Laser-assisted uvulopalatoplasty for snoring: does it meet the expectations?
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The high prevalence of habitual snoring (35% of the general population) and the increasing demand for an effective treatment have led, in the last decade, to the generalisation of laser-assisted uvulopalatoplasty (LAUP). However, acceptable studies on its effectiveness are lacking. The present randomised, placebo-controlled study included 25 nonapnoeic and mild obstructive sleep apnoea snorers to evaluate LAUP effectiveness for snoring. Group I received a one-stage LAUP treatment and group II a placebo (simulated snore surgery followed by an oral placebo). Before each treatment and 3 months after, the variables and procedures assessed were: body weight; sleepiness (Epworth sleepiness scale); quality of life (SF-36); subjective snoring intensity (0-10 analogue scale); objective snoring intensity (average decibel intensity); snoring index (number of snores per hour); and apnoea/hypopnea index. No differences were observed in body weight, sleepiness, quality of life, subjective and objective intensity, and frequency of snoring, and apnoea/hypopnea index between the groups before and 3 months after treatment. In conclusion, this study provides evidence of the lack of effectiveness of one-stage laser-assisted uvulopalatoplasty for snoring in nonapnoeic and mild obstructive sleep apnoea patients, with the result that it does not meet the expectations generated by the procedure. (+info)
Uvular edema secondary to snoring under deep sedation.
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A 57-year-old male with a documented history of obstructive sleep apnea with loud snoring received deep intravenous sedation with midazolam, fentanyl, ketamine, and propofol infusion and a left interscalene brachial plexus nerve block for a left biceps tendon repair. Loud snoring during the case was noted. On the second postoperative day, he was observed to have significant uvular edema. After due consideration of the various elements in the differential diagnosis, it was concluded that negative pressure trauma from deep snoring during the sedation was the most likely etiology. (+info)
Topography and axonal collaterals of trigeminocerebellar projection to the paramedian lobule and uvula in the rabbit cerebellum.
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To study projections of the trigeminal sensory nuclei (TSN) to the rostral parts of the paramedian lobule (PML) and of the uvula of the rabbit cerebellar cortex, the retrograde double fluorescent labeling method was used. Injections of Fast Blue (FB) into PML and Diamidino Yellow (DY) into the uvula, resulted in prominent labeling neurons with FB bilaterally and with DY ipsilaterally, in the principal trigeminal nucleus, subnucleus oralis, and rostral and caudal subnucleus interpolaris. We observed topographical arrangement of neurons in such a fashion that FB labeled cells were localized in the medial and DY labeled cells in the lateral regions of TSN. Apart from this small number of double FB+DY labeled neurons (n = 138) were found in the narrow common region of single labeling. This implies that PML and the uvula receive independent trigeminal sensory information from neurons in separate regions of TSN. However, some trigeminal neurons may also exert simultaneous influences upon these hemispheral and vermal components by way of axonal branchings. (+info)
A comparative study between ketorolac and ketoprofen in postoperative pain after uvulopalatopharyngoplasty.
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Postoperative pain is a serious problem, requiring an appropriate response from the medical doctor. In otolaryngology special attention is needed after uvulopalatopharyngoplasty (UP3). AIM: To compare the efficacy of postoperative analgesia using ketorolac and ketoprofen after UP3. PATIENTS AND METHODS: A prospective, randomized, double-blind study was made of 24 patients that were divided into 2 groups (14 received ketorolac and 10 received ketoprofen). Pain intensity was based on an analog visual scale and the need for opioids (tramadol). RESULTS: Of the 13 patients that received ketorolac, 3 (21%) required opioids; 7 of 10 (70%) patients in ketoprofen group used opioids. 12 hours after surgery, 71% of the patients that received ketorolac had mild or absence of pain. 70% of the ketoprofen users reported moderate to significant pain. 24 hours after surgery, 60% of the patients using ketoprofen reported moderate to significant pain, while 86% of the ketorolac users reported mild or absence of pain. CONCLUSION: We concluded that ketorolac is more effective compared to ketoprofen in the treatment of immediate postoperative pain after UP3, as patients using ketorolac had less pain and used opioids to a lesser degree. (+info)
A Japanese family of typical Loeys-Dietz syndrome with a TGFBR2 mutation.
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This report describes a Japanese family with vessel and craniofacial abnormalities. Although the clinical findings of the patient's father fulfilled the diagnostic criteria for Marfan syndrome, arterial tortuosity, aneurysms, hypertelorism and a bifid uvula were noted in both the patient and his father. These findings were compatible with the clinical manifestations that were previously reported in Loeys-Dietz syndrome. A molecular genetic analysis demonstrated a heterozygous missense mutation of the transforming growth factor-beta receptor II gene in both the patient and his father, which thus caused Loeys-Dietz syndrome. This is the first Japanese family case report of typical Loeys-Dietz syndrome. (+info)
Cervical CT derived neck fat tissue distribution differences in Japanese males and females and its effect on retroglossal and retropalatal airway volume.
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