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The aim of this study was to introduce and assess a new minimally invasive expansion pharyngoplasty for obstructive sleep apnea (OSA) using bilateral new advancement sutures without tonsillectomy. Among 24 patients who had OSA with Friedman stage II or III and type I Fujita, bilateral sutures were performed to advance and stabilize palatopharyngeus and palatoglossus muscles anterolaterally. Mean apnea hypopnea index decreased significantly from 28.6 ± 4.2 preoperatively to 8.9 ± 4.9 postoperatively. The lowest oxygen saturation increased significantly from 79.25 ± 4.12 to 89.29 ± 4.12. Moreover, the visual analog score showed statistically significant reduction in the snoring intensity from a preoperative mean of 8.2 ± 1.4 to 2.1 ± 1.4 at 6 months postoperatively. Significant improvements were also documented in the Epworth Sleepiness Scale, as its mean decreased from 11.7 ± 2.9 preoperatively to 5.1 ± 2.2 postoperatively. In conclusion, the described new sutures could significantly correct OSA in patients with retropalatal obstruction and lateral pharyngeal walls collapse with easy applicability and no reported complication.

The described technique proved to be effective and easier, with good long-term satisfactory results in a large series of patients. This technique allows early use of both nasal passages for simultaneous endoscope and instrument insertion to excise both atretic plates without the use of stents or flaps.

Introduction The ability to treat fracture with open reduction and internal fixation (OR/IF) has dramatically revolutionized the approach to mandible fracture. With OR/IF, the postoperative role of rigid maxillomandibular fixation (MMF) has declined, but it is used to maintain proper occlusion until internal fixation of the fracture is achieved. Objective To assess intraoperative manual MMF during OR/IF of selected cases of mandibular fractures. Methods This prospective study was conducted on 80 patients with isolated mandibular fractures managed by OR/IF using two titanium miniplates. The patients were classified into two groups: a control group (40 patients) treated by OR/IF after intraoperative rigid MMF followed by immediate MMF removal, and a study group (40 patients) treated by rigid MMF, which was replaced by temporary intraoperative manual MMF (3MF) until plate fixation. Results There were no significant differences of the postoperative complication and dental occlusion, although a highly significant reduction of operative time was achieved in the 3MF group. Patient who received the 3MF technique had statistically significantly better average intrinsic vertical mouth opening in the early postoperative period (1 week after surgery), and normal mouth opening could be achieved in all cases in both groups 8 weeks after surgery. Conclusions Intraoperative rigid MMF is not mandatory and can be replaced in selected cases of fracture mandible by manual maintenance of proper dental occlusion until hardware fixation, gaining the advantages of shorter operative time and less risk of blood-transmitted diseases to the surgical team and the patient in addition to the benefits of immediate postoperative mandible mobilization.