A new palatal procedure for snoring/obstructive sleep apnea (OSA) is described. The procedure was named as barbed reposition pharyngoplasty (BRP). The technique is described step by step. The new surgical technique was carried out in ten adult OSA patients with mean age of 53.4 ± 12.4 years (average 30-70) with confirmed retropalatal obstruction. In this pilot study; we assessed the feasibility by calculating the number of cases that failed to be operated and converted to other palatal technique during the same surgical setting, safety was assessed by evaluating both intra-operative and post-operative complications, teachability measured by the learning curve of our team members (the time of surgical procedure). In this study, the technique is proved to be feasible in all cases. There were no significant intra-operative or post-operative complications. Objective clinical improvement was confirmed by polysomnography 6 months post-operative with significant decrease in mean AHI from 43.65 ± 26.83 to 13.57 ± 15.41 (P = 0.007), daytime sleepiness assessed by Epworth Sleepiness Scale from 11.6 ± 4.86 to 4.3 ± 2 (P < 0.01), ODI from 44.7 ± 27.3 to 12.9 ± 16.3 (P = 0.004). Operative time decreased over the course of the study with an initial steep ascent in technical skill acquisition followed by more gradual improvement, and a steady decrease in operative time to as short as 20 min. Our preliminary results suggest that BRP technique is feasible, safe and effective in management of OSA patients. Moreover, it is easy to learn even for not experienced surgeons, less time consuming and with no significant complications.

The aim of this study was to evaluate outcomes related to swallowing function in patients who underwent transoral robotic surgery (TORS) for sleep apnea on both short- and long-term scales. 78 patients who underwent TORS for sleep apnea between 2011 and 2014 were followed up for an average period of 20 ± 7.12 months (range 7-32 months), then swallowing outcomes determined by MD Anderson Dysphagia Inventory (MDADI) questionnaire, gastrografin fluoroscopy imaging results, nasogastric tube dependence and subjectively by recording the patients' complaints were analyzed and reported. Minimal insignificant short-term impact on swallowing function (4.58 ± 7.03 preoperative MDADI score versus 5.18 ± 8.32 post-operative) (p = 0.56) was registered. Mean time for start of oral feeding was 1.05 ± 0.25 days (average, 1-3). In no case nasogastric tube feeding was required. Only five patients (6 %) showed significant aspiration on gastrografin fluoroscopy examination after 1 week; there was no significant correlation between the volume of tissue removed from both tongue base and epiglottis to the incidence of aspiration as shown by gastrografin fluoroscopy examination (p = 0.72). No long-term swallowing complaint was registered. Patients who underwent TORS tongue base reduction and supraglottoplasty for sleep apnea proved to have a reasonable short-term swallowing outcomes with no long-term sequelae.

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Introduction Coronavirus disease 2019 (COVID-19) has dramatically spread all over the world, crossing the borders of all countries. It is presented mainly by lower respiratory tract symptoms such as fever, cough, dyspnea, and chest tightness. However, COVID-19 causes different upper respiratory tract-related symptoms including nasal congestion, sore throat, and olfactory dysfunction. Objective To discuss different ear, nose and throat (ENT) manifestations in COVID-19-positive patients and their relation to other manifestations and to the severity of COVID-19. Methods We detected ENT manifestations in polymerase chain reaction (PCR)-confirmed positive COVID-19 patients at Zagazig Isolation Hospitals (Zagazig University hospitals, Zagazig Chest hospital, Al-Ahrar hospital, and Zagazig Fever hospital) with proportional allocation in the period from April 15 to June 15, 2020. All patients were subjected to full history taking and COVID-19 was categorized into 4 classes of severity after all patients underwent computed tomography (CT) of the chest. Afterwards, the collected data was analyzed and compared. Results Among the included 120 COVID-19 patients, the most frequent reported ENT manifestations were; sore throat (30%), nasal congestion (28.3%), nasal obstruction (26.7%), sneezing (26.6%), headache (25%), smell and taste dysfunction (25%), rhinorrhea (20%), upper respiratory tract infection (URTI) (15%), and tonsil enlargement (10%). The most common non-ENT manifestations were fever (88.3%), cough (63.3%), and dyspnea (45%). Conclusion Fever and cough are the dominant symptoms of COVID-19, but ENT manifestations for COVID-19 are common and should be a part of the suspected clinical criteria for COVID-19, particularly if the nasal examination was nonsignificant. The most common symptoms are sore throat, followed by nasal congestion and obstruction, headache, and lastly, olfactory dysfunction.

Introduction Anosmia is one of the common symptoms of COVID-19, the link between severity of chest infection and anosmia was investigated by few studies. Objectives To find an association between anosmia and severity of chest infection. Methods An analysis of patients admitted to isolation hospital of our university with confirmed polymerase chain reaction positive testing for COVID-19, between March 2021 until September 2021. We called all patients who reported anosmia during their time of illness and asked them about anosmia. We examined their chest CT. A statistical analysis was done. Results A total of 140 patients completed the study; 65% were female and 56.4% had complete anosmia. Anosmia was significantly associated with loss of taste. Smell returned in 92.5% of anosmic patients. Duration of smell loss was ∼ 2 weeks in 40.5%. The most common symptoms associated with anosmia were running nose, sore throat, fever, and cough. Loss of smell was significantly associated with mild chest disease. 73.4% of anosmic patients had mild chest infection, 21.5% of them had moderate infection, and 5.1% had severe chest infection. Conclusion The pattern of anosmia in COVID-19 patients has some common similarities in general; the way it starts, the associated symptoms, the time until smell returns and, the most important, the severity of chest infection. As anosmia is significantly associated with mild chest infection. the presence of anosmia could be an independent predictor of good COVID-19 outcome as reflected by a lower disease severity and less frequent ICU admissions.