Uvulopalatopharyngoplasty: the treatment of obstructive sleep apnoea

Obstructive sleep apnoea [OSA] is a troublesome disease with a risk of long term complications. Uvulopalatopharyngoplasty [UPPP] is a useful surgical technique provided the site of obstruction is at the soft palate level. To assess the efficacy of this operative procedure. DESIGN: Case study. PERIOD: From 1990-1996. SETTING: ENT Department of Allied Hospital Faisalabad. PATIENTS AND METHODS: 15 patients admitted from outpatient department with symptoms of OSA and radiological confirmation of obstruction at soft palate level are included in this study. Apart from routine investigations ECG, X-ray of neck soft tissue lateral view, blood gases and Muller maneuver were done in all cases. OPERATIVE PROCEDURE: It includes standard tonsillectomy and removal of 1 cm of soft palate, uvula, anterior and posterior pillars and stitching them together to increase the oropharyngeal space. Majority of patients were between 21-40, all were males. Apnoea attack during sleep, excessive day time somnolence, excessive snoring and obesity were the main symptoms. Majority of the patients were satisfied with the result of operation. There were no longterm complications. Success of surgical procedure depends on patient selection and good operative technique. Our results compare favourably with other published series

Malignant otitis externa

Malignant external otitis is a serious pseudomonas infection of the external ear which when untreated may extend towards the base of the skull. To find out the results of conservative treatment and compare it with previous studies. To diagnose this condition at its earlier stage to improve the prognosis. Design: Case study. Setting: ENT Department Punjab Medical College Hospital Faisalabad. Period: Mar 86 to March 1996. Subjects: Fifteen patients, 9 females, 6 males between the ages of 20-26 years, all diabetics presented during the period Mar 86 to Mar 1996. Diagnosis was based upon clinical findings and positive pseudomonas aeruginosa in culture of ear swab. Local debridement, cleansing local drops and systemic use of aminoglycoside with third generation cephalosporin in resistent case used for treatment. 9 Females and 6 Males all between 20-26 years of age presented with pain, discharge, edema, granulations and fever. All were confirmed diabetics and ear swab revealed pseudomonas aeruginosa. Local cleansing with local and systemic aminoglycoside was sufficient in 10 cases but in 5 cases Ceftazidime was also added. Antibiotics were continued 4 weeks after control of symptoms. 13 patients [86.6%] cured without any long term complications, 2 patients [13.3%] died due to MEO. Malignant otitis externa through a dangerous infection can be cured on conservative treatment if diagnosed early