Obstructive Sleep Apnea Is Associated With Late-Onset Preeclampsia in Overweight Pregnant Women in Korea

Background@#Obstructive sleep apnea (OSA) is closely related to maternal obesity in pregnant women, and the association increases with later pregnancy. Obesity and OSA are risk factors of pregnancy-related complications, including gestational hypertension, gestational diabetes mellitus (GDM), and fetal morbidities. We aimed to determine the prevalence of OSA and to assess the impact of OSA on pregnancy-related disorders in overweight pregnant women. @*Methods@#Eligible participants who were overweight [body mass index (BMI) ≥ 23 kg/m 2 ] in gestational age 30 weeks or more, assessed OSA using a portable polysomnography at home.Clinical data were collected from pregnant women and their babies. @*Results@#The average age of 51 participants was 34.5 years (27–44 years). The number of primipara was 25 (49%) and that of multipara was 26 (51%). Eight cases of GDM (15.7%) and five cases of preeclampsia (9.8%) were reported, and six patients (11.8%) experienced preterm delivery. In results of polysomnography, 14 patients (27.5%) were diagnosed as OSA. Apnea-hypopnea index moderately correlated with BMI (r = 0.515, P < 0.001). The BMI (P < 0.005) and preeclampsia rate (P < 0.017) were higher in the OSA group compared to the control group. Odds ratios (ORs) adjusting age, BMI, parity, and abortion history were calculated. The presence of OSA increased OR of preeclampsia (OR, 13.1; 95% confidence interval, 1.1–171.3). The majority of preeclampsia patients (4/5, 80%) underwent preterm delivery. @*Conclusion@#OSA is an important risk factor for preeclampsia, resulting in preterm delivery.For overweight pregnant women, an OSA evaluation should be mandatory.

One-Unit Osteotomy to Correct Deviated Bony Dorsum

Objectives@#. A crooked nose is frequently caused by nasal bony vault deviation, and proper management of the bony vault is an integral part of rhinoplasty. Conventional osteotomy to correct a deviated nose favors simultaneous medial and lateral osteotomies, which allows the free independent movement of each nasal bone. However, patient satisfaction with deviated nose surgery is sometimes low. In the present study, we introduce a one-unit osteotomy procedure that combines bilateral and root osteotomies with unilateral triangular bony wedge resection to allow symmetry of both nasal bones. @*Methods@#. Twenty consecutive patients who presented with bony vault deviation and underwent one-unit osteotomy were enrolled in this retrospective single-center study. The Nasal Obstruction Symptom Evaluation (NOSE) questionnaire was used to evaluate each patient’s functional outcome. The angle of bony vault deviation before and after one-unit osteotomy was measured using a protractor and compared with the results of 14 patients who had undergone conventional osteotomy. The improvement in dorsal deviation was evaluated using facial photography preoperatively and 3 months postoperatively. @*Results@#. NOSE values improved from 8.4±6.4 to 4.1±4.2 (P =0.021). The angle of bony vault deviation improved from 6.9°±2.2° to 2.1°±1.2° (P <0.001) in one-unit osteotomy and from 7.3°±4.0° to 2.7°±1.2° (P =0.001) in conventional osteotomy. The preoperative deviation angle improved by 70.3% in one-unit osteotomy compared with 56.6% in conventional osteotomy, which was a significant difference (P =0.033). The mean grade of the postoperative esthetic outcomes for the remaining deviation was 1.6±0.5, which was similar to that in the conventional osteotomy group. @*Conclusion@#. One-unit osteotomy is a relatively simple procedure that balances the width of both lateral walls by removing excessive bony fragments from the wider bony wall and providing better structural integrity. This technique improves functional outcomes and has equivalent esthetic results to those of the traditional procedure.

