Radiofrequency-Assisted Uvulopalatoplasty with Tonsillectomy for the Treatment of Mild to Moderate Obstructive Sleep Apnea

BACKGROUND AND OBJECTIVES: In radiofrequency surgery, energy is usually delivered to the submucosal tissue of the palate through a special probe in order to reduce the volume and rigidity (palatal channeling). However, the same probe can be used to make cuts in the free edge of the soft palate, as in laser-assisted uvulopalatoplasty [radiofrequency-assisted uvulopalatoplasty (RAUP)]. The objective of the current study was to evaluate the role of RAUP with tonsillectomy for the treatment of mild or moderate obstructive sleep apnea (OSA). MATERIALS AND METHODS: Eighty-two patients with mild to moderate obstructive sleep apnea (5< or =AHI<30, BMI<30) were included in this clinical trial. All patients received RAUP with tonsillectomy. Patients were followed for six months and were asked to respond to a questionnaire regarding standard visual analogue score pattern. Assessment was performed prior to the surgery and was repeated six month postoperatively. Visual analogue scores were measured for the parameters of pain, speech deficits, dysphagia and snoring (according to the partner). The Epworth sleepiness scale (ESS) was also utilized. Polysomnography was conducted preoperatively and was repeated six months postoperatively. RESULTS: There were significant differences in improvement of snoring, ESS and AHI before and after the procedure, and the success rate of the surgical treatment was 62%. Postoperative pain, speech disturbance, dysphagia were decreased two weeks after the operation. CONCLUSION: The results of the study suggest that RAUP with tonsillectomy is an effective treatment for patients with mild to moderate obstructive sleep apnea.

Prevention of Septal Perforation During Septal Surgery Using Inferior Turbinate Mucosa and Fibrin Glue

BACKGROUND AND OBJECTIVES: As septal surgery is being performed more and more often, the incidence of septal perforation as a complication arising from the surgery has also increased. In septal surgery, if corresponding mucoperichondrial tears occurred on both sides, autologous cartilage is usually placed between the injured mucopercondrium. However, septal perforation is sometimes found after septal surgery even after this effort. The aims of this study were to introduce a new technique for the prevention of septal perforation during septal surgery using inferior turbinate mucosa and fibrin glue and to determine its usefullness by evaluating the treatment outcome. MATERIALS AND METHODS: Between June 2005 and May 2007, 358 cases of septal surgery were performed. Bilateral mucoperichondrial tears on corresponding areas occurred in 26 cases. In Group 1 (15 cases), autologous cartilage was inserted between injured mucoperichondrium. In Group 2 (11 cases), autologous cartilage was inserted and then was repaired using fibrin glue and inferior turbinate mucosa. The authors compared the perforation rate between the two groups. RESULTS: In Group 1, septal perforation occurred in 7 of 15 patients (46.7%) and in Group 2, 1 of 11 patients (9.0%) had perforation. Perforation rates were significantly lower in Group 2. CONCLUSION: The technique of using fibrin glue and inferior turbinate mucosa may be an easy, effective method for the prevention of septal perforation during septal surgery.

Activation of Lysozyme and Lactoferrin in Endolymphatic Duct of Rats / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Secretory activity, particularly of antibacterial agents such as lysozyme and lactoferrin, is an important aspect of the mucosal defense mechanism. The development of these agents may have a direct bearing on the susceptibility of the mucosa to infection. The antibacterial secretory enzymes such as lysozymes and lactoferrins are found in various mucosal tissues, and it has been suggested that these enzymes contribut to the defense against local mucosal infection. Specifically, lysozyme and lactoferrin are important components of innate immunity against pathogens at mucosal surfaces. The purpose of this study is to identify the distribution and expression of lysozyme, lactoferrin in endolymphatic duct of rat. MATERIALS AND METHOD: Normal rats (129P3/J, 10 cases) were used for this study. The expression level and distribution of lysozyme mRNA were analyzed by RT-PCR and quantitative image analysis. RESULTS: The expression of lysozyme and lactoferrin mRNA in endolymphatic ducts of rats was compared by quantitative image analysis. The results indicate that the relative expression of lysozyme mRNA resulted as 2.5 times greater than that of lactoferrin mRNA. CONCLUSION: The distribution and expression of lysozyme and lactoferrin in the endolymphatic duct of rat were identified. The study suggests that innate immunity such as lysozyme and lactoferrin are important components of defense mechanisms along with mucociliary clearance. Additionally, the authors think that the activity of lysozymes is more effective than that of lactoferrin in the endolymphatic duct of rat.

Inferior Turbinate Surgery for Chronic Hypertrophic Rhinitis: Comparison of Three Techniques / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Surgical reduction of the turbinate size is the treatment of choice for symptomatic hypertrophy of the inferior turbinate, which is unresponsive to medication. In the present series, three of techniques for the reduction of the size of the inferior turbinate were evaluated and compared. SUBJECTS AND METHOD: Sixty patients with chronic hypertrophic rhinitis which is refractory to medical therapy were divided into three groups, the submucosal resection with microdebrider (SMRM) group (20 patients), the radiofrequency-assisted partial turbinoplasty (RFAPT) group (20 patients) and the partial turbinectomy (PT) group (20 patients). Postoperative changes in degrees of nasal obstruction, minimal cross-sectional area and the volume of nasal cavity were evaluated prospectively at 3 months after operation. Operation time, postoperative pain, duration of crust formation and delayed bleeding were also compared. RESULTS: Nasal obstruction was improved significantly in all groups. In the SMRM and PT group, the degree of improvement was higher than that of the RFAPT group. In the RFAPT group, the operation time and duration of crust formation were shorter, and postoperative pain was less than those of the SMRM and PT group. In the SMRM group, the duration of crust formation was shorter than that of the PT group. CONCLUSION: This study suggest that SMRM is a more effective treatment of chronic hypertrophic rhinitis for patients with bony hyprtrophy, whereas RFAPT is better for patients with prominent mucosal hypertrophy.