RESUMO
Objective: Vaginal agenesis or atresia in females suffering from MRKH syndrome is more common and management involves both surgical and non-surgical approaches. Use of prefabricated stents to maintain the patency of the canal may not fit appropriately during the initial surgical phase and are not economical. This case report discusses a series of modifications in a custom-made vaginal dilator to improve the retention for expansion after surgical management of MRKH syndrome. Case report: A 28-year-old female diagnosed with MRKH syndrome with characteristic Mullerian agenesis was referred for customised vaginal stent. Customised surgical stent was fabricated with loops for orientation and retention, which was later modified into interim expansion and passive stent. Conclusion: The customisation of the vaginal stent, provision of a retentive loop that positioned the stent in the proper orientation, and gradual increase in the size of the stent, ensured dilatation in a patient with vaginal agenesis.
RESUMO
BACKGROUND: Obstructive sleep apnea (OSA) was estimated to affect 15% to 30% of males and 5% to 15% of females with prevalence increasing with progressive tooth loss and its early identification can reduce the sequalae of OSA. Apnea-hypopnea index is confirmatory but unsuitable for clinical settings to detect OSA and concise screening tools are required to detect OSA in edentulous patients. AIM: To evaluate the impact of soft palate visibility and tongue position on incidence of OSA among edentulous patients. METHODOLOGY: Thirty two edentulous participants aged between 30 and 65 years were grouped as partially edentulous (PE) and completely edentulous (CE). STOP-BANG Questionnaire (SBQ) was used to assess the scores in OSA risk factors. Mallampati score assessed soft palate visibility. Wright's Classification graded tongue position. Spearmann test evaluated the correlation between the soft palate visibility and tongue position on the OSA scores. Mann-Whitney U test evaluated influence of tooth loss and gender on OSA scores. RESULTS: Positive correlation existed between Mallampati scores, Wright's classification and OSA scores (p < .05). CE participants and male participants had more OSA scores at (p < .05) and (p < .01). CONCLUSIONS: SBQ and Mallampati score can assist in chairside screening of OSA. Early screening for OSA in edentulous patients will direct for early intervention and prevent unforeseen sequalae.
