The Clinical Effects of Laser Surgery in Simple Snorers on Polysomnography / 대한이비인후과학회지

OBJECTIVES: We aimed to evaluate the clinical effects of the recently developed laser surgery in patients who were diagnosed by polysomnography as simple snorers. MATERIALS AND METHODS: We operated on 35 patients with apena index of below 5, using CO 2 laser, from June, 1993 through May, 1994 at Yongdong Severance Hospital. For these patients, we carried out before and after assessments of three different kind: first, a follow-up assessment of subjective symptoms, such as snoring, daytime somnolence, nocturnal arousal, and headache; second, a psychodynamic analysis done by a psychiatrist on insomnia and depression: and third, an assessment of subjective atisfaction for 24 weeks following the surgery. RESULTS: Snoring improved in 74.2% of the patients, and daytime somnolence improved in 80.0% of the patients. Nocturnal arousal showed improvement in all the subjects whereas headache showed improvement in 66. 7% of the patients. In the psychodynamic analysis, insomnia as observed in 22.9% of the subjects, showing significant improvemnt. However, depression didn't improve significantly. Subjecive satisfaction of the surgery was noted to be the greatest at the fouth week of the operation but it gradually decreased thereafter. The most common postoperative complication was foreign body sensation (31.4%), which disappeared spontaneously within 3 to 6-months of the operation. CONCLUSION: Laser snoring surgery in simple snorers is found to be an effective method to lessen snoring. However, patients should be informed beforehand that this method of surgery may not fully meet their expectations.

Reversibility of Ultrastructural Changes of Cultured Human Nasal Epithelial Cells Induced by Tumor Necrosis Factor-alpha

Tumor necrosis factor (TNF)-alphacan induce ultrastructural changes in cultured human nasal epithelial cells. The aims of this study are to determine the recovery time from the changes induced by TNF-alphaand observe whether various degrees of changes will result in a complete return to normal status. The recovery of cilia was observed on the third day after cessation of adding TNF-alphaand the normalization of secretory cell area was observed on the fifth day. The morphologic changes induced by TNF-alpha were reversible except with the concentration of 100 ng/ml. The results suggest that the ultrastructural changes induced by TNF-alpha are mostly reversible and that this reversibility corresponds with the in vivo state.