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.
View Article and Find Full Text PDFObstructive sleep apnea has been linked to an increased risk of pneumonia, possibly due to higher rates of nighttime aspirations. Few studies have directly investigated such aspirations in individuals with sleep apnea. This retrospective study included 142 adult patients with obstructive sleep apnea who underwent drug-induced sedation endoscopy between 2017 and 2020.
View Article and Find Full Text PDFObjectives: Tumor depth of invasion is a known prognostic factor in several head and neck cancers, but data on early laryngeal squamous cell carcinoma (SCC) are sparse. In this study, we aim to determine whether radiological tumor thickness serves as a prognostic factor in early SCC of the glottis treated with radiation.
Methods: One hundred thirty-two adult patients (age >18 years) underwent pretreatment computed tomography (CT) and were treated with radiation for pathologically proven early stage (T1 or T2) glottic SCC.
Purpose: To assess the effect of simethicone, a defoaming agent, on improving visibility during drug-induced sleep endoscopy (DISE) in obstructive sleep apnea (OSA).
Methods: The study was a retrospective case-series study on patients with OSA who failed positive airway pressure (PAP) treatment. Patient parameters were recorded including age, BMI, neck and abdominal circumference, and apnea-hypopnea index (AHI).
Guidelines for management of sleep disorders from national or regional societies provide recommendations that may be regionally appropriate but may not always be practical or relevant in other parts of the world. A task force of experts from the World Sleep Society's (WSS) International Sleep Medicine Guidelines Committee and Sleep and Breathing Disorders Task Force reviewed the European Respiratory Society's guideline on non-CPAP therapies for obstructive sleep apnea (OSA) with respect to its relevance and applicability to the practice of sleep medicine by sleep specialists in various regions of the world. The task force and the WSS guidelines committee endorsed the European Respiratory Society's guideline with respect to the utilization of bariatric surgery, mandibular advancement devices, positioning devices, myofunctional therapy, hypoglossal neurostimulation, maxilo-mandibular surgery, and carbonic anhydrase inhibitors for the treatment of OSA.
View Article and Find Full Text PDFObjectives: Postoperative antibiotic therapy is a common practice following septoplasty with intra-septal splints placement (ISS), even though there is a lack of evidence to support it. We sought to investigate the role of antibiotic therapy in septal surgeries with the placement of ISS.
Design: A retrospective comparative study was conducted using the electronic charts of adult patients who underwent septoplasty with the placement of ISS with or without turbinate reduction.
Introduction: Obstructive sleep apnoea (OSA) has been thought to be associated with glaucoma, however there are many conflicting studies on this topic. With many new studies having been published since the previous meta-analysis, we believe it is important to clarify this association. Hence, in this study we meta-analyse the recent literature regarding the association between OSA and glaucoma.
View Article and Find Full Text PDFObjective: Chronic sialadenitis is the most common complication of radioactive iodine (RAI) treatment. The aim of the study was to ascertain sonographic features of the major salivary glands in patients with papillary thyroid cancer (PTC) treated with RAI.
Methods: The database of a tertiary medical center was retrospectively searched for consecutive patients who underwent total thyroidectomy for PTC in 2011-2020 with ultrasound follow-up after 1 year.
Importance: Obstructive sleep apnea (OSA) is associated with a rise in serum inflammatory markers, which may be attenuated by sleep surgery.
Objective: To evaluate whether sleep surgery was associated with improved levels of proinflammatory markers in adults with OSA.
Data Sources: Two authors independently searched Cochrane, Embase, and PubMed databases from inception through June 14, 2022.
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.
Unlabelled: Hypoglossal nerve stimulation (HGNS) has evolved as a novel and effective therapy for patients with moderate-to-severe obstructive sleep apnea. Despite positive published outcomes of HGNS, there exist uncertainties regarding proper patient selection, surgical technique, and the reporting of outcomes and individual factors that impact therapy effectiveness. According to current guidelines, this therapy is indicated for select patients, and recommendations are based on the Stimulation Therapy for Apnea Reduction or STAR trial.
View Article and Find Full Text PDFBackground: This study explores the unique characters of high dose radioactive iodine (RAI) induced chronic sialadenitis.
Methods: A retrospective study of patients having received salivary endoscopy and followed in our outpatient clinic.
Results: A total of 100 patients met the inclusion criteria, 75 were diagnosed with chronic idiopathic sialoadenitis and 25 with radio-iodine induced sialoadenitis (RIS).
