Recurrence after laser assisted uvulopalatoplasty [LAUP], long-term study

Laser assisted uvulopalatoplasty is a well established operation for treatment of snoring and mild obstructive sleep apnea with good results on short term basis. However, long term follow-up studies, in addition to their scarcity, had conflicting results regarding the percentage of recurrences and the change of snoring quality. This is a long term retrospective follow up study conducted on 676 patients operated upon by laser assisted uvulopalatoplasty as an office based procedure in National Institute of Laser Enhanced Sciences, Cairo university. A specially designed questionnaire was used to ask the patients about the quality of snoring regarding its severity, relation to sleeping position and loudness and all was expressed using visual analogue score. The patients were asked for weight and neck circumference. The patients were evaluated preoperatively, 6 weeks postoperatively and on long term follow-up [mean 59 months]. After the initial improvement 6 weeks postoperatively, on long term evaluation, 64.5% had reported recurrence, however, the recurrence showed marked improvement in snoring quality subjectively in the three criteria examined. In conclusion, laser assisted uvulopalatoplasty is a good operation for snoring but with long term recurrence, which can be explained by the gain of extra weight

Effect of thickness of cartilage disc on the hearing results of perichondrium/cartilage island flap tympanoplasty

The aim of this study was to analyze the effect of the thickness of cartilage disc on the hearing result after perichondrium/cartilage island flap tympanoplasty. Our hypothesis was that thinning the rigid thick cartilage disc to half of its thickness could increase the compliance and give better acoustic gain and hearing results to the reconstructed tympanic membrane. Prospective before/after clinical trial was conducted between January 2003 and March 2004. Patients with chronic suppurative otitis media [mucosal type], central perforations and intact ossicular chain we divided randomly into 2 groups, the 1st group was treated with the perichondrium/cartilage island flap technique using full thickness cartilage disc, while the 2nd group was treated by the same technique but after bisecting the cartilage to half of its thickness, Hearing was evaluated using four frequency [500-1000-2000-3000H z] pure tone average air-bone gap [PTA-ABG] before and then 8-9 months after the tympanoplasty, and results were compared statistically

Single stage partial cricotracheal resection [CTR] with thyrotracheal anastomosis for the management of severe post intubation tracheal and subglottic stenosis: a short term report

Subglottic stenosis [SGS] and tracheal stenosis can be caused by a wide variety of disease processes, but mechanical trauma from endotracheal tubes remains the most common cause. The management of laryngotracheal stenosis continues to challenge the head and neck surgeon. In this work we review our experience in managing 14 adult patients with severe [Cotton's grade III and IV] SGS and upper tracheal stenosis using partial cricotracheal resection with end to end thyrotracheal anastomosis,and we proved that this treatment modality is an effective, safe, and single stage treatment modality that can be applied safely to cases of severe subglottic and upper tracheal stenosis.