ObjectiveRapid eye movement (REM)-related obstructive sleep apnea (OSA) is characterized by respiratory events such as apnea and hypopnea predominately or exclusively during REM sleep. Several studies have revealed clinical predictors of adherence to the use of continuous positive airway pressure (CPAP). However, the effect of REM-related OSA on adherence to CPAP use remains unclear. Therefore, we investigated the effects of REM-related OSA on adherence to CPAP use 6 months after treatment initiation.MethodsWe enrolled 161 patients in this study and divided them into 3 groups: the good adherence, poor adherence, and dropout groups. We compared polysomnographic data and clinical findings, including those regarding morbidity of REM-related OSA, among the three groups to identify predictors of adherence to CPAP use.ResultsNone of the 43 patients in the good adherence group had REM-related OSA. Multivariate logistic regression analysis of the good adherence and dropout groups indicated that REM-related OSA was the only factor associated with adherence to CPAP use (odds ratio, 41.984; 95% confidence interval, 2.257–781.007).ConclusionsREM-related OSA is a reliable risk factor for dropout from CPAP therapy.

There are some simplified devices for screening SAS. However, they have some problems as to a way to operate and disconnection of oro-nasal sensors in children. The simplified device that had used the multipoint pressure sensor seat (SD-101) recently was developed in Japan. For adults, the utility of SD-101 is reported. This study was performed to clarify the usefulness of SD-101 in detecting SAS in children. The infant (0-12 years old) from whom they consulted Sleep Disorders Center or otorhinolaryngology at Aichi Medical University hospital and SAS had been doubted was targeted between October 2005 and November 2009. The inspection was executed using PSG together with SD-101 under hospitalization and using another simplified device (LS-300) with SD-101 at house. The analysis of SD-101 was done by using software for adults and added to the manual correction. SD-101 judged apnea-hypopnea when the respiratory pressure changes decrease. The correlation was admitted in AHI of 31 examples that used PSG together with SD-101 (R 2 = 0.87). The cases who had used LS-300 together with SD-101 were 75 examples. AHI could not be obtained in the remaining 21 children with LS-300, but was obtained in all children with SD-101. AHI of SD-101 tended to go out to a low value compared with other methods. The high utility of SD-101 became clear. However, as there was a problem in the mode of analysis as well, it will be necessary to develop analytical software with the infant in the future.

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Primary and metastatic malignancies arising in the sinuses are rare and histologically diverse. The role of fine-needle aspiration cytology (FNAC) and the cytomorphologic characteristics of these tumors have not been specifically addressed. We described two cases of suspected malignant maxillary sinus tumors in 85- and 90-year-old patients with comorbid conditions, both of whom underwent tissue biopsies that failed to yield a definitive diagnosis. We performed FNAC after imaging confirmed that the malignant tumors were outside the maxillary sinus. The 85- and 90-year-old patients were diagnosed with squamous cell carcinoma (SCC) and adenocarcinoma, respectively. In the latter, the cell block method was used to prepare the specimen, rendering individual cells identifiable. Atypia of the histological structure was confirmed without the influence of cell duplication, a known weakness of FNAC. Thus, the diagnosis was made quickly. We believe that FNAC would be utilized more frequently for the definitive diagnosis of sinonasal tumors as the technique and diagnostic technology improve further.

Although LPR symptoms had no significant relationship with the findings of EE, hiatal hernia and edema of the interarytenoid mucosa were significantly related with EE and were considered to be independent predictors of EE.