Correction of post-palatoplasty velopharyngeal insufficiency by two different techniques

Evaluation the success of 2 different techniques in treating post-palatoplasty residual velopharyngeal insufficiency [VPI]. Prospective study on 48 cases of post-palatopl asty hypernasality. The cases classified into 3 groups according to the type of velopharyngeal closure. Group A had coronal closure pattern and treated by sphincter pharyngoplasty, group B had sagittal closure pattern and treated by pharyngeal flap and group C had circular closure pattern and treated by sphincter pharyngoplasty. Postoperative follow-up by flexible nasopharyngoscopy, auditory perceptual assessment and parent's questionnaire. The incidence of residual VPI after sphincter pharyngoplasty was 11.5% while it was 9% after pharyngeal flap [p value=0.784]. The satisfactory speech improvement was 88.5% for cases underwent sphincter pharyngoplasty and 91% for cases underwent pharyngeal flap [p value=0.784]. The incidence of snoring was 3.8% for cases underwent sphincter pharyngoplasty and 27% for cases underwent pharyngeal flap [p value=0.038]. No cases developed sleep apnea after pharyngoplasty while it was developed in 13.5% after pharyngeal flap [p value=0.089]. No statistically significant difference in outcomes between the 2 procedures for speech assessment score [p value=0.540]. Mobility was detected in the flaps of sphincter pharyngoplasty while the posterior pharyngeal flaps were static. Sphincter pharyngoplasty and pharyngeal flap are good operations for correction of post-palatoplasty hypernasality. But in cases with circular closure pattern, sphincter pharyngoplasty is the operation of choice as it carries low risk of obstructive complications and it is dynamic

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

Laser assisted uvulopalatoplasty for management of upper airway resistance

This study included 60 patients with snoring underwent laser assisted uvulopalatoplasty [LAUP]. Questionnaires ranking snoring symptoms were completed by the patient and bed partner before and after LAUP. Average follow up period was 14.5 months. The questionnaires showed significant improvements in snoring, quality of sleep and partner satisfaction. The symptomatic improvement persisted as assessed in the intermediate term. In conclusion, LAUP is an effective method for the management of snoring. The study demonstrated intermediate-term improvement in subjective measures

Bioactive-glass powder obliteration of open mastoid cavity

Forty patients with chronic suppurative otitis media of the cholesteatomatous type were included in this study. Their open radical mastoid cavity were obliterated using a new bioactive glass powder; 30 of them as a primary procedure at the time of radical mastoidectomy and 10 as a secondary procedure later on. The study aimed to evaluate a new bioactive glass powder [particulates] as an obliterative material in open mastoid cavities. The results of this technique were promising. It was concluded that bioactive glass powder is a safe and effective biomaterial to be used as on obliterative material in open mastoid cavities

Rhinoplasty without splints or packing

To present our experience of rhinoplasty without nasal or packing. Prospective case series. Thirty cases presenting to Aston Hospital, Al Khobar, K.S.A. during the period of May 2000 to January 2003 were subjected to rhinoplasty due to either traumatic "13" or congenital "17" causes. Rhinotherapy was performed using small instruments to reduce trauma to nasal tissues and to eliminate nasal packing and external immobilization. No significant complications occurred n our series. Of the 30 cases only 3 cases required merocil packing for one day only. One case required secondary proteomics because of late bony displacement, which occurred after 2 months. Patients performed well on the GBI questionnaire with an average score of 86%. By using hyponasty without splints or packing, there is less risk of headache, rhinitis, sinusitis and otitis. Unpleasant dour doesn't occur; general edema and ecchymosis of the eyelids are decreased significantly

Clinical significance of the immunological and serological parameters in early and long standing rheumatoid arthritis

To investigate the additional predictor value of different immunological and serological parameters by evaluating the relationships of these parameters to each other, to the activity, and to the radiological damage in RA patients with different disease durations and grades of activity. Sixty patients [53 females and 7 males], mean age 36.2 years [range 20 - 57] and median disease duration from <6 weeks-28 years were evaluated clinically, with laboratory and radiology in the Rheumatology Department of Assiut University Hospital. Patients met the 1987 American College of Rheumatology Revised [ACR] Criteria. The disease duration didn't seem to influence the rate of occurrence of RF or ANA. The results presented here support that there was a significant positive correlation between CRP with the mean disease grading activity MDGA [p<0.01] and with the degree of radiological damage [p=0.02]. While RF levels in seropositive patients with different grades of activity did not correlate with any of the disease parameters used for assessment of the patients. However, positive RF positively correlated with radiological damage [p=0.04]. ANA positivity only correlated with pain score but not with grades of the disease activity or the severity of the radiological damage