Eye diseases associated with obstructive sleep apnea syndrome in an Asian population.

Background: Sleep apnea syndrome is one of the leading causes of excessive daytime sleepiness. There is no literature exploring the prevalence of sleep-associated disorders in the eye of Asians with obstructive sleep apnea syndrome (OSA). Objective: Study the prevalence of eye abnormalities in Asian patients with OSA. Material and method: Asian patients with definite OSA diagnosis via the polysomnography were recruited into the study. Complete eye examination and special investigations were performed to define eye diseases: floppy eyelids, dry eyes, keratoconus, Fuchs’ endothelial dystrophy, recurrent corneal erosions, open-angle glaucoma, ophthalmoplegia, papilledema and optic neuropathy. Results: One-hundred Asian OSA patients were examined. We found that floppy eyelids, dry eyes, and normal tension glaucoma were more prevalent compared to the normal population. Abnormal endothelial change and papilledema were detected. Optic neuropathy and ophthalmoplegia were not found in this study, although some patients did have subnormal contrast sensitivity. Conclusion: There is a higher prevalence of floppy eyelids, dry eyes, and glaucoma in OSA patients. Complete eye examination is recommended in OSA patients to detect early eye abnormalities.

Results of temperature-controlled radiofrequency tissue volume reduction for the turbinate hypertrophy.

OBJECTIVES: To assess the efficacy of temperature-controlled radiofrequency tissue volume reduction (RFTVR) for the inferior turbinate. RESEARCH DESIGNS: Prospective, single-blinded, experimental clinical trial. METHOD: Twenty patients with nasal obstruction secondary to inferior turbinate hypertrophy were enrolled. Nasal obstruction was compared between before and after the treatment (at 1-3 days, 1 week and 6-8 weeks) of RFTVR using subjective symptom scores, physical findings and videotape images. RESULTS: Improvement of nasal symptoms was observed as early as 1 week after the operation. However, significant improvement was obtained at 6-8 weeks. CONCLUSION: RFTVR for the turbinate may be useful as an alternative approach for the treatment of chronic turbinate hypertrophy.

Radiofrequency tissue volume reduction: suggested treatment for lymphatic malformation.

Lymphatic malformation is a benign congenital lesion but is often challenging to deal with. Complete excision is its treatment of choice. It has a high rate of recurrence, since a complete excision is difficult, and it may cause cosmetic or functional defect. Radiofrequency tissue volume reduction (RTVR) is used for the treatment of sleep-disordered breathing and other areas of surgery. A case of cervical lymphatic malformation reported here is effectively treated by radiofrequency without scar or any complication.

Recurrent epistaxis from an intranasal glomus tumor: the 22nd case report.

The case of a 66-year-old Thai woman who was treated at King Chulalongkorn Memorial Hospital due to recurrent epistaxis for two years is presented. Her physical examination revealed a 0.7-cm tumor mass on the right nasal septum. A biopsy was subsequently done and the tissue was sent for pathological examination. The lesion was then diagnosed as "glomus tumor of the nasal septum". Histologically, the tumor was rather well-circumscribed and located in the submucosal region. The neoplastic cells were uniform, round to ovoid in shape and contained bland-looking, finely chromatic nuclei and moderate amount of cytoplasm with ill-defined cell borders. These cells were intervened by tortuous vascular structures. Immunohistochemically, the tumor cells were strongly reactive to smooth muscle actin and negative to cytokeratin and S-100 protein. A glomus tumor is rare in the sinonasal region. So far, there have been only 21 reported cases in the literature. Almost all cases of sinonasal glomus tumor are benign and are usually cured by complete excision.

A comparative study of diagnostic tests for tuberculous lymphadenitis: polymerase chain reaction vs histopathology and clinical diagnosis.

To compare diagnostic tests for tuberculous lymphadenitis by polymerase chain reaction (PCR) with histopathology and clinical diagnosis in sensitivity, specificity and predictive value. This retrospective analytic, single blind study was done at King Chulalongkorn Memorial Hospital. Paraffin-embedded specimens were classified into 2 groups. The study group contained 30 proved AFB positive paraffin-embedded specimens from patients who also had clinical diagnosis of tuberculosis and improved by antituberculous treatment. The control group contained 30 formalin-fixed, paraffin-embedded specimens of lymph node hyperplasia proved by histopathological and clinical review. All 60 specimens were slided, and systematically labeled and sent to PCR lab. Polymerase Chain Reaction method had sensitivity = 43.33 per cent, specificity = 100 per cent, positive predictive value = 100 per cent and negative predictive value = 63.83 per cent. The present findings revealed that the PCR results were related to the age of the paraffin-embedded tissues. No positive results were obtained from tissues kept since 1996. Positive results were obtained in 3/7 cases (42.86%), 2/3 (66.67%) and 8/10 cases (80%) from tissue of 1997, 1998 and 1999 respectively. Conclusion: Polymerase chain reaction has sufficient reliability best as a confirmatory diagnostic test for tuberculous lymphadenitis; however, it is not appropriate as a screening test.