Velopharyngeal surgical procedures may have adverse effect on the airway of the patients with velopharyngeal insufficiency (VPI). The aim of this study was to evaluate the polysomnographic parameters (PSG) in patients who underwent corrective surgery for treatment of VPI. The study included 39 patients who underwent 1 of 3 velopharyngeal surgical techniques; Furlow palatoplasty (12 patients), pharyngeal flap (18 patients), and sphincter pharyngoplasty (9 patients). The patients were subjected to PSG, and they were considered to have obstructive sleep apnea (OSA) with apnea-hypoapnea index (AHI) >1.Comparison of PSG parameters of patients showed insignificant difference regarding the total sleep time, sleep efficiency, arousal index, desaturation index, and minimum oxygen saturation. Significant difference was detected regarding peak end-tidal CO2 and AHI. Pharyngeal flap was detected as the most surgical technique that worsened the PSG parameters with OSA in 78% of patients, followed by sphincter pharyngoplasty with OSA in 56% of patients. Furlow palatoplasty was detected as the least impacting technique on the airway in 25% of patients who demonstrated OSA. In conclusion, velopharyngeal surgery has a variable impact on the PSG; pharyngeal flap has the most worsening effect followed by sphincter pharyngoplasty, while Furlow palatoplasty has the least adverse effect.
Oroantral fistula (OAF) is a pathologic communication between the oral cavity and the maxillary sinus. It is usually associated with maxillary sinusitis, where drainage of sinus infection is a mandatory step during closure of the fistula. The flap used for closure of OAF should be tension free, broadly based and well vascularized. The aim of this study was to assess the effectiveness of closure of OAF using buccal fat pad (BFP) flap with concomitant endoscopic middle meatal antrostomy for maxillary sinus drainage. Nineteen patients with chronic OAF were included in the study. Closure was performed using BFP with endoscopic middle meatal antrostomy. Preoperative and postoperative assessments were carried out. Patients were followed up for at least 1 year postoperatively. Complete closure of all OAFs was achieved with no recurrence or dehiscence. In conclusion, closure of OAF with BFP flap and concomitant endoscopic drainage of the maxillary sinus through the middle meatus is an effective, easy, and simple method. It has a high success rate with no effect on the vestibular depth or mouth opening.
Background Evidence of systematic relationships between the perceptual characteristics of tinnitus, like its pitch or loudness, and those of the absolute hearing threshold curves, like the presence and degree of hearing loss at certain frequencies, would probably help to understand how tinnitus is related to the configuration of hearing loss. Objective The objective of this study was to determine the effects of hearing aid fitting on the perceptual characteristics of tinnitus. Participants and methods The participants of the study were 50 adults (20-60 years old) with subjective tinnitus and different degrees of hearing loss. Otorhinolaryngological examination, tonal audiometry, and acoustic immittance testing were done. Participants answered Tinnitus Handicap Inventory (THI) Questionnaire at the time of the first fitting with their hearing aid and performed at 0, 3, 6, and 12 months postfitting. Results THI showed a significant decrease throughout the 12 months from 74.80±15.98 at baseline to 61.84±14.02 3 months later, then 38.35±10.98 by the sixth month and 12.90±4.26 by the end of 12 months. At the baseline, no slight or mild cases were detected, whereas moderate THI represented 16%, severe 28%, and catastrophic 56%. These rates changed 3 months later as catastrophic cases decreased almost to one-third of its rate at the baseline. By the sixth month, no catastrophic cases were detected and severe stages recorded trivial rates, whereas most of cases were categorized as mild or moderate. By the end of the study, the great majority of cases were slight (81.6%) and the remaining portion was mild, with no moderate, severe, or catastrophic cases recorded. Conclusion Analysis of the results has shown that the use of hearing aids are one of the number of therapeutic options offered to tinnitus patients and promote the improvement in the perceptual characteristics of tinnitus.
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