This is the first reported case of malignant immature teratoma to involve the larynx, trachea, and recurrent laryngeal nerve in an adult patient, and the first single-stage technique described to use free tissue transfer without prefabrication for a 7-cm airway defect.
Hepatic echo patterns and "right lobe to left lobe longitudinal diameter ratio" were compared in age- and sex-matched 100 normal subjects and 76 patients with diffuse liver diseases (38 cirrhotics and 38 noncirrhotics) in a prospective sonographic study. Various echo patterns, assigned to cirrhotic livers (bright liver, micronodulation, beam attenuation), could not differentiate cirrhosis from other diffuse liver diseases. In cirrhotic livers, the right lobe manifested a significant shrinkage, while the left lobe exhibited almost no alteration. Considering the right to left lobe ratio of 1.30 as a discriminatory value, the cirrhosis could be diagnosed with a sensitivity of 74%, a specificity of 100%, and an accuracy of 93%; the sensitivity rates were seen to be higher in postnecrotic cirrhosis than in alcoholic cirrhosis.
ObjectivesObstructive sleep apnoea is a common chronic sleep disorder characterised by collapse of the upper airway during sleep. The nasal airway forms a significant part of the upper airway and any obstruction is thought to have an impact on obstructive sleep apnoea. A systematic review was performed to determine the role of rhinological surgical interventions in the management of obstructive sleep apnoea.MethodsA systematic review of current literature was undertaken; studies were included if they involved comparison of a non-surgical and/or non-rhinological surgical intervention with a rhinological surgical intervention for treatment of obstructive sleep apnoea.ResultsSixteen studies met the selection criteria. The pooled data suggest that there are reductions in the apnoea/hypopnea index and respiratory disturbance index following nasal surgery. However, the current body of studies is too heterogeneous for statistically significant meta-analysis to be conducted.ConclusionNasal surgery may have limited benefit for a subset of patients based on current evidence.
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