Obstructive sleep apnea and hypothyroidism

Excessive daytime somnolence, apathy and lethargy are known to occur in persons with hypothyroidism, the same symptoms have been recognized in some persons who have obstructive sleep apnea. The occurrence of these symptoms in both conditions raises the question to define the exact incidence, relation in-between and to settle down a rational for management. In the department of otolaryngology of Kasr El-Aini Beni Suif University and new dar al sheaf [Kuwait] hospitals, 2 groups of patients; 1[st] group with hypothyroidism and a 2[nd] group with obstructive sleep apnea were included in this study, from September 2004 to March 2006. The records of these patients were reviewed. In the 1[st] group, eight patients, from total number of eleven, had episodes of apnea, with the number of episodes per hour of sleep, apnea index, ranging from 18 to 169 [mean 69.7]. Six of the eight patients were obese and had 92.6 episodes per hour compared with 17.3 episodes per hour in the 2 non obese patients [p<0.001]. After 4-12 months of thyroxine replacement therapy, the mean apnea index decreased from 69.7 to 12.5 episodes per hour, without reduction in body weight [p<0.001]. In the 2[nd] group [36 patients], the incidence of hypothyroidism among the patients suggestive to have obstructive sleep apnea [OSA] was 5.6% [2 patients]. In patients diagnosed as hypothyroidism, OSA was controlled to a significant degree with thyroxine replacement therapy, even without changes in body weight. The incidence of hypothyroidism among the patients suggestive to have OSA is low and so measurement of thyroid hormones is not a routine step in this type of patients

Perichondrium versus composite cartilage perichonderial graft in revision tympanoplasty

Numerous grafting materials could be used in tympanoplasty either autografts or homografts. Still, temporalis fascia and perichondrium are the most common grafts to be used. Cartilage has shown promising results as a graft material to close perforations. It has more rigid quality and tends to resist resorption and retraction. In this study, we used perichondrial cartilage composite graft [PCCG] in comparison with perichondrium. The inclusion criteria included 30 patients with large, recurrent, safe perforations and bad E.T. function. They were divided according to graft type into 2 equal groups. PCCGs gave better results as regards correction of E.T. function and prevention of graft retraction. In conclusion we found that the perichondrium and PCCG are suitable and efficient grafting materials in revision tympanoplasty

Clinical anatomy of the inferior turbinate

This study was conducted to examine the anatomical configuration of the inferior turbinate, so that its abnormalities can be handled accurately during sinus surgery. The inferior turbinate and meatus were studied radiologically through CT scan films in 30 normal adult individuals and anatomically in the postmortem room in 5 cadavers died from other pathology than nasal disease. The results showed variations in the attachment and shape of the skeleton and soft tissue of the turbinate and its vessels throughout its anteroposterior dimension. Variations were also found in the shape of attachment of the uncinate process to the inferior turbinate