Obstructive sleep apnea: relationship of some clinical parameters to severity of the disease

Although essential before surgery, in-lab lysomnography and in-hospital sleep studies cannot be done indiscriminately for all patients with potential diagnosis of obstructive sleep apnea [OSA]. Some clinical parameters may be used to select patients for these studies, thus increasing their cost-effectiveness. Studying the relationship of body mass index [BMI], modified Mallampati index [MMI], tonsil size and thyroid-mental distance [TMD] to the grade of OSA. Tertiary referral hospital. Thirty consecutive patients [20 men and 10 women] in the age range of 30 to 60 years with snoring for at least 3 months and observed cessation of respiration during sleep were included. SAM[TM] monitor [Intercare Technologies, Inc, Milwaukee, WI] was used for an eight-hour in-hospital sleep study. There was a statistically significant relationship between BMI, MMI and tonsil grade and the grade of OSA [p=0.01, p=0.036, p=0.05 respectively]. No statistically significant relationship was found between TMD and grade of OSA [p=0.456]. In patients with potential diagnosis of OSA, BMI, MMI and tonsil size grade are helpful in selecting patients for in-hospital sleep studies

Micro debrider assisted FESS in Nasal polyposis surgery

This work was conducted on 40 patients with persistent sinonasal polyposis, despite a one-month trial of medical treatment. The patients were randomly assigned into two equal groups: Group A included 20 patients subjected to conventional FESS, while group B included 20 patients had their polyps removed by the use of microdebrider. Both groups were compared according to certain parameters including the intraoperative time, amount of blood loss, postoperative complication, postoperative healing and relief of symptoms. Microdebrider assisted FESS was found to decrease the intraoperative complications, has better postoperative healing and relief of symptoms

Intratympanic methylprednisolone acetate [MPA] in treatment of induced sensorineural hearing loss in guinea pigs: a scanning electron microscopic study

This study was carried out to evaluate the effect of intratympanic steroid injection in treatment of induced sensorineural hearing loss in guinea pigs using scanning electron microscope. This work was conducted on 25 healthy guinea pigs with normal eardrum, preserved pinna reflex. The animals were divided into five groups: Control group, steroid group to evaluate the effect of intratympanic methylprednisolone acetate [MPA] injection by scanning electron microscope [SEM], noise group to demonstrate the scanning electron microscopic pictures immediately after the acoustic trauma, noise plus time group to evaluate effect of induced sensorineural hearing loss using micromotor drill against the body of incus by SEM and noise plus MPA group to evaluate the effect of MPA after 12 days from induced sensorineural hearing loss by SEM. The results showed that MPA had no damaging effect on inner ear structure, noise plus time group showed significant improvement but scar formation was noticed, while noise plus steroid group showed significant improvement with near normal pictures. It was concluded that MPA is a definite treatment of induced sensorineural hearing loss

role of pharyngo-esophageal manometery in the evaluation of dysphagia in patients with multinodualr goiter

The incidence of dysphagia was reported in up to 35% of goiter patients with mild to moderate severity. Pharyngo-esophageal manometry is a diagnostic test that provides both quantitative and qualitative assessment of pressure, coordination and motility for both the pharynx and esophagus

Intratympanic instillation of gentamicin: an alternative to surgery in the treatment of unilateral Meniere 's disease.

To evaluate the use of intratympanic instillation of gentamicin in 40 patients with unilateral Meniere's disease [MD] who become eligible for the evaluation of treatment efficacy according to the guidelines set by the American Academy of Otolaryngology, Head and Neck Surgery [AAO-HNS]. An initial ventilation tube was inserted in the affected ear, followed by a weekly instillation of 40 mg of gentamicin until the symptoms disappear. An objective evaluation using caloric and videonystagmography [VNG] was used for the follow up. Vertigo control was achieved in 78% of the patients. A predetermined maximum of four instillation sessions was set to prevent the sensorineural hearing loss. An 18-month follow up was reported. The intratympanic instillation of gentamicin showed an adequate vertigo control with few side effects and is considered a good alternative to surgical treatment