Objective: To evaluate the precision and utility of fine-needle aspiration (FNA) in differentiating between benign and malignant parotid tumours, and the implications of FNA results on management and outcomes.
Design: Retrospective case series.
Setting: Tertiary medical centre.
Background: Obstructive sleep apnea (OSA) is associated with a significantly increased risk of motor vehicle accidents in addition to such cognitive impairments as attention and memory deficits. The aim of the study was to examine the effect of upper airway surgery for OSA on driving and cognitive function.
Methods: Adult patients who underwent surgery for OSA at a tertiary medical center in 2016-2019 were prospectively recruited.
Background: The role of induction chemotherapy (IC) in locally-advanced head and neck squamous cell carcinoma (LAHNSCC) is unclear.
Methods: A retrospective study of 104 patients with LAHNSCC of the larynx and hypopharynx, treated with IC or up-front chemoradiotherapy (CRT).
Results: Eighty patients received CRT and 24 IC followed by CRT; median follow up was 51.
In recent years, minimally invasive surgeries have been undergoing a revolution with the development of robotic assisted surgery. Due to the anatomical region in which many operations are carried out, in small spaces through natural orifices in the body such as the mouth, the nose or the ear, as well as the esthetic discomfort caused by external scars in the head and neck, the use of robotic assisted surgery in the field of head and neck surgery is gaining momentum and is being implemented more and more in Israel and around the globe. Most of the operations currently performed in otolaryngology are carried out through the oral cavity or through distant and camouflaged skin cuts.
View Article and Find Full Text PDFAnn Otol Rhinol Laryngol
January 2020
Objectives: Intranasal septal splints are often used in nasal septal surgeries. Routine use of postoperative antibiotics is an accepted practice, although data regarding its efficacy in preventing postsurgical complications are limited. This study aimed to examine bacterial colonization on septal splints following prophylactic antibiotic therapy and the association with postoperative infections.
View Article and Find Full Text PDFObjectives/hypothesis: Prognostic variables upon presentation can assist in recommending the optimal treatment for patients and may help in management of patient's expectations and side effects. Our objective was to evaluate prognostic factors for survival and nonfunctional larynx in patients with laryngeal squamous cell carcinoma (SCC).
Study Design: Retrospective chart review.
Cochrane Database Syst Rev
November 2018
Background: Endoscopic sinus surgery (ESS) is often recommended for symptomatic patients with recurrent acute or chronic rhinosinusitis who have failed conservative treatment. Postoperative care has been felt to be critical for both maintaining the surgical patency of the operated sinuses and improving patient symptoms. Debridement of the sinonasal cavities is one such postoperative care measure that has frequently been studied in the literature, often with conflicting conclusions.
View Article and Find Full Text PDFObjectives/hypothesis: To assess the differences between patients with laryngeal squamous cell carcinoma under 40 years old and those 40 years old or older. A secondary objective was to compare survival outcome between these cohorts.
Study Design: Retrospective chart review.
Laryngeal carcinoma rarely occurs in the young adult population. Therefore, the optimal treatment for this age group is unclear, specifically regarding organ preservation treatment. In order to assess the distinct characteristics of laryngeal squamous cell carcinoma (SCC) in young adults and describe the effect of treatment on survival, a retrospective chart review of all patients aged <40 years, who were treated in a tertiary referral center for laryngeal SCC between January 1960 and December 2013, was performed.
View Article and Find Full Text PDFBackground: The optimal treatment method of T1 glottic squamous cell carcinoma (SCC) with involvement of the anterior commissure is still debatable. We compared the outcomes of radiotherapy (RT) and transoral laser microsurgery (TLM).
Methods: Data were retrospectively collected for 54 patients who were treated by RT (n = 38) or TLM (n = 16) from 2006 to 2013.
Objective: To determine if the clinical behavior of T1 glottic squamous cell carcinoma varies by its location on the medial free edge or upper aspect of the vocal cords.
Study Design: Retrospective cohort.
Setting: Single tertiary university-affiliated medical center.
Objectives/hypothesis: During robot-assisted transaxillary thyroidectomy, the patient's arm is maintained in an overhead flexed position for a prolonged time, which poses a risk of postoperative brachial plexopathy. The aim of the study was to identify the causes of brachial plexopathy and to assess the benefit of intraoperative neurophysiological monitoring (IONM) in preventing positional brachial plexopathy in this setting.
Study Design: Retrospective case series.