Patients with obstructive sleep apnea are at great risk of flavor disorders: a 15-year population-based cohort study.

OBJECTIVE: Obstructive sleep apnea (OSA) results from upper airway remodeling, which has been suggested to alter sensory and motor neuron function due to hypoxia or snore vibration. This study investigated whether OSA was associated with the risk of flavor disorder (FD). MATERIALS AND METHODS: Seven thousand and eight hundred sixty-five patients with OSA and 7865 propensity score-matched controls without OSA were enrolled between 1999 and 2013 through a nationwide cohort study. The propensity score matching was based on age, sex, comorbidities including hypertension, hyperlipidemia, chronic obstructive pulmonary disease (COPD), asthma, ankylosing spondylitis, and Charlson comorbidity index, and co-medications during the study period, including statins and angiotensin-converting enzyme (ACE) inhibitors. The adjusted hazard ratio (aHR) of incident FD following OSA was derived using a Cox proportional hazard model. A log-rank test was used to evaluate the time-dependent effect of OSA on FD. Age, sex, comorbidities, and co-medications were stratified to identify subgroups susceptible to OSA-associated FD. RESULTS: Patients with OSA were at a significantly great risk of FD (aHR = 1.91, 95% CI = 1.08-3.38), which was time-dependent (log-rank test p = 0.013). Likewise, patients with hyperlipidemia were at a significant great risk of FD (aHR = 2.99, 95% CI = 1.33-6.69). Subgroup analysis revealed that female patients with OSA were at higher risks of FD (aHR = 2.39, 95%CI = 1.05-5.47). CONCLUSIONS: Patients with OSA were at significantly great risk of incident FD during the 15-year follow-up period, especially in female patients with OSA. CLINICAL RELEVANCE: Timely interventions for OSA may prevent OSA-associated FD.

[Measurement of temporomandibular joint space of patients with obstructive sleep apnea hypopnea syndrome].

PURPOSE: This research evaluated the morphological differences of temporomandibular joint (TMJ) between patients with obstructive sleep apnea hypopnea Syndrome (OSAHS) and normal population using magnetic resonance imaging (MRI). METHODS: Eighteen OSAHS patients were admitted from January 2014 to May 2016 and 18 healthy adults were chosen as control. OSAHS patients were divided into three sub-groups (n=6), i.e. the mild group, the moderate group and the severe group, according to apnea and hypopnea index (AHI). All subjects underwent TMJ MRI for measurement of joint space. Statistical analysis was performed using SPSS 17.0 software package. RESULTS: There was no significant difference between the two groups in age, gender, superior joint space and displacement of condyle. The left anterior joint space [(2.63±0.18)mm vs (2.48±0.17)mm, P<0.05] and right anterior joint space [(2.63±0.18) mm vs (2.48±0.17) mm, P<0.05] of the TMJ of OSAHS patients was bigger than that of healthy people. The left posterior joint space [(2.43±0.20) mm vs (2.51±0.19) mm, P<0.05] and right posterior joint space [(2.44±0.20) mm vs (2.60±0.13) mm, P<0.05] of the TMJ of OSAHS patients was smaller than that of healthy people. The left anterior joint space [(2.53±0.26) mm vs (2.73±0.07) mm, P<0.05] and right anterior joint space [(2.54±0.11) mm vs (2.74±0.14) mm, P<0.05] of the TMJ of OSAHS patients in the mild sub-group was smaller than that of the OSAHS patients in the severe sub-group; the left posterior joint space [(2.56±0.29) mm vs ( 2.29±0.09) mm, P<0.05] and right posterior joint space of OSAHS patients in the mild sub-group was bigger than that of the OSAHS patients in the severe sub-group. CONCLUSIONS: The condyle of OSAHS patients is at the posterior position of glenoid compared with heath people. The tendency of posterior position of condyle at glenoid is related to the severity of OSAHS.

[Clinical manifestation and diagnosis of non-Hodgkin's lymphoma (NHL) in head and neck : analysis of 138 cases].