Digital Twins in Healthcare and Their Applicability in Rhinology: A Narrative Review

Digital twins were initially introduced in the aerospace industry, but they have been applied to the medical field in the 2020s. The development of the Internet of Things, sensor technology, cloud computing, big data analysis, and simulation technology has made this idea feasible. Essentially, digital twins are virtual representations of real-world data that can generate virtual outcomes related to a patient based on their actual data. With this technology, doctors can predict treatment outcomes, plan surgery, and monitor patients’ medical conditions in real time. While digital twins have endless potential, challenges include the need to deal with vast amounts of data and ensure the security of personal information. In the field of rhinology, which deals with complex anatomy from the sinus to the skull base, the adoption of digital twins is just beginning. Digital twins have begun to be incorporated into surgical navigation and the management of chronic diseases such as chronic rhinosinusitis. Despite the limitless potential of digital twins, challenges related to dealing with vast amounts of data and enhancing the security of personal data need to be surmounted for this method to be more widely applied.

Clinical Practice Guideline: Clinical Efficacy of Nasal Surgery in the Treatment of Obstructive Sleep Apnea

Obstructive sleep apnea (OSA) is a common disorder characterized by upper airway obstruction during sleep. To reduce the morbidity of OSA, sleep specialists have explored various methods of managing the condition, including manifold positive airway pressure (PAP) techniques and surgical procedures. Nasal obstruction can cause significant discomfort during sleep, and it is likely that improving nasal obstruction would enhance the quality of life and PAP compliance of OSA patients. Many reliable studies have offered evidence to support this assumption. However, few comprehensive guidelines for managing OSA through nasal surgery encompass all this evidence. In order to address this gap, the Korean Society of Otorhinolaryngology-Head and Neck Surgery (KORL-HNS) and the Korean Society of Sleep and Breathing designated a guideline development group (GDG) to develop recommendations for nasal surgery in OSA patients. Several databases, including OVID Medline, Embase, the Cochrane Library, and KoreaMed, were searched to identify all relevant papers using a predefined search strategy. The types of nasal surgery included septoplasty, turbinate surgery, nasal valve surgery, septorhinoplasty, and endoscopic sinus surgery. When insufficient evidence was found, the GDG sought expert opinions and attempted to fill the evidence gap. Evidence-based recommendations for practice were ranked according to the American College of Physicians’ grading system. The GDG developed 10 key action statements with supporting text to support them. Three statements are ranked as strong recommendations, three are only recommendations, and four can be considered options. The GDG hopes that this clinical practice guideline will help physicians make optimal decisions when caring for OSA patients. Conversely, the statements in this guideline are not intended to limit or restrict physicians’ care based on their experience and assessment of individual patients.

Two Cases of Herpes Virus Infection of Nose Mimicking Acute Invasive Fungal Infection in Immunocompromised Hosts

Various invasive fungal infections can occur in immunocompromised hosts, and an acute invasive fungal infection (AIFI) can be fatal. Because of its high mortality rate, AIFI must be quickly diagnosed and treated, such as anti-fungal agents or surgical debridement. In an immunocompromised host, nasal herpes simplex infection, usually caused by herpes simplex virus (HSV) type-1, can have various clinical manifestations, some of which can mimic AIFI. However, the management of acute viral infection differs significantly from invasive fungal infections of the nose. A fast and accurate differential diagnosis is mandatory because a delay in the disease-specific treatment of acute invasive infections can lead to mortality. This report describes two immunocompromised patients with mucosal and skin lesions around the nose. We provide clinical clues when mucosal lesions of the nasal cavity and skin lesions around the nose develop in immunocompromised hosts.

Clinical Practice Guideline: Nasal Irrigation for Chronic Rhinosinusitis in Adults

