ABSTRACT
PURPOSE: Learning how to use barbed sutures and perform Barbed Pharyngoplasty (BP) is challenging due to limited surgical training opportunities. This work aims to design, develop, and validate a new 3D surgical simulator to train ENT residents and specialists in performing BP. METHODS: The Barbed Pharyngoplasty Simulator (BPS) was designed using diagnostic images of the facial mass and testing different materials to replicate the mucosal and bony tissues. ENT specialists with experience in BP and ENT residents were included in the validation study and were asked to perform the Alianza BP. After the simulation, they compiled the Face and Content Validity Questionnaires. RESULTS: The BPS consists of a reusable cranial structure that contains the disposable palatopharyngeal structure, replicating the palatal structures and the tongue. Fifteen experienced ENT specialists and nine residents were included in the study. Findings demonstrated that the BPS faithfully replicated the muscular and fibrous-bony palatopharyngeal structures, with only 11% of residents having a negative opinion of the mucosal tissue. All the participants positively rated the sensation of using surgical instruments on the simulator. Also, ENT residents rated all aspects of the content validity test from normal to excellent, while specialists rated the BPS as a general training tool from normal to excellent; for lateral pharyngoplasty, BP, and Alianza, only 6.7% of participants disagreed with its usefulness, and 13.3% disagreed with it for anterior pharyngoplasty. CONCLUSION: The BPS proposed in this preliminary study can potentially be a valuable tool in BP surgical training for residents and young otolaryngologists.
ABSTRACT
INTRODUCTION: Polysomnography is the gold standard for diagnosing sleep-related breathing disorders. Respiratory pulse oximetry can be used for screening, and several pre-screening questionnaires are available to assess the risk of obstructive sleep apnea. STOP-BANG questionnaire is simple and effective according to the literature. OBJECTIVE: Investigating the effectiveness of the STOP-BANG questionnaire for screening benign snoring and mild obstructive sleep apnea. METHOD: We analyzed the data of patients examined in our department for suspected sleep-related breathing disorder between 20. 06. 2021 and 19. 03. 2022. We compared the subsequently calculated STOP-BANG scores to the respiratory pulsoximetry results. Due to the lack of information regarding the intensity of snoring, the analysis was performed both with positive and negative results for this criterion. Sensitivity, specificity, positive and negative predictive values were calculated. RESULTS: We analyzed the data of 36 patients, one of them was examined twice due to weight loss. Benign snoring was confirmed by 19 patients, mild obstructive sleep apnea in 9, moderate in 4, and severe in 5 cases. Assuming loud snoring, the sensitivity was 100%, the specificity 21%, the positive predictive value 29%, and the negative predictive value 100%. Assuming no loud snoring, the sensitivity was 100%, the specificity 54%, the positive predictive value 41%, and the negative predictive value 100%. CONCLUSION: STOP-BANG questionnaire is effective, and can also be used in primary care to screen benign snoring and mild obstructive sleep apnea. Unnecessary device tests can be reduced by using it, resulting in significantly shorter waiting times for the sleep tests for high-risk patients. Orv Hetil. 2023; 164(7): 265-272.