PURPOSE: To analyze the clinical features, pathological classification, causes of misdiagnosis, treatment and prognosis of non-Hodgkin's lymphoma (NHL) originated in head and neck and to afford experience in early diagnosis and treatment. METHODS: The clinical manifestation , treatment and prognosis of 138 cases of primary head and neck NHL were studied retrospectively. RESULTS: The incidence in male was higher than that in female (male:female=1.26:1). Among non-Hodgkin's lymphomas, 86.2% were neoplasms originating from B lymphocytes,which was remarkably higher than those originating from T lymphocyte(13.8%). The early symptom was mainly painless mass(71.7%). The primary location was in the following order: cervical region, submandibular region , parotid gland, skin of face, maxilla and mandible, tongue and palate. The main treatment was multimodal therapy(chemotherapy and operations).The five- year survival rate was 59.4%. CONCLUSIONS: The clinical manifestation of head and neck NHL is not specific and has a high misdiagnosis rate,so we must pay more attention to improve the early diagnosis and treatment of NHL.

[Comparison of therapeutic efficacy between surgical and non-surgical treatment on mandibular condylar fractures].

PURPOSE: To compare the therapeutic efficacy between surgical and non-surgical treatment on mandibular condylar fractures. METHODS: Patients with mandibular condylar fractures who were treated in our department with complete record from January, 1987 to June, 2009 were collected in this study. We conducted a retrospective analysis on the pathogenic factor, type, treatments and therapeutic efficacy of mandibular condylar fractures to compare the therapeutic efficacy between surgical and non-surgical treatment. RESULTS: A total of 228 patients were included in this study,among which 130 patients were treated by surgical procedure and the other 98 patients were treated by non-surgical treatment. All the patients were followed up for 1.5 years at average. Postoperative opening wide in the midline, occlusal relation and radiographs were examined to evaluate the therapeutic efficacy. Both surgical and non-surgical treatment showed good result. CONCLUSIONS: Surgical and non-surgical treatment for mandibular condylar fracture can achieve good results, when indication is selected appropriately. Non-surgical treatment is acceptable for young children or preschool children, whose mandibular condylar can accommodate well because of their vigorous growth and development and reconstruction function.

[Changes of the ultrastructures of temporomandibular joint after removal of emotional stress factors in rats].

OBJECTIVE: To examine the changes of the ultrastructures of temporomandibular joint after removal of the emotional stress factors in rats. METHODS: Thirty-two 12-week-old male Wistar rats were divided into two groups randomly, experimental group and control group. Each group was divided into two subgroups according to execution time, 9-week subgroup and 12-week subgroup with eight rats in each subgroup. Chronic unpredictable stress animal model were firstly established in experimental group in the first 6 weeks, then all the stimulation factors removed and breed normally. After 9 weeks, rats in 9-week subgroup were killed. After 12 weeks, rats in 12-week subgroup were killed. All condyles and articular discs were dissected and observed by scanning electron microscope. RESULTS: There was some recovery in condyles and articular discs in experimental group under scanning electron microscope. The gelatum on the surface of condyles increased, collagen fibrils became regular and deep layer collagen fibrils less exposed. There were no such obvious changes on the surface of condyles and articular discs in control group. CONCLUSIONS: The ultrastructure injures of temporomandibular joint in rats induced by emotional stress could be reversed if the stress factors were removed.

[Bone density and biomechanics study of alveolar ridge augmentation with titanium nickel shape memory alloy distractor and acellular dermal matrix].

OBJECTIVE: To observe the dynamic changes of bone density and bone strength after alveolar ridge augmentation with Titanium Nickel shake memory alloy (TiNi-SMA) distractor and acellular dermal matrix (ADM). METHODS: Twelve adult healthy male dogs were selected. After the animal model of alveolar atrophy was set up, on one side of mandible, two S-shaped distractors were placed. The diameter of S-shaped distractor was 1 mm and the rebound temperature was 33 degrees C. The ADM was placed on the distraction gap and fixed by the feet of distractors. The other side was placed only with distractors, serving as control side. Six dogs' mandibles were harvested after 1 and 3 months respectively. Dual energy X-ray absorptiometry (DEXA) was used to scan bone density around the distraction gap. Mechanical machine was used to test compression strength and elastic modulus. RESULTS: Months after distraction, the bone density of upper distraction gap, distraction gap and low distraction gap were respectively (0.714 +/- 0.238) g/cm2, (0.512 +/- 0.435) g/cm2 and (0.615 +/- 0.043) g/cm2 on experimental side. The compression strength and elastic modulus were (36.54 +/- 7.32) MPa and (1674.10 +/- 256.43) MPa. All of above were higher than those of control side. CONCLUSIONS: ADM can improve the bone quality, increase bone density and intensity and is an ideal guided bone regeneration(GBR) membrane for alveolar ridge augmentation with TiNi-SMA distractor.