Objective To determine the test-retest reliability of drug-induced sleep endoscopy (DISE). Methods Prospective cohort study. Patients with OSA underwent two separate DISE examinations. The following outcomes were measured: a global assessment of obstruction at the palate and/or hypopharynx; the degree of obstruction at the palate and hypopharynx; and contribution of individual structures (palate, tonsils, tongue, epiglottis, and lateral pharyngeal walls) to obstruction. Results 32 patients underwent two separate DISE examinations. The apnea-hypopnea index was 40.7±21.1, and the lowest oxygen saturation was 79.8±17.4%. Point estimates for the intraclass correlation coefficient analogs related to palatal obstruction ranged from 0.41-0.89; related to the hypopharyngeal airway, the point estimates ranged from 0.57-0.84. Conclusion The test-retest reliability of DISE appears good, especially in the evaluation of the hypopharyngeal airway. Larger studies can generate more-precise confidence interval estimates and test the generalizability of these findings.

Routine panendoscopy of the upper aerodigestive tract in patients who have never smoked is unlikely to result in identification of synchronous second primary tumors.

The complete rhinoplasty surgeon must possess an understanding of functional nasal airway obstruction. An increasingly sophisticated grasp of the pathophysiology of fixed nasal obstruction has led surgeons to develop and refine surgical techniques aimed toward alleviating nasal valve insufficiency. This article reviews an assortment of techniques within nasal valve surgery, highlighting the underlying pathophysiology, anatomy, and technical considerations.

There is an unprecedented acceptance of rhytidectomy by today's society. No longer limited to the affluent few, middle class citizens are devoting their expendable income to achieve a more youthful appearance that is natural and inconspicuous. Despite recent difficult economic times, the mindset of the working population continues to be welcoming of rhytidectomy as a way to achieve a refreshed look while expecting minimal downtime and morbidity. To achieve these results, the current literature has described an array of techniques; however, there is no consensus on a preferred method, which reflects limitations and advantages inherent to every style of face-lifting. Each individual patient will have specific needs, and it is key for the facial plastic surgeon to select a technique that can address those areas most affected by the aging process. Whichever method used, an emphasis on safety is of the utmost importance. A solid understanding of the relevant anatomy is imperative as is the awareness of how to best avoid complications. Rhytidectomy can be a challenging procedure, and although complications are fortunately rare, they can be cosmetically devastating and poorly accepted by the elective cosmetic patient. This article aims at providing a summary of the history, the anatomy, and the currently accepted methods in rhytidectomy, emphasizing principles and practices of safety.

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