The Korean Society of Otorhinolaryngology-Head and Neck Surgery and Korean Rhinologic Society appointed a guideline development group (GDG) to establish a clinical practice guideline, and the GDG developed a guideline for nasal irrigation for adult patients with chronic rhinosinusitis (CRS). The guideline focuses on knowledge gaps, practice variations, and clinical concerns associated with nasal irrigation. Nasal irrigation has been recommended as the first-line treatment for CRS in various guidelines, and its clinical effectiveness has been demonstrated through a number of studies with robust evidence. However, no guidelines have presented a consistent nasal irrigation method. Several databases, including OVID Medline, Embase, the Cochrane Library, and KoreaMed, were searched to identify all relevant papers using a predefined search strategy. When insufficient evidence was found, the GDG sought expert opinions and attempted to fill the evidence gap. Evidence-based recommendations for practice were ranked according to the American College of Physicians grading system. The committee developed 11 evidence-based recommendations. This guideline focuses on the evidence-based quality improvement opportunities deemed the most important by the GDG. Moreover, the guideline addresses whether nasal lavage helps treat CRS, what type of rinsing solution should be used, and the effectiveness of using additional medications to increase the therapeutic effect.

Long-Term Clinical Course of Benign Fibro-Osseous Lesions in the Paranasal Sinuses

Objectives@#. Fibro-osseous lesions of the paranasal sinuses can present various clinical manifestations. This study aimed to report the long-term clinical course of benign fibro-osseous lesions (BFOLs) in the paranasal sinuses, including clinical and radiologic features. @*Methods@#. Radiologically confirmed BFOLs between 1994 and 2016, with the exclusion of osteoma cases, were retrospectively reviewed. We compared demographic characteristics between the surgery and observation groups. The reasons for the imaging study, radiographic features, histopathology, and clinical course based on serial image scans were analyzed. @*Results@#. In total, 183 subjects were selected from a thorough review of head and neck radiologic tests (n=606,068) at a tertiary referral hospital over 22 years. Patients’ mean age was 28.6±18.1 years, and 56.3% were males. A diagnostic imaging workup was performed in 55.7% of patients due to facial asymmetry, headache, skull mass, or other symptoms related to BFOLs. In other patients (37.7%), BFOLs were found incidentally on computed tomography or magnetic resonance imaging. The most common diagnosis was fibrous dysplasia, followed by ossifying fibroma, based on both radiologic exams and histopathologic results. In total, 42.6% of the patients underwent surgery because of subjective symptoms or esthetic concerns. The patients who underwent surgery were younger (P<0.001) and had a longer follow-up duration (P<0.001) than those who underwent observation. Patients who experienced lesion growth (11.5%) were younger (P<0.001) and had more lesion sites (P=0.018) than those who did not, regardless of surgical treatment. Five patients underwent optic nerve decompression, and one patient experienced malignant transformation. @*Conclusion@#. BFOL in the paranasal sinuses is a rare disease, and most cases were observed without specific treatment. Surgical treatment should be considered in symptomatic patients with aggressive clinical features. Regular observation and management are needed, particularly in younger patients in their teens.

A Comparison of Olfactory and Sinonasal Outcomes in Endoscopic Pituitary Surgery Performed by a Single Neurosurgeon or a Collaborative Team of Surgeons

Objectives@#. Endoscopic pituitary surgery usually requires a collaboration between neurosurgeons and ENT surgeons to achieve optimal outcomes. However, neurosurgeons occasionally perform these procedures alone without an ENT surgeon. In this study, postoperative sinonasal quality of life and olfactory function were compared in patients who underwent endoscopic pituitary surgery performed by a single neurosurgeon or by a collaborative team of a neurosurgeon and an ENT surgeon. @*Materials and Methods@#. A retrospective review of prospectively collected data was performed. Patients who underwent endoscopic pituitary surgery for pituitary adenoma from January 2015 to April 2018 were included. The study patients were divided into two groups; patients in group 1 underwent surgery performed by a single neurosurgeon, while patients in group 2 received surgery performed by a collaborative team of surgeons. Olfaction was assessed using a subjective Likert scale, the Cross-Cultural Smell Identification Test (CC-SIT), and the butanol threshold test (BTT). In addition, patients answered the Sino-nasal Outcome Test (SNOT-22) questionnaire regarding sinonasal quality of life before and 3 months after surgery. @*Results@#. This study included 152 patients (46 patients in group 1 and 106 patients in group 2). Significant differences were not observed between the two groups regarding age, sex, tumor size, or operation time. Although subjective olfaction was not significantly different before and after surgery, group 2 showed significantly better objective olfactory function based on the CC-SIT (8.44±3.00 vs. 9.84±1.40; P=0.012) and BTT (4.67±0.84 vs. 5.02±0.33; P=0.022) scores at 3 months after surgery. The SNOT-22 scores were not statistically significantly different between the two groups (P>0.05). @*Conclusion@#. In the present study, better olfactory outcomes were observed in patients who underwent surgery performed by a collaborative team of a neurosurgeon and an ENT surgeon. This result shows the need for collaboration between neurosurgeons and ENT surgeons in endoscopic pituitary surgery.

