Are Sleep Questionnaires Valid in All Adult Age Groups as Screening Tools for Obstructive Sleep Apnea?

Background and Objectives@#Evaluation of Epworth Sleepiness Scale (ESS), Berlin, STOP, and STOP-Bang questionnaire validities for obstructive sleep apnea (OSA) screening among various adult age groups.Materials and Method: Results for each of those questionnaires were compared with diagnostic overnight polysomnography (PSG) data obtained for 396 patients suffering either insomnia, sleep apnea, excessive daytime sleepiness, or chronic snoring who had been divided into three age groups (20-39, 40-59, or ≥60 years). For each questionnaire, the sensitivity, specificity, accuracy, and area under the curve (AUC) were calculated. @*Results@#Among the OSA group [apnea hypopnea index (AHI) cutoff ＞5], Berlin and STOP questionnaire sensitivity and specificity were significantly different among the age groups. Among the moderate-to-severe OSA sub-group (AHI cutoff ＞15), the specificity of Berlin, STOP, and STOP-Bang questionnaire was significantly different among age groups. @*Conclusion@#The Berlin and STOP questionnaires differed with patient age in OSA screening. The ESS questionnaire, by contrast, did not show any age-related differences of sensitivity and specificity in OSA screening or moderate-to-severe OSA screening.

A Case of the Carotid-Cavernous Fistula Due to the Internal Carotid Artery Injury During Endoscopic Sinus Surgery

Rupture of the internal carotid artery (ICA) during endoscopic sinus surgery is a rare complication. However, it can potentially result in death within minutes. In the event of a traumatic injury to the ICA during sphenoid sinus exploration, it is very difficult to control the bleeding. We present a case of carotid-cavernous fistula after an accidentally-developed ICA bleed during endoscopic sphenoidotomy. The patient was successfully treated with endovascular embolization techniques that included detachable microcoils.

A Case of Ethmoid Osteoma with Orbital Extension Presenting with Occipital Headache

Osteoma is a slow-growing benign tumor composed of mature bone. Paranasal sinus osteoma is benign, well-circumscribed, slow-growing, frequently asymptomatic and usually diagnosed incidentally. However, depending on the location, osteoma may lead to headaches, proptosis, rhinorrhea, diplopia, hyposmia and facial deformity. While it is generally agreed that surgical intervention is not indicated, symptomatic osteomas are always treated surgically, typically with open procedures. As an alternative, the endonasal technique presents several important advantages: better visualization of anatomic structures; preservation of the natural drainage pathway; absence of scar formation; reduced morbidity; shorter hospital stay; and limited bleeding. We experienced a case of osteoma presenting with occipital headache and that was removed using anintranasal endoscopic approach. Here we report this case with a review of literature.

A Case of Extranasopharyngeal Angiofibroma Arising from the Inferior Turbinate Removed without Pre-Operative Embolization

The angiofibroma is a highly vascular and histologically benign neoplasm that usually arises in the nasopharyx in adolescent male patients. It accounts for less than 0.5% of all head and neck neoplasm. Reports of primary extra-nasopharyngeal angiofibroma have appeared sporadically in the literature. The inferior turbinate is a very rare site of extra-nasopharyngeal angiofibroma, with only 5 cases reported in the medical literature. Also, the value of embolization in surgery for extra-nasopharyngeal angiofibroma is a controversial matter. We report a case of extra-nasopharyngeal angiofibroma arising from the inferior turbinate of a 37-year-old male. The tumor was completely removed through endonasal, endoscopic technique without pre-operative embolization. Histopathology confirmed it to be a case of angiofibroma. The patient is currently free of relapse 6 months after surgery. Endoscopic resection is a feasible and safe method for angiofibroma surgery. The current evidence does not support obligatory embolization in every case of endoscopic angiofibroma resection.

A Case of Extranasopharyngeal Angiofibroma Arising from the Inferior Turbinate Removed without Pre-Operative Embolization

The angiofibroma is a highly vascular and histologically benign neoplasm that usually arises in the nasopharyx in adolescent male patients. It accounts for less than 0.5% of all head and neck neoplasm. Reports of primary extra-nasopharyngeal angiofibroma have appeared sporadically in the literature. The inferior turbinate is a very rare site of extra-nasopharyngeal angiofibroma, with only 5 cases reported in the medical literature. Also, the value of embolization in surgery for extra-nasopharyngeal angiofibroma is a controversial matter. We report a case of extra-nasopharyngeal angiofibroma arising from the inferior turbinate of a 37-year-old male. The tumor was completely removed through endonasal, endoscopic technique without pre-operative embolization. Histopathology confirmed it to be a case of angiofibroma. The patient is currently free of relapse 6 months after surgery. Endoscopic resection is a feasible and safe method for angiofibroma surgery. The current evidence does not support obligatory embolization in every case of endoscopic angiofibroma resection.

Three Cases of Organizing Hematoma in the Maxillary Sinus

Organizing hematomas are rare benign tumors and appear as masses that are composed of neovascularization with organizing fibrotic tissue in a hematoma. Although histologically benign, this condition may be clinically progressive. Radiological findings can range from a benign appearance to a more aggressive process, including bony erosion. Organizing hematoma of the maxillary sinus is a rare clinical disease. To our knowledge, only a few cases have previously been published, and most were without bleeding history and disorders. Until now, all of the reports about this lesion have discussed the clinical course, and no previous report has closely considered pathologic findings and pathogenesis. We report three cases of organizing hematoma of the maxillary sinus presenting with an enlarging maxillary sinus mass.