Surgical alternatives to uvulopalatopharyngoplasty in sleep apnea syndrome.

Uvulopalatopharyngoplasty (UPPP) is the surgery most often performed for sleep apnea syndrome (SAS). However, good results with UPPP, demonstrated by polysomnography, have been reported in only 50% of cases. Failure of UPPP may be caused by: 1) bad management of the SAS, which is better treated in some patients with nasal CPAP than with surgery; and 2) an airway obstruction located not only at the palatopharynx (PP) level.

Why don't all heavy snorers have obstructive sleep apnea?

Patients with obstructive sleep apnea (OSA) and heavy snorers without apnea both show intrathoracic suction pressures during sleep that exceed their static upper airway closing pressures. Complete airway occlusion, however, occurs only in the former patient group. We hypothesized that the kinetic properties of the airflow would be different in these two types of patients because of differences in upper airway morphology.

Partial upper airway obstruction in sleep after uvulopalatopharyngoplasty.

Uvulopalatopharyngoplasty is the treatment of choice for selected patients with obstructive sleep apnea, although the response to surgery is variable. We measured, in addition to obstructive apnea, the frequency of sleep-related partial upper airway obstruction in 11 patients with the obstructive sleep apnea syndrome both before and after uvulopalatopharyngoplasty. Partial obstruction was detected indirectly by recording the secondary hemodynamic changes and respiratory stimulation with the static charge sensitive bed.

[Obstructive dyspnea of oropharyngeal origin].

Obstructive dyspnoea of oropharyngeal origin is a recently recognized entity with numerous clinical forms depending on age, severity and symptoms. The authors insist on the two facets of this pathology that are most frequently seen and therefore of special interest to practitioners: the oropharyngeal obstructive syndrome due to enlarged tonsils in children, and the pharyngeal obstruction responsible for snoring and for the sleep apnoea syndrome in adults. In children, tonsillectomy is necessary to avoid complications which are sometimes severe.

[Snoring and sleep apnea syndrome in the elderly].

After shorts general considerations about physiologic and epidemiologic features relative to sleep, snoring and apneas in elderly, authors bring analysis of 30 snorers over sixty years. They all had a sleep recording, a ENT examination, and a pharyngeal C.T.

[Primary cervico-facial amylosis. Apropos of a case].

Diagnosis in a case of primary localized amylosis of the sinuses and cervical nodes was from the discovery of nasal obstruction with conductive hearing loss and cervical nodes. Biopsy confirmed the presence of amyloid deposits in the maxillary sinuses mucosa and the cervical nodes. This case illustrates the value of typing of the amylosis, rectal biopsy and investigation to detect a myeloma, thus providing confirmation of a primary localized amylosis.