Augmentation Rhinoplasty with Expanded Polytetrafluoroethylene: A Ten-Year Experience for Safety / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES@#Expanded polytetrafluoroethylene (ePTFE) is an alloplastic implant widely used in augmentation rhinoplasty. However, ePTFE implant is known to be vulnerable to postoperative infection and inflammation. We aimed to verify the safety of the material by analyzing the results of augmentation rhinoplasty using ePTFE carried out in a single institution for 10 years.SUBJECTS AND METHOD: From April 2009 to June 2018, 238 patients who underwent augmentation rhinoplasty with ePTFE were included in the study. There were 187 male patients and 51 female patients. Patients' medical records, preoperative and postoperative photographs were analyzed, and postoperative implant migration, inflammation, and infection were investigated.@*RESULTS@#Of the 238 patients, 10 underwent revision surgery, and 87 (36.6%) underwent concomitant osteotomy for the correction of the deviated nose. Of the 5 patients (2.1%) who showed postoperative implant migration, 4 patients belonged to the osteotomy patients group while 1 patient belonged to the no-osteotomy group. There was more frequent implant migration in patients who underwent osteotomy; however, there was no statistically significant difference (p=0.06). In all of the five patients, the degree of implant migration was minimal, therefore no patient required revision surgery. No inflammatory reaction or infection was found after surgery.@*CONCLUSION@#ePTFE is a safe material for augmentation rhinoplasty and is not susceptible to infection after surgery if used through appropriate surgical procedures

Virtual Reality in Endoscopic Sinus Surgery and Facial Plastic & Reconstructive Surgery / 대한이비인후과학회지

With the recent development of information and communication technology, social interest in virtual reality (VR) is increasing rapidly. VR technology is expanding into applications such as games, movies, entertainment, healthcare, education/media, manufacturing, and construction. In the healthcare, VR is used for surgical training, medical education, rehabilitation medicine, pain control, and treatment for psychiatric disorder, but the market size of VR in healthcare is not big compared to VR application in other industries. However, as the demand for high-quality medical care increases and the training time of the resident physicians is reduced, the demand for VR in the healthcare is expected to increase rapidly. Especially, the nose and paranasal sinus are composed of complicated osseous structures, which makes it difficult to understand the exact anatomy and requires highly skilled techniques to perform accurate and safe surgery. For this reason, nose and sinus are a suitable field to apply VR technology. In this review article, we describe the overview of VR technology used in healthcare, the status and prospects of VR in endoscopic sinus surgery and facial plastic surgery.

Correction of Tilted Cartilaginous Nasal Dorsum with Clocking Suture Single Technique / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Deviated nose is a commonly encountered deformity, and the correction of deviated nose is the most difficult part of septorhinoplasty. Generally, additional cartilaginous graft is required for straightening the deviated segment. However, there are many cases where sufficient cartilage grafts are not available due to revision surgery or cases with small cartilage. In such cases, tilted cartilaginous dorsum should be corrected without grafting. The purpose of this study is to evaluate the usefulness of clocking suture single technique for cartilaginous deviation by analyzing the surgical results of cases who underwent corrective rhinoplasty without any cartilaginous graft. SUBJECTS AND METHOD: From June 2009 to June 2016, 43 patients with tilted cartilaginous dorsum were corrected with clocking suture single technique. Cases underwent additional graft for straightening dorsum were excluded. The patients' medical records and facial photographs were analyzed to assess surgical outcomes and complications. Surgical outcomes were graded as excellent, fair and poor according to patients' satisfaction and evaluation by two physicians. RESULTS: Mean follow up period was 15.4 (5-39) months. There were 39 patients (90.7%) with excellent result, 3 patients (7.0%) with fair results, and 1 patient (2.3%) with poor result. Augmentation was performed with expanded polytetrafluoroethylene or septal cartilage in 26 patients (60.5%) and dorsal hump was removed in 22 patients (51.2%). Concomitant augmentation didn't affect surgical results. No postoperative complication such as infection or inflammation were found. CONCLUSION: The clocking suture single technique is an effective surgical method for the correction of dorsal cartilaginous deviation.

