Comparative Analysis for the Surgical Outcomes of Uvulopalatal Flap and Palatal Muscle Resection in Patients with Obstructive Sleep Apnea / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The purpose of this study was to compare the surgical outcomes of uvulopalatal flap (UPF) and palatal muscle resection (PMR) techniques in the treatment of obstructive sleep apnea (OSA). SUBJECTS AND METHOD: Forty-three consecutive patients (40 men and 3 women) with OSA were included. Only patients with Fujita type I obstruction were enrolled in this study. Patients with macroglossia or retrognathia were excluded from the study. Twenty patients underwent a UPF and twenty-three patients underwent a PMR. In both groups, nasal surgery was performed if necessary. Questionnaires based on Visual Analogue Scale (VAS) about snoring, apnea, morning headache, tiredness, daytime sleepiness and Epworth Sleepiness Scale (ESS) were analyzed before and after each surgical treatment. Preoperative and postoperative polysomnography (PSG) were completed by every patient. RESULTS: In UPF group, every aspect of VAS except morning headache was significantly improved after surgery. In PMR group, every aspect of VAS and ESS were significantly improved after surgery. Comparing the surgical outcomes between two groups, every VAS and ESS showed much better result in PMR than UPF group. In both UPF and PMR group, the mean apnea-hypopnea index decreased significantly after surgery. However, there's no significant difference between two groups in the PSG findings. CONCLUSION: PMR could be a better surgical technique than UPF with respect to subjective outcome although both UPF and PMR are effective surgical techniques for the treatment of OSA with Fujita type I obstruction.

A Case of Lobular Capillary Hemangioma with Epidural Abscess / 대한이비인후과학회지

Lobular capillary hemangioma (LCH), also known as pyogenic granuloma, is a benign capillary proliferation with a microscopically distinctive lobular architecture that affects the skin and mucous membrane of the oral cavity and nasal region. LCH commonly involves the nasal cavity as a small hypervascular lesion arising from the anterior third of the septum or the lateral wall. Its diagnosis may be difficult in those rare instances of a large LCH that entirely fills the nasal cavity, which can be confused with more aggressive neoplasms such as hemangiopericytoma or angiosarcoma. We report an intriguing case of LCH associated with epidural hematoma presenting as a huge expansile lesion involving the anterior skull base and orbit.

Spatial changes of the maxillary molar following unilateral derotation with the precision TPA / 대한치과교정학회지

The purpose of this study was to evaluate the spatial changes of mesial-in rotated maxillary molar and opposite anchor tooth during derotation by the precision transpalatal arch (TPA) with the use of a new typodont simulation system, the Calorific machine system, which was designed to observe the whole process of tooth movement. The maxillary right first molar was used for the anchor tooth and the maxillary left first molar was used for the mesial-in rotated tooth, and the angle of rotation was increased to 20, 40, and 60. A passive precision TPA was fabricated and then activated by bending the left arm to 20, 40, and 60. Each experiment was repeated five times under the same conditions and analyzed by ANOVA and Tucky's Studentized Range (HSD) test. In the occlusal plane, when the bending angle of precision TPA was increased, the mesiobuccal cusp of the rotated molar moved more buccally (p<0.001) and less distally (p<0.001) while the distolingual cusp moved in the mesiopalatal direction. In the sagittal plane, the palatal roots of the derotated molar moved mesially (p<0.001). In the traverse plane, the derotated molar showed slight extrusion (p<0.001). The upper right first molar, which was used as an anchor tooth, showed clinically insignificant movement across all three planes.