The long-term results of modified maxillomandibular advancement in Asian OSA patients.

Objective: Maxillomandibular advancement (MMA) surgery is considered a highly successful treatment for obstructive sleep apnea (OSA). Various modifications to the technique have been described. We aim to study the long-term results in Asian patients who underwent a modified MMA procedure intended to avoid bimaxillary protrusion and which involved four-quadrant bicuspid extractions with posterior maxillary alveolar setback.

Genioglossus Advancement and Hyoid Surgery.

The structure and dimensions of the mandible, tongue, and hyoid complex are important variables in the pathophysiology of obstructive sleep apnea at the hypopharyngeal level. Genioglossus advancement is based on mandibular osteotomy, which brings the genioglossus muscle (GGM) forward and prevents posterior collapse during sleep. The genioglossus advancement technique has recently undergone several modifications; each has attempted to minimize surgical morbidity while improving the incorporation and advancement of the GGM.

Advances in Box Surgery for Obstructive Sleep Apnea: Genioglossus Advancement, Hyoid Suspension, and Maxillomandibular Advancement.

Box surgery for obstructive sleep apnea (OSA) patients consists of mandibular surgery, including genioglossus advancement, hyoid suspension, and maxillomandibular advancement, as an airway reconstruction. This surgery was developed in the early 1980s. Thereafter, techniques were modified in each surgery for the enhancement of outcome and prevention of complications.

Evaluation of recurrent nodal disease after definitive radiation therapy for nasopharyngeal carcinoma: diagnostic value of fine-needle aspiration cytology and CT scan.

Background: Recurrent nodal disease in patients with nasopharyngeal carcinoma (NPC) after definitive radiotherapy presents a difficult clinical problem. This cohort of patients poses a diagnostic challenge to the head and neck surgeon because evaluation of the post-irradiated neck, both clinically and radiologically, is known to be difficult, and it is not uncommon for neck dissection specimen in suspected recurrent nodal disease to contain no viable tumor cells. Currently, there is no well-accepted method for the preoperative determination of the presence of malignancy in these nodal diseases.

Idiopathic submandibular sialoceles in the neck.

A submandibular sialocele is a subcutaneous cavity containing saliva. The clinical and radiologic features of 3 patients with an idiopathic submandibular sialocele are presented. All 3 patients were males in their twenties.

Pseudocyst of the auricle: a histologic perspective.

Objective: The aim of the study is to describe the histologic spectrum in the pseudocyst of the auricle and to identify any consistent histologic features of this condition.

Study Design: A prospective study was performed in which the tissue specimen from patients with pseudocyst of the auricle treated at the Department of Otolaryngology, Singapore General Hospital during a 1-year period was sent for histology.

Methods: Consecutive patients with pseudocyst of the auricle who were treated had their tissue specimen sent for histology.

Modified maxillomandibular advancement for the treatment of obstructive sleep apnea: a preliminary report.

Objective: A prospective study to evaluate the modified maxillomandibular advancement (MMA) technique for the treatment of obstructive sleep apnea (OSA).

Methods: Eleven patients underwent modified MMA for the treatment of OSA. All the patients underwent presurgical and postsurgical polysomnography, nasolaryngoscopy, and clinical facial photographic assessment.

The physiologic impact of sleep apnea on wakefulness.

The physiologic impact of sleep apnea on wakefulness is believed to be mediated by sleep fragmentation secondary to airway obstruction. Although there has been much study on the association between sleep apnea and daytime sleepiness, little is known about the effects of sleep apnea on non-sleepiness-related manifestations of impaired wakefulness, such as fatigue and depression. Present studies suggest that impaired wakefulness secondary to sleep apnea probably plays a contributory role in traffic and industrial accidents.

Parotid gland surgery: 4-year review of 118 cases in an Asian population.

Background: To determine the presentation and management of parotid lesions requiring excision in a largely Chinese Asian population.

Methods: Retrospective study of 118 consecutive parotidectomies.

Results: Thirty-seven percent were Warthin's tumor (WT), 33% pleomorphic adenoma (PA), 21% other benign disease (OBD), and 9% malignant tumor (MT).

Endovascular treatment of epistaxis in patients irradiated for nasopharyngeal carcinoma.

Posterior epistaxis commonly occurs after radiotherapy for nasopharyngeal carcinoma and is difficult to treat. Endovascular treatment was carried out on 11 previously irradiated patients who presented with intractable epistaxis over 4 years. We review their outcomes.

Cribriform-morular variant of papillary carcinoma: the sporadic counterpart of familial adenomatous polyposis-associated thyroid carcinoma. A case report with clinical and molecular genetic correlation.

The increased incidence of thyroid carcinomas in familial adenomatous polyposis (FAP) patients is well recognised. These thyroid neoplasms display distinctive clinicopathological features and generally show good prognostic outcome. Recently, unusual sporadic tumours that share the morphological features of FAP-associated thyroid carcinomas have also been described.