Mouse Model for the Research of Sinusitis Induced Olfactory Dysfunction / 대한이비인후과학회지

Olfactory dysfunction is one of the most debilitating problem in chronic rhinosinusitis (CRS) patients, and exact mechanism underlying sinusitis induced olfactory dysfunction was not fully understood. In vivo manipulation for olfactory epithelium and fresh specimen for histopathological analysis are essential for research, but it is nearly impossible to do in human due to inaccessibility of olfactory epithelium and risk for complication. For this reason, several animal models using toxic materials, such as 3-methylindole or bromomethane, have been suggested for mimicking olfactory epithelial damage in CRS, but none of them could truly imitate the event which happens in real patient. Inducible olfactory inflammation (IOI) mouse is a transgenic mouse model selectively producing tumor necrosis factor-alpha (TNF-alpha) in sustentacular cell of olfactory epithelium. The production of TNF-alpha can be actively initiated by giving food containing doxycycline to IOI mouse, and inflammation is stopped in the absence of doxycycline. Both toxicity model and transgenic model have their own advantages and disadvantages, therefore appropriate model should be selected for optimal results.

Practice Patterns in Endoscopic Sinus Surgery: Survey of the Korean Rhinologic Society

BACKGROUND AND OBJECTIVES: Endoscopic sinus surgery (ESS) has become the standard treatment modality in chronic rhinosinusitis. However there is no uniform treatment protocol regarding preoperative, intraoperative, and postoperative care. The objectives of this study are to identify and report the practice patterns of ESS in South Korea. MATERIALS AND METHOD: A series of eight surveys were sent to the board members of the Korean Rhinologic Society via e-mail between August 2013 and September 2014. Responses to questions regarding detailed practice patterns were recorded anonymously. RESULTS: The average number of replies to each survey was 41.5. Routine antibiotics were prescribed just before computed tomography by 46.9% of the respondents, and the mean duration of antibiotics treatment was 1.90 weeks. A routine preoperative olfactory test was conducted by 64.3% of respondents, and allergy tests were conducted by 82.2%. General anesthesia was preferred by 76.8%, and the mean hospitalization period was 3.12 days. The mean rotation speed used for a microdebrider was 3,054 rpm, and 3,000 rpm was selected by 51.6% of the respondents. In addition, 74.2% of respondents reported that they operate the foot switch themselves. Finally, an absorbable pack was preferred after ESS. CONCLUSION: The current study was the first nationwide survey on practice patterns in endoscopic sinus surgery in Korea, and the data reflects the opinions of expert sinus surgeons.

