Cryoneurolysis of alveolar nerves for chronic dental pain: A new technique and a case series.

Background: Chronic neuropathic dental pain has a poor prognosis with a low chance of significant spontaneous improvement. Local or oral therapies may be efficient, however short in terms of duration with potential side effects. Cryoneurolysis has been described to prevent acute postoperative pain or to treat some chronic pain conditions; however, application to dental orofacial pain has not been reported so far.

[New therapy for sleep apnea at CHUV: hypoglossal nerve stimulation].

Neurostimulation of the hypoglossal nerve is a new alternative treatment to CPAP (Continuous Positive Airway Pressure) for patients with moderate-to-severe OSAS (Obstructive Sleep Apnea Syndrome) with anteroposterior pharyngeal obstruction visualized during a Drug Induced Sleep Endoscopy (DISE). Implantation and follow-up are performed at the CHUV with the collaboration between the SAOS-ronchopathie unit, the maxillofacial and dental surgery division and the center for investigation and research on sleep (CIRS). In this article, we present the technique, its indication and the outcomes through a recent review of the literature.

[Sleep apnea : diagnostic and therapeutic modalities in case of failure of the CPAP].

Obstructive sleep apnea (OSA) is a sleep disorder that affects 49 % of men and 23% of women over 40 years old. CPAP is currently the treatment of choice for severe OSAS, but there are mild to moderate cases of OSAS with poor compliance or intolerance to CPAP, for which alternative treatments should be considered. In this article, we present a tool for evaluation of the upper airways, the DISE (Drug-induced sleep endoscopy), the OAM (mandibular advancement device), the bimaxillary advancement osteotomy, the hypoglossal nerve stimulation and the positional treatment.

[When should a patient with malaise be referred to the emergency ward?].

General physicians (GPs) and emergency doctors are regularly called upon to deal with cases of "malaise" or sudden unforeseen feelings of debility. As highly disparaged as this designation may be, it remains commonly used in everyday life, enabling patients to express a general sensation of ill-being, accompanied by various non-specific symptoms. The lack of a preliminary case history and clinical analysis makes difficult to swiftly determine the severity of the situation, let alone its etiology.