to areas of the pharynx that are difficult to reach with line-of-sight instrumentation. Although the application of TORS in head and neck surgery has expanded considerably, there are still only limited data available on the postoperative complications and their management.

Barbed reposition pharyngoplasty (BRP) for OSAHS: a feasibility, safety, efficacy and teachability pilot study. "We are on the giant's shoulders".

A new palatal procedure for snoring/obstructive sleep apnea (OSA) is described. The procedure was named as barbed reposition pharyngoplasty (BRP). The technique is described step by step.

Combined transoral robotic tongue base surgery and palate surgery in obstructive sleep apnea-hypopnea syndrome: expansion sphincter pharyngoplasty versus uvulopalatopharyngoplasty.

Background: Transoral robotic surgery (TORS) for obstructive sleep apnea-hypopnea syndrome is a relatively young technique principally devised for managing apneas in the tongue base (TB) area and supraglottic larynx. This procedure is included in the so-called "multilevel surgery" often including a palatal and nasal surgery.

Methods: We carried out a retrospective analysis in order to understand in detail the relative impact on apneas of the 2 different procedures carried out in the palate area (expansion sphincter pharyngoplasty and uvulopalatopharyngoplasty).

Sphenoid sinus mucocele.

The authors present their experience of managing an interesting case of a 65-year-old woman who presented to their clinic with 1-month history of persistent deep-seated headache. The patient sought medical advice in neurology and ophthalmology clinics before being referred to the ear, nose and throat clinic. CT imaging revealed isolated opacification and expansion of both sphenoid sinuses with bony continuity along the periphery of the sinuses features consistent with mucocele.

Acute tuberculous abscess of the thyroid gland.

The authors are presenting our experience of managing an interesting case of a 28-year-old woman who presented to our clinic with a midline neck swelling of 1-month duration. There was a rapid increase in the degree of swelling associated with erythema, pain and fever 7 days before seeking medical help. Plain and contrast-enhanced CT scans of the neck were done.