The Anatomical Relationship between the Anterior Ethmoid Artery, Frontal Sinus, and Intervening Air Cells; Can the Artery Be Useful Landmark? / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The anatomy surrounding the frontal sinus (FS) and the anterior ethmoid artery (AEA) is variable and complex. We tried to determine the value of AEA as a landmark for finding FS during endoscopic sinus surgery. SUBJECTS AND METHOD: Using the high-resolution CT scans of coronal and sagittal reconstruction, the distance between AEA and FS (D-AF) and the number and type of intervening cells between these two structures were investigated. Next, the distance between AEA and the anterior skull base (D-AS) was measured and the correlation between D-AF and D-AS was analyzed. RESULTS: A total of 119 nasal cavities from 70 subjects was analyzed. Of these analyzed, AEA was located just behind the frontal recess in only 17 nasal cavities (14%) and one or two intervening cells were located between FS and AEA in the remaining 86% of the nasal cavities. The most frequent type of intervening cells was supra bullar cell, followed by supraorbital and frontal bullar cells. The mean D-AF and D-AS measurements were 8.58+/-5.56 mm (0-22.6 mm) and 1.65+/-1.90 mm (0-6.7 mm), respectively. D-AS was not significantly correlated with the distance between the FS and AEA (p=0.433), therefore, D-AS could not be predicted. CONCLUSION: The relationship between FS and AEA was non-predictable, and in most cases, there were one or two intervening cells between FS and AEA. Therefore a thorough review of thin section CT scans is necessary.

Two Cases of Cerebrospinal Fluid Rhinorrhea Caused by Closed Nasal Reduction / 대한이비인후과학회지

Cerebrospinal fluid (CSF) rhinorrhea usually occurs after a traumatic or non-traumatic head injury, as more than 80% of all cases of CSF rhinorrhea are caused by traumatic head injuries. In fact, CSF rhionorrhea is observed in 2 to 3% of traumatic head injuries, with 50% of the CSF found in the anterior cranial fossa, but mostly of them in the cribriform plate. CSF rhionorrhea can occur two days after a traumatic head injury, but it can take up to 3 months to notice the symptoms of CSF rhionorrhea in a patient with a traumatic head injury. Iatrogenic CSF rhionorrhea is usually caused by neurosurgery operation or otorhinolaryngological surgery such as sinus surgery. For example, closed reduction treating nasal bone fractures can cause CSF rhionorrhea, so patients should be watched at all times. This paper reports two cases of CSF rhionorrhea caused by closed nasal reduction.

Tailored Correction of Deviated Nose / 대한이비인후과학회지

The correction of deviated nose is the most challenging step among various procedures of rhinoplasty. Many effective surgical methods for correction of bony and cartilaginous deviation have been developed since the beginning of rhinoplasty, however it is not easy to choose appropriate surgical method for each patients. Surgical procedure should be personalized depending on patients' characteristics of nasal framework and covering skin, therefore same method cannot be applied to all patients. Size, strength and thickness of bony and cartilaginous structure, thickness of skin, existence of nasal hump are the essential components which should be considered. Surgical method for correction of deviated nose cannot be applied uniformly to patients, and should be tailored to individual patient. For this reason, rhinoplasty surgeon should be skilled at various techniques of corrective rhinoplasty.

Nasal Obstruction and Palate-Tongue Position on Sleep-Disordered Breathing

OBJECTIVES: We wanted to evaluate whether the presence of nasal obstruction makes a change on the association between the modified Mallampati score and the severity of sleep-disordered breathing (SDB) and the sleep quality. METHODS: Polysomnography (PSG), the modified Mallampati score (MMS), the body-mass index, and a questionnaire about nasal obstruction were acquired from 275 suspected SDB patients. The subjects were divided into two groups according to the presence of nasal obstruction. The clinical differences between the two groups were evaluated and the associations between the MMS and PSG variables in each group were also assessed. RESULTS: Significant correlations were found between the MMS and many PSG variables, including the apnea-hypopnea index, the arousal index and the proportion of deep sleep, for the patients with nasal obstruction, although this was not valid for the total patients or the patients without nasal obstruction. CONCLUSION: The severity of SDB and the quality of sleep are well correlated with the MMS, and especially for the patients with nasal obstruction. The MMS can give more valuable information about the severity of SDB when combined with simple questions about nasal obstruction.

