Review of Current Techniques of Cleft Palate Repair Concerning Palatal Innervation: A Preliminary Assumption.

Objective: To highlight the possible surgical steps that could affect the neural supply of soft palate and velopharyngeal sphincter during Furlow palatoplasty and posteriorly-based myo-mucosal buccal flaps in patients with persistent velopharyngeal insufficiency after primary cleft palate repair.

Design: Institution-based retrospective study.

Setting: Academic Medical Center.

The palatopharyngeal muscle in otolaryngology practice: an anatomical-based surgical report.

Objectives: The author discusses current otolaryngological procedures employing the palatopharyngeus muscle, based on the surgical anatomy of the muscle and its neural supply. These techniques should be deeply revised for more conservative, anatomically-based maneuvers.

Methods: Revision of anatomical and surgical research and comments with the provision of a primary concept.

Role of DISE in the surgical outcome for patients with obstructive sleep apnea.

Purpose: To investigate and compare the surgical outcomes of DISE and non-DISE-guided surgery in cases with obstructive sleep apnea.

Methods: Sixty-three patients with severe OSA and BMI ≤35 kg/m were included in the study. Patients were randomly divided into group A where surgical intervention was performed without DISE, and group B where surgery was planned according to the findings of DISE.

Suspension-expansion pharyngoplasty: a modified technique for oropharyngeal collapse in obstructive sleep apnea.

Background And Purpose: Lateral pharyngeal wall (LPW) collapse plays a fundamental role in the pathogenesis of obstructive sleep apnea (OSA) and might determine the severity of the disease. This study presents the suspension/expansion pharyngoplasty (SEP) for the treatment of selected cases of OSA. The procedure aimed to splint LPW collapse via supporting and lateralization of both superior constrictor muscle (SCM) and palatopharyngeal muscle (PPM) individually and in two different planes.

Anterolateral advancement palatoplasty with tonsillectomy for retropalatal obstruction in selected cases of obstructive sleep apnea.

Purpose: This study tried to assess the surgical outcome of anterolateral advancement palatoplasty (ALP) with simultaneous tonsillectomy for the treatment of retropalatal obstruction in selected cases of obstructive sleep apnea (OSA).

Methods: In this clinical trial, 22 adult OSA patients having predominant retropalatal collapse were managed by ALP and tonsillectomy.Thirteen patients had positional OSA (PP) and 9 patients had non-positional (NPP).

Could mandibular fractures lead to obstructive sleep apnea?

Objective: To detect and assess obstructive sleep apnea (OSA) before and after repair of different types of mandibular fractures.

Methods: In patients with traumatic isolated mandibular fractures who were indicated for open reduction and internal fixation (OR/IF), polysomnography (PSG) was done before and 3 months after surgery.

Results: Of 51 patients (80 mandibular fractures), fractures were unilateral in 29 patients (56.

Trans-hyoid hyoidthyroidpexy: A modified technique for selected cases of obstructive sleep apnea.

Objective: Hypopharyngeal collapse (HC) considered a challenge in surgery of obstructive sleep apnea (OSA). Several procedures were presented to deal with HC indirectly via providing support to the lateral walls of the hypopharynx preventing transverse collapse but hyoidthryoidpexy had gained more popularity. The procedure aimed to fix the mobile hyoid bone to a rigid mid-line neck structure, thus preventing the bone and its attached muscles from collapsing during sleep with the negative intrathoracic pressure on inspiration.

Diode laser versus bipolar diathermy for turbinate reduction in cases of inferior turbinate hypertrophy.

This study was designed to assess the surgical outcomes of two commonly used techniques for turbinate reduction (diode laser and bipolar diathermy) in selected group of patients with chronic nasal obstruction which resulted from inferior turbinate hypertrophy. The current study was conducted on adult patients with a diagnosis of inferior turbinate hypertrophy. 42 patients (21 in each group) with an age range of 21-38 years (mean = 26.

Positional awake nasoendoscopic pattern-based surgical decision for correction of retropalatal obstruction in OSA.

Purpose: To evaluate differential surgical interventions for obstructive sleep apnea (OSA) patients with single-level retropalatal based on the preoperative topographical diagnosis using nasoendoscopy with Müller's maneuver during supine position (MM-P).

