Sleep on lateral position as a treatment of obstructive sleep apnea syndrome

Sleep on lateral position was supposed to be the most conservative method for treatment of patients with obstructive sleep apnea syndrome [OSAS]. This study was performed to objectively evaluate the effect of sleep position on one hundred-eight cases suffering from OSAS with mean age 46.7+12.4 years and mean body mass index [BMI] 26.6+3.7 Kg/m[2]. Polysomnographic recording was done for each patient after insertion of a soft silicon catheter with 4 barosensors. The terminal sensor was adjusted at the lower half of the esophagus to be confirmed by roentogenography. The study was conducted during the afternoon period; one hour on supine position and one hour on lateral position. Analysis of the pressure recording indicated that the negative intrae-sophageal pressure decreased from 54. 7+24.2 cm H[2]O on supine position to 33.9+25.7 cm H[2]O on lateral position [38%, P<0.001, n= 108]. Sixty-three patients [58.3%] indicated a remarkable response during sleep on lateral position [Le. 75-100% decrease of either intraesophgeal pressure or apnea/ hypopnea index]. We concluded that prescription of lateral position as a treatment of OSAS can be useful for some patients without surgery and can be adjuvant for others after performing sleep apnea surgery. This should be based on upper airway pressure recording to exclude patients who indicate no improvement and those who become worse

Dysphagia after total laryngectomy: motility report.

Detailed motility studies of the pharynx and esophagus with its two sphincters were performed in 31 patients having cancer larynx to find the correlation between postoperative motility changes and occurrence of dysphagia. After the operations, there was only one patient complained of dysphagia although all patients showed a well-defined decrease in the intraluminal pressures in the pharynx and upper esophageal sphincter. The upper and middle thirds of the esophageal body showed normal contractions in eight patients and weaker contractions in 23 of the cases postoperatively. All cases showed weaker contractions in the lower esophageal body. All the postoperative recordings resulted in an incomplete relaxation of the upper esophageal segment [UES] and incoordination. Although total laryngectomy completely interrupted the continuity of the proximal digestive tube and may caused derangement in the esophageal motility, dysphagia was not a striking postoperative symptom in those patients

Chlamydia IgA in acute ENT infections

Detection of Chlamydia IgA was done in 106 patients with acute infections in ear, nose and throat sites. The patients were divided into 3 diagnostic groups [pharyngitis, otitis media and sinusitis groups]. Acute phase serum antibodies were measured by using ELISA diagnostic kit Chlamydia IgA [eurogenetics]. The antibodies were detected in 8.8% [6/68] of those patients with pharyngitis, 30.7% [8/26] of those with otitis media and 8.3% [1/12] of those with sinusitis, whereas no one of the control group had acute antibodies. The overall incidence of acute antibodies was 14.2% [15/106]. This put Chlamydia species as an important etiologic pathogen in acute ENT infections

Computed tomography and MRI evaluation of mucoceles of the paranasal sinuses with reference to intracranial and extracranial extensions

15 patients with mucoceles of the paranasal sinuses were studied, the commonest sinus to be involved was the ethmoid followed by the frontal maxillary and spheno-ethmoidal, while sphenoid sinus alone was not involved. All the cases were subjected to computed tomography and only 2 cases were examined by magnetic resonance imaging. CT was usually sufficient for making diagnosis and defining the extent of the lesion, accurately demonstrating the orbital and intracranial extensions by both axial and coronal sections. All cases were explored surgically verifying the extension and the chronicity. MRI was very valuable in detecting the nature of the mucocele by high T2-Wls, while Tl-Wls differed according to the chronicity of the mucocele also MRI by its multiplanner capability demonstrated the extent of the lesion. One drawback of the MRI was its poor demonstration of the bones and calcifications of the sinuses, while high resolution CT demonstrated bone details and intracranial extension better. T2-weighted image and it displays the sinus in 3 plane imaging with direct sagittal sections