Otolaryngologist-Performed Ultrasound and Ultrasound-Guided Fine Needle Aspiration for Thyroid Nodule and Meaningful Ultrasound Finding / 대한갑상선학회지

BACKGROUND AND OBJECTIVES: Ultrasonography is a safe and noninvasive imaging modality with high sensitivity that can be used to identify the presence, location, and size of thyroid nodules. Fine-needle aspiration (FNA) biopsy of thyroid nodules is a minimally invasive and safe procedure that is usually performed on an outpatient basis. The purpose of this study was to investigate the diagnostic efficacy of ultrasonography performed by an otolaryngologist (OUS) and OUS-guided FNA for the thyroid and determine the clinical value of OUS in predicting the presence of malignancy in thyroid nodules. MATERIALS AND METHODS: A single otolaryngologist examined 151 consecutive patients referred to our institution and performed OUS or OUS-guided FNA biopsies on all of them in an office setting. Final diagnosis was based on the FNA biopsy or pathological result of operation. We used the following parameters to assess the relevance of the sonographic findings in the prediction of thyroid malignancy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and relative risk (RR). RESULTS: In total, 12.9% of all the patients showed malignancy. The PPVs for the sonographic features were as follows: a taller-than-wide shape, 63.6%; marked hypoechogenicity, 61.5%; microcalcification, 46.7%; microcalcification or macrocalcification, 44.0%; and spiculated margin, 38.2%. The RR values showed that microcalcification or macrocalcification (p<0.05, RR=7.2) and marked hypoechogenicity (p<0.05, RR=6.7) are significant findings that indicate thyroid malignancy. CONCLUSION: Microcalcification or macrocalcification and marked hypoechogenicity observed on OUS are significant finding that indicate thyroid malignancy, and the most reliable finding are microcalcification or macrocalcification.

Role of Intranasal Topical Steroid in Pediatric Sleep Disordered Breathing and Influence of Allergy, Sinusitis, and Obesity on Treatment Outcome

OBJECTIVES: To evaluate efficacy of short term intranasal corticosteroid (mometasone furoate) treatment in pediatric sleep-disordered breathing (SDB) patients. METHODS: A prospective, observational study was done. A total of 41 children (2-11 years old) were enrolled into this study. All patients received 4-weeks course of mometasone furoate 100 microg/day treatment. They were evaluated at pretreatment and immediately after treatment with obstructive sleep apnea (OSA)-18 quality of life survey and lateral neck X-ray. Also, the assessment of each patients included history, skin prick test or CAP test, and sinus radiography. We compared the OSA-18 survey score and adenoidal-nasopharyngeal (AN) ratio between before and after treatment. RESULTS: Total OSA-18 score and AN ratio decreased significantly after treatment regardless of allergy, sinusitis, and obesity (P=0.003, P=0.006). There was no complication after treatment of mometasone furoate. CONCLUSION: Pediatric SDB patients with adenoid hypertrophy could be effectively treated with 4-weeks course of mometasone furoate. Allergy, obesity, and sinusitis did not affect on the result of treatment.

Role of Intranasal Topical Steroid in Pediatric Sleep Disordered Breathing and Influence of Allergy, Sinusitis, and Obesity on Treatment Outcome

OBJECTIVES: To evaluate efficacy of short term intranasal corticosteroid (mometasone furoate) treatment in pediatric sleep-disordered breathing (SDB) patients. METHODS: A prospective, observational study was done. A total of 41 children (2-11 years old) were enrolled into this study. All patients received 4-weeks course of mometasone furoate 100 microg/day treatment. They were evaluated at pretreatment and immediately after treatment with obstructive sleep apnea (OSA)-18 quality of life survey and lateral neck X-ray. Also, the assessment of each patients included history, skin prick test or CAP test, and sinus radiography. We compared the OSA-18 survey score and adenoidal-nasopharyngeal (AN) ratio between before and after treatment. RESULTS: Total OSA-18 score and AN ratio decreased significantly after treatment regardless of allergy, sinusitis, and obesity (P=0.003, P=0.006). There was no complication after treatment of mometasone furoate. CONCLUSION: Pediatric SDB patients with adenoid hypertrophy could be effectively treated with 4-weeks course of mometasone furoate. Allergy, obesity, and sinusitis did not affect on the result of treatment.