Subjects And Methods: This case series included adult patients with OSA who showed a predominant single-level retropalatal collapse on MM-P. An anteroposterior pattern of collapse was managed by an anterior advancement procedure, while a transverse pattern of collapse was managed by lateral/anterolateral advancement procedures (double suspension sutures).

Positional Awake Endoscopy Versus DISE in Assessment of OSA: A Comparative Study.

Objective: To compare awake endoscopy with Müller's maneuver (MM) during both sitting and supine positions, with drug-induced sleep endoscopy (DISE) as regard determination of different levels, patterns, and degrees of collapse of the upper airway in adult patients with obstructive sleep apnea (OSA).

Methods: The study included adult patients with OSA symptoms, who had apnea hypopnea index (AHI) > 15. Patients were examined by MM in a sitting position, then during supine position; DISE then followed.

Mastoid Reconstruction With Platelet-Rich Plasma and Bone Pate After Canal Wall Down Mastoidectomy: A Preliminary Report.

Objectives: Mastoid reconstruction principle had been described to overcome problems of chronic discharging cavity. Different materials were used; nonbiologic materials seem to be less preferred. Platelet-rich plasma (PRP) could promote the regeneration of mineralized tissues.

A Modified Technique of Transposition of Temporalis Muscle in Selected Cases of Longstanding Facial Paralysis.

The authors present a modified technique of temporalis muscle transposition technique in cases of longstanding facial paralysis. Slips of the temporalis fascia were passed through the tunnels to reach the contralateral para-median plane. The procedure provides 2 point of fixation to the transferred muscle.

Trans-oral, Carbon Dioxide-Assisted Excision of an Unusual Schwannoma of the Tongue Base: Case Report and Review of the Literature.

 Schwannomas are benign, solitary, encapsulated tumors that may originate at any site of the peripheral nervous system, with the exception of the olfactory and optic nerves. Schwannomas of the base of tongue are very rare, and only sporadic cases are documented. The tongue base represents a challenge for surgeons.

Hyoid Periosteum Sutures: A Modified Tissue-Preserving Hyoid Suspension Technique for Obstructive Sleep Apnea.

Objective: To present and assess a new, simple, conservative modification of hyoidthyroidpexy using 2 sutures between hyoid periosteum and thyroid lamina.

Methods: Included patients had obstructive sleep apnea with apnea hypopnea index >20. Through a small midline neck incision, 2 Vicryl sutures were applied between the hyoid periosteum and thyroid cartilage.

Palatal Sphincter Pharyngoplasty With Cephalic Mucosa Preservation in Selected Cases of Velopharyngeal Insufficiency.

Objectives: Sphincter pharyngoplasty is a commonly performed procedure for the treatment of velopharyngeal insufficiency and is often indicated in patients with circular or coronal closure patterns of the velopharyngeal sphincter. The authors present a modified technique of sphincter pharyngoplasty (partially mucosalized palatal sphincter pharyngoplasty [PMPSP]) in which bilateral superiorly based myomucosal palatopharyngeal flaps were elevated (in a newly designed fashion) and inserted in the palate through preformed palatal tunnels.

Methods: This case series included 14 patients (5 male, 9 female) with persistent hypernasality who were subjected to treatment by PMPSP between May 2015 and August 2018.

Single versus double suspension sutures for selected cases of obstructive sleep apnea.

Objective: To compare the results of expansion pharyngoplasty using bilateral single palatal suspension sutures (SSS) versus double suspension sutures (DSS) for the treatment of selected cases of obstructive sleep apnea (OSA) with retropalatal collapse.

Methods: Patients were randomly categorized into two groups: the first group for whom bilateral SSS were performed and a second group for whom bilateral DSS were done. Snoring on the basis of the visual analog scale (VAS), Epworth Sleepiness Scale (ESS), apnea hypopnea index (AHI), lowest O saturation were assessed preoperatively and 6 months postoperatively in all patients.

Expansion Hyoidthyroidpexy: Combined Hyoid Surgery Techniques for Obstructive Sleep Apnea: All in One.

We provide expansion hyoidthyroidpexy as a novel surgical procedure for obstructive sleep apnea (OSA) that could combine different techniques of hyoid bone surgery in 1 procedure. This case series included patients with OSA who had an apnea-hypopnea index (AHI) >15 and showed predominant lateral wall hypopharyngeal collapse. In 21 patients, the procedure was performed smoothly without technical difficulties or operative adverse events, resulting in lateral expansion of each horn of the hyoid bone by ≥1 cm without early or late complications.

Cephalic de-mucosalized superiorly-based pharyngeal flap: A modified mucosa-preserving technique for velopharyngeal insufficiency.

Introduction: Superiorly-based pharyngeal flap (PF) is the most frequently employed surgical technique to correct velopharyngeal insufficiency (VPI). Bared posterior pharyngeal wall might prolong the period of convalescence with throat pain and discomfort. Delayed donor site healing problems and subsequent fibrosis with downward migration of the transposed flap might be one a cause of failure and might necessitate revision.

Could Nasal Surgery Affect Multilevel Surgery Results for Obstructive Sleep Apnea?

Objective: To study the role of nasal surgery as a part of multilevel surgery for management of obstructive sleep apnea (OSA).

Methods: All patients underwent multilevel surgery for relieving OSA symptoms and they were classified according to type of surgical intervention into: group A (20 patients), who underwent hyoid suspension (Hyoidthyroidpexy), tonsillectomy, suspension (El-Ahl and El-Anwar) sutures and nasal surgery (inferior turbinate surgery). Group B (20 patients), who underwent hyoid suspension (Hyoidthyroidpexy), tonsillectomy and suspension sutures.

Hyoid Bone Suspension as a Part of Multilevel Surgery for Obstructive Sleep Apnea Syndrome.

 Since oropharyngeal surgery alone is often insufficient to treat obstructive sleep apnea (OSA), advances have been developed in hypopharyngeal surgery.  To assess hyoid suspension surgery as part of a multilevel OSA surgery, also including palatal surgery.  The study included patients with OSA symptoms with apnea hypopnea index (AHI) > 15.

De-mucosalized pharyngeal flap: a modified technique for selected cases of velopharyngeal insufficiency.

Background And Purpose: Superiorly based posterior pharyngeal flap is performed via rotation of tissues of the posterior pharyngeal wall anteriorly and anchoring it to the soft palate. Unfortunately, bad healing of the donor site defect might be a considerable cause of morbidity of the surgery. With some modifications of flap elevation we could achieve better surgical outcomes.

Modified anterior palatoplasty and double suspension sutures (with or without tonsillectomy) in selected patients with obstructive sleep apnea: a preliminary report.

Background: Retropalatal region might be considered the most common site of obstruction in patients with snoring and OSA. We aimed at presentation of two combined techniques: modified anterior palatoplasty (MAP) and bilateral double suspension suture (DSS).

Methods: This prospective study was conducted on OSA patients with retro-palatal collapse only that was confirmed by nasoendoscopy during Muller's maneuver and drug induced sleep endoscopy.

Voice and Swallowing Outcomes after Hyoid Suspension Surgery in Patients with Obstructive Sleep Apnea.

Objective: The role of hyoidthyroidpexia (HTP) surgery in the management of patients with obstructive sleep apnea (OSA) is well described with good reported outcomes. The effect of HTP on other laryngeal functions is not well discussed. This study was designed to evaluate voice and swallowing outcomes after HTP.

Single-Stage Repair of Palatal Fistula and Velopharyngeal Incompetence by the New L Flap.

Objective: To describe and assess the results of use of the new L-shaped posterior pharyngeal flap for repair of both palatal fistula and velopharyngeal incompetence.

Methods: This study included 10 patients who were diagnosed to have soft palate fistula and persistent velopharyngeal insufficiency (VPI). L-shaped superiorly based pharyngeal flap was harvested from oropharynx and inserted into the soft palate closing the fistula after fistula trimming.

Ipsilateral reduced olfactory bulb volume in patients with unilateral nasal obstruction.

Objectives: To evaluate the effect of unilateral nasal obstruction (by nasal polyps of different histopathology) on olfactory bulb volume using MRI technique.

Study Design: Cross-sectional study.

Setting: Tertiary university hospitals, Departments of Otolaryngology and Radiology.