Since the earliest report of success with the uvulopalatopharyngoplasty (UPPP) operation, several authors have reported less than optimal results in their experience with the procedure. Part of the difficulty in evaluating the objective results of postoperative sleep studies has been the variations in reporting data. In addition, no standard of postoperative care, including analgesia, and immediate postoperative monitoring has been described. Our experience with 42 UPPP patients (34 studied with preoperative and postoperative polysomnography) indicates a 76% response (56% successes, and an additional 20% with limited success) with use of the more stringent criteria described recently. We discuss our management of these cases, including postoperative oxygen saturation monitoring and avoidance of narcotic analgesia as necessary factors for success with this operation.

Perichondritis of the pinna is a serious late infection of burns involving the ear. The avascular nature of this injury renders systemic antibiotic therapy ineffective in delivering adequate levels of drug to the area to provide antimicrobial activity. Treatment has traditionally been surgery in some form, resulting in further disfigurement of the damaged cartilagenous framework. Iontophoresis, a method of dispersing charged particles through a relatively impermeable membrane by a light electrical field, appears to be a feasible method of antibiotic delivery. This initial pilot study investigated the development of perichondritic-like burns in ten rabbit ears, and techniques for gentamicin iontophoresis and assay in devitalized cartilage. Five rabbits, with ear burns simulating perichondritis, were treated with gentamicin iontophoresis on one ear and gentamicin-soaked gauze on the other. Resulting assays of the ear cartilages, after four treatments over a 2-day period, demonstrated a nearly twenty-fold increase in gentamicin levels in the iontophoresis-treated ears, compared to low levels in the soaked ears. Systemic absorption was negligible in all rabbits.