Comparison of postoperative pain scores and dysphagia between anterior palatoplasty and uvulopalatal flap surgeries.

BACKGROUND: Dysphagia and pain are most common problems after soft palate surgery in obstructive sleep apnea (OSA) patients. OBJECTIVE: The aim of this study was to compare the postoperative pain scores and presence of dysphagia in patients who underwent anterior palatoplasty (AP) or uvulopalatal flap (UPF) surgeries. MATERIALS AND METHODS: In this prospective study, AP or UPF was performed on the patients with mild or moderate OSA. Daytime sleepiness of all patients was evaluated with Epworth sleepiness scale (ESS). Snoring, pain and dysphagia complaint of the patients was evaluated with visual analog scale (VAS). RESULTS: In both AP and UPF groups, VAS snoring and ESS scores decreased significantly after operation. VAS pain and dysphagia scores were determined to be significantly higher in UPF compared with the AP. CONCLUSION AND SIGNIFICANCE: Since the success rates of surgical interventions to the soft palate are similar, preferring surgical approaches with a less damage to the life quality of patients after operations is more rational. In this regard, AP, which is technically quite simple with a short operation time and fewer postoperative complaints affecting life quality such as pain or dysphagia may be preferred in selected patients with OSA.

The effects of anterior palatoplasty on floppy eyelid syndrome patients with obstructive sleep apnea.

OBJECTIVES/HYPOTHESIS: To investigate the effects of anterior palatoplasty on the presence and stage of floppy eyelid syndrome (FES) among patients diagnosed with mild or moderate obstructive sleep apnea (OSA) according to the apnea-hypopnea index (AHI). STUDY DESIGN: Prospective controlled trial. METHODS: Those patients whose AHI scores were between 5 and 30 according to full-night polysomnography were included in the study. The patients in whom anterior palatoplasty was performed were included in the study group, whereas those refusing surgery comprised the control group. All patients were evaluated for the presence of FES. The sleep studies were repeated after the third postoperative month, and the results were statistically compared. RESULTS: Sixty-two patients were included in the study. Thirty-five patients who were treated with anterior palatoplasty comprised the study group, and 27 patients were included in the control group. In the surgically treated group, 60% (n = 21) had FES, whereas 55.5% (n = 15) of the control group had FES (P = .798). In the surgically treated group, the FES ratio decreased to 25.7% (n = 9) after the third postoperative month (P = .007). In surgically successful cases, the preoperative-postoperative oxygen desaturation index and preoperative-postoperative lowest oxygen saturation values were 11.755% ± 9.037% and 6.77% ± 5.362% (P = .04), and 86.1% ± 3.89% and 87.8% ± 2.85%, respectively (P = .124). These values were 12.166% ± 5.767% and 14.780% ± 9.924% (P = .385), and 86.13% ± 4.18% and 85.26% ± 4.26%, respectively (P = .579), in patients who underwent unsuccessful surgery. CONCLUSIONS: FES presence and stages were decreased following successful anterior palatoplasty surgery. This effect may have resulted from the correction of tissue hypoxia, which is common in the pathophysiology of both OSA and FES. LEVEL OF EVIDENCE: 2b Laryngoscope, 126:2171-2175, 2016.

Atrophic rhinitis caused by Cedecea davisae with accompanying mucocele.

Atrophic rhinitis is a chronic inflammatory disease characterized by progressive atrophy of nasal mucosa. Cedecea davisae, a rare pathogen, is a new member of Enterobacteriaceae family. In this article, we report a patient with atrophic rhinitis whose culture test revealed Cedecea davisae. The patient was operated due to accompanying posterior ethmoid mucocele. Levofloxacin and nasal irrigation were administered for two months. Significant improvement was observed in patient's complaints and nasal signs at postoperative sixth month. In conclusion, Cedecea davisae has been thought to cause atrophic rhinitis and mucocele in this patient. Patient recovered with simple treatment. These bacteria should be kept in mind as a causative agent for atrophic rhinitis.