The aim of this study was to determine the associated factors affecting the outcome of uvulopharyngopalatoplasty (UPPP) in patients with severe obstructive sleep apnea hypopnea syndrome (OSAHS), and to investigate whether cephalometric measurements were predictive of the therapeutic response to UPPP in patients with severe OSAHS. We retrospectively studied 51 consecutive patients who underwent revised UPPP with uvula preservation (H-UPPP), or Z-palatopharyngoplasty (ZPPP) for severe OSAHS [apnea-hypopnea index (AHI) >30]. All patients were evaluated using physical examination, Epworth Sleepiness Scale (ESS), cephalometry, and nocturnal polysomnography (PSG) before surgery and at 6-12 months after surgery. Based on the success criteria defined as an AHI of <20 and a decrease >50 %, the overall success rate was 45.1 %. The preoperative distance from the posterior border of the uvula to the middle pharyngeal wall (U-MPW) was significantly longer in the responder group than in the nonresponder group, when considering the whole group or the H-UPPP group alone. Among all study subjects, U-MPW and change in body mass index (△BMI) were the significant predictors of surgical success. U-MPW was the key predictor for H-UPPP surgical success, whereas mandibular plane angle (MPA) and Friedman stage were the key predictors for ZPPP surgical success. In conclusion, U-MPW was a significant predictor of UPPP surgical success. Patients with U-MPW >10 mm who are unwilling to receive nasal continuous positive airway pressure (CPAP) therapy might be suitable candidates for UPPP surgery.
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http://dx.doi.org/10.1007/s00405-013-2404-5 | DOI Listing |
Medicine (Baltimore)
January 2025
Department of Internal Medicine, Division of Hematology and Oncology, Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju, Republic of Korea.
Rationale: Aggressive angiomyxoma (AAM) is an exceptionally rare mesenchymal tumor that predominantly manifests in the female genital organs during the reproductive age. Its rarity alone makes it a fascinating subject for study. The diagnosis of AAM necessitates differentiation from other benign or mesenchymal tumors and can be confirmed through immunohistochemistry (IHC) staining.
View Article and Find Full Text PDFJ Neurosurg Spine
January 2025
2Cleveland Clinic Center for Spine Health, Cleveland Clinic, Cleveland; and.
Objective: Spinal fusion is a commonly performed surgical procedure used to relieve pain, deformity, and instability of various spinal pathologies. Although there have been attempts to standardize spinal fusion assessment radiologically, there is currently no unified definition that also considers clinical symptomology. This review attempts to create a more holistic and standardized definition of spinal fusion.
View Article and Find Full Text PDFJBJS Case Connect
January 2025
Department of Orthopaedics, Mass General Brigham, Boston, Massachusetts.
Case: A 51-year-old male polytrauma patient presented with bilateral calcaneus fractures after a fall. This report describes treatment of his right comminuted Sanders IV calcaneus fracture with percutaneous open reduction internal fixation (ORIF) and minimally invasive surgery (MIS) primary subtalar fusion to restore alignment and preserve soft tissue.
Conclusion: Unlike traditional open approaches, which are prone to wound complications due to larger incisions, our approach of maintaining fracture alignment during joint preparation using an MIS burr for acute posttrauma subtalar arthrodesis and percutaneous ORIF appears to have reduced these risks, resulting in successful radiological healing and functional recovery at 1-year follow-up.
PLoS One
January 2025
Helsinki University Hospital, Abdominal Centre, Transplantation and Liver Surgery, and University of Helsinki, Helsinki, Finland.
Background: Patients with end-stage kidney disease often prefer home-based dialysis due to higher self-efficacy, which relates to improved medical treatment adherence. Kidney transplantation (KT) success depends on adhering to immunosuppressive medication post-transplant.
Objectives: To investigate whether adherence post-kidney transplantation (KT) and patients' attitudes toward immunosuppression were influenced by their prior dialysis type modality.
PLoS One
January 2025
Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia (IC/FUC), Serviço de Nutrição e Dietética, Porto Alegre, Rio Grande do Sul, Brazil.
Background: Obesity is a risk factor for cardiovascular diseases and associated with reduced life expectancy metabolic bariatric surgery (MBS) is the treatment indicated when patients are unable to lose weight through lifestyle changes and medication alone. However, more evidence is necessary to show non-inferiority of e-health compared to in-person monitoring with regard to important parameters for the success of surgical treatment of obesity such as anthropometric changes.
Methods And Analyses: This review study will include cohort studies involving individuals with obesity and e-health or in-person patient monitoring before and after MBS.
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