Is there a relationship between tonsil volume and the success of pharyngeal surgery among adult patients with obstructive sleep apnea?

xlomafota13 shared this article with you from Inoreader Is there a relationship between tonsil volume and the success of pharyngeal surgery among adult patients with obstructive sleep apnea? Via Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial Braz J Otorhinolaryngol. 2022 Jan 4:S1808-8694(21)00214-7. doi: 10.1016/j.bjorl.2021.12.002. Online ahead of print. ABSTRACT OBJECTIVES: Hypertrophