Effect of hypoglossal nerve stimulation on snoring: an evaluation using objective acoustic parameters.

Study Objectives: Hypoglossal nerve stimulation is an established therapy for sleep apnea syndrome. Whether or not this therapy on snoring and nighttime noise exposure is effective and how strong this effect may be has not been objectively investigated thus far and was the aim of this study.

Methods: In 15 participants (14 males; age: 30-72 years; mean: 51.

Reconstruction of the Exenterated Orbit with an Island Pericranial Flap: A New Surgical Approach.

Unlabelled: Reconstruction of the bony socket after orbital exenteration is a matter of much debate. Prompt defect closure with a microvascular flap is desirable but involves a major surgical procedure and hence, places considerable burden on the patient. The new surgical technique presented here permits a technically simpler wound closure with fewer complications after orbital exenteration.

Effect of postoperative systemic prednisolone on short-term and long-term outcomes in chronic rhinosinusitis with nasal polyps: A multi-centered randomized clinical trial.

Introduction: The objective of this study was to determine whether postoperative additive systemic steroid administration in chronic rhinosinusitis with nasal polyps (CRSwNP) impacted selected endoscopic, subjective and objective outcome measures.

Methods: This was a prospective, randomized, double-blind, placebo-controlled, noninferiority multicenter trial of n=106 patients with CRSwNP. All patients underwent primary functional endoscopic sinus surgery (FESS) followed by topical nasal steroids.

Effectiveness of the lateral pedicled endonasal flap for prevention of restenosis in frontal sinus drillouts.

Background: Frontal sinus median drainage according to Draf is an established procedure for achieving maximum drainage of the frontal sinus. Despite great efforts and several modifications, restenosis of the neo-ostium is still a persistent problem. This study presents an approach by implementing local mucosal flaps to prevent restenosis and compares it with the conventional technique without using the flap.

Are annoyance scores based on sound pressure levels suitable for snoring assessment in the home environment?

Purpose: An objective statement about the annoyance of snoring can be made with the Psychoacoustic Snore Score (PSS). The PSS was developed based on subjective assessments and is strongly influenced by observed sound pressure levels. Robustness against day-to-day interfering noises is a fundamental requirement for use at home.

Snoring: is a reliable assessment possible?

Purpose: It is not easy to assess how severe and annoying a patient's snoring is. Solid parameters are lacking; snorers cannot deliver a reliable self-assessment and it is uncertain whether bed partners' statements can be relied upon. The purpose of the present study was therefore to investigate whether and how well snoring assessment based on acoustic parameters and bed partners' reporting agree.

Calculating annoyance: an option to proof efficacy in ENT treatment of snoring?

To develop and validate an objective method for calculating the annoyance caused by snoring sounds. 53 subjects assessed 50 different snoring and breath sounds on a visual analog scale for level of annoyance. A linear regression analysis was used to correlate these subjective assessments with objectively calculated psychoacoustic parameters (loudness, roughness, sharpness, and fluctuation strength, calculating the maximum, mean, and 5th percentile in each case).

The International Frontal Sinus Anatomy Classification (IFAC) and Classification of the Extent of Endoscopic Frontal Sinus Surgery (EFSS).

The frontal recess and frontal sinus anatomy can vary from simple to complex. The variations in the anatomy of the frontal recess and frontal sinus are considerable but almost all variations can be classified if the various cell patterns are analyzed. This consensus document was developed to improve the ability of the surgeon to understand these possible variations, plan the surgery, and communicate these complexities when teaching or reporting outcomes.

Safety Approach to Otoplasty: A Surgical Algorithm.

An algorithm was developed through an evolution of refinements in surgical technique with the goal to minimize risk and morbidity in otoplasty. Key principles were avoidance of cartilage incisions and transections and the use of multiple surgical techniques to distribute the "surgical load" evenly among these techniques. The present retrospective study was designed to test safety and efficacy of the concept in 100 consecutive patients and to discuss the results in light of the literature.

Are subjective assessments of snoring sounds reliable?

The aim of this study is to investigate whether snoring sounds can be reliably, i.e. reproducibly and comparably, assessed by the listener.

The nasal cycle during wakefulness and sleep and its relation to body position.

Objectives/hypothesis: To compare the occurrence, duration, and relative amplitudes of the nasal cycle (NC) during wakefulness and sleep, and to investigate the relationship of the NC to body position.

Study Design/methods: In 20 healthy subjects, the NC was measured by long-term rhinoflowmetry for an average 23.1 hours during wakefulness and sleep.

Prelamination to reconstruct internal nasal lining.

The reconstruction of internal lining in nasal reconstruction is critical to the final result. Most established techniques carry important drawbacks, which include limited available lining surface area, compromise of nasal physiologic function, or donor site morbidity. In this report, we demonstrate a technique that is reliable, technically facile, and allows for the reconstruction of large surface areas: the creation of a bilaminated forehead flap by in situ split-thickness skin grafting.

Distinguishing snoring sounds from breath sounds: a straightforward matter?

Background: Although snoring is a common problem, no unequivocal definition yet exists for this acoustic phenomenon. The primary study objective was to investigate whether snoring sounds can be distinguished at all clearly from breath sounds. Our secondary objective was to evaluate whether the sound pressure level in common use and psychoacoustic parameters are suitable for making this distinction.

Nasal tip recontouring in primary rhinoplasty: the endonasal complete release approach.

Objective: Surgery of the nasal tip is a particular challenging aspect of rhinoplasty. We describe a surgical concept in nasal tip surgery that is novel in certain aspects. It combines maneuvers that are typically reserved for the open approach with the minimally invasive concept of endonasal rhinoplasty.

The annoyance of snoring and psychoacoustic parameters: a step towards an objective measurement.

The aim of this study was to find out whether objective analysis of snoring sounds (sound pressure level and psychoacoustic parameters) correlates with the subjective rating by participants with respect to perceived annoyance and hence whether it is useful. 43 participants, aged 22-65 years with normal hearing, were asked to rate 60 snoring sounds from simple and obstructive snorers according to their level of annoyance. A correlation analysis according to Spearman was then performed on objectively calculated parameters.

A retrospective analysis of low dose, intranasal injected bevacizumab (Avastin) in hereditary haemorrhagic telangiectasia.

The constantly recurring epistaxis means a great reduction of quality of life for patients with hereditary haemorrhagic telangiectasia (HHT). As yet, an ideal treatment has not been found. Vascular endothelial growth factor (VEGF) has been described as a possible new therapy.

[Elective use of extracorporeal lung assist: prevention of an airway disaster].

The use of extracorporeal membrane oxygenation (ECMO) was established in Germany 25 years ago in specialized centers as an approach for patients suffering from severe life-threatening lung failure. Apart from such indications the inclusion of ECMO as a planned intervention for safety purposes in the postoperative weaning from mechanical ventilation in a 22-year-old woman is described. Following a complex tracheal reconstruction due to oesophageal-tracheal fistula formation, conventional weaning procedures would have been accompanied by a very high risk as extubation failure might have caused an airway disaster.

Clonidine premedication in patients with sleep apnea syndrome: a randomized, double-blind, placebo-controlled study.

Patients with sleep apnea often present with cardiac diseases and breathing difficulties, with a high risk of postoperative respiratory depression. We conducted a randomized, double-blind, prospective study in 30 adult patients with obstructive sleep apnea, undergoing elective ear-nose-throat surgery. The patients were randomly assigned to receive placebo or clonidine (2 microg/kg oral) the night before and the next morning 2 h before surgery.

An intradermal nevus of the external auditory meatus.

We herein describe a rare case of an intradermal nevus arising in the external auditory meatus. A 36-year-old woman presented with progressive hearing loss on the right ear, and otomicroscopic examination revealed the presence of a large, violaceous, dome-shaped, papillomatous lesion originating from the posterior wall of the external canal of the right ear. Upon excisional biopsy, the tumor was diagnosed as an intradermal nevus.

Penetration of telithromycin into the nasal mucosa and ethmoid bone of patients undergoing rhinosurgery for chronic sinusitis.

Objectives: Telithromycin has a broad spectrum of activity against respiratory tract pathogens including penicillin- and macrolide-resistant streptococci. The aim of the study was to investigate the penetration of telithromycin into nasal tissue following a single oral dose of 800 mg.

Patients And Methods: A total of 29 patients undergoing rhinosurgery for chronic sinusitis were evaluated.