Résumé
BACKGROUND AND OBJECTIVES: Nasal obstruction is common in patients with snoring and obstructive sleep apnea (OSA). A hypothesis has been reported that nasal obstruction causes more negative pressure in the upper airway and induces an inspiratory collapse at the pharyngeal level. We tried to assess the efficacy of the septal surgery on snoring and OSA by using portable polysomnography (PSG). MATERIALS AND METHOD: We reviewed 21 patients who had nasal obstruction and snoring. Septal surgery was performed. Each patient was assessed by pre and postoperative PSG. We measured respiratory distress index (RDI), apnea index (AI), oxygen saturation index (OSI) and the duration of the snoring. Selection criteriae were a RDI over 15 on the PSG, clinical nasal obstruction and deviated nasal septum by examination. RESULTS: After septal surgery, RDI decreased from 39 to 29 (p=0.0001). AI decreased from 19 to 16 (p=0.0209). OSI decreased from 48 to 32 (p=0.0001). The duration of the snoring decreased from 44% to 39% (p=0.1595). Snoring and OSA were completely relieved in 4 patients (19%) who didn't need any additional surgical therapy. CONCLUSION: Snoring and OSA can be corrected merely by the septal correction in some patient. And secondary surgery (uvulopalatoplasty) should be considered after thorough evaluation of postoperative PSG.
Sujets)
Humains , Apnée , Obstruction nasale , Septum nasal , Oxygène , Sélection de patients , Polysomnographie , Syndromes d'apnées du sommeil , Syndrome d'apnées obstructives du sommeil , RonflementRésumé
A carcinoma arising in the thyroglossal duct remnant is an unusual entity, especially in the young, and it constitutes less than 1% of all thyroglossal duct abnormalities. Clinically, it has been confused with benign tumor and is usually diagnosed postoperatively. Papillary carcinoma is the most common malignancy arising in the thyroglossal duct remnant. The recommended treatment is the Sistrunk procedure and the prognosis is excellent. We present a case report of a 10 years old girl and discuss the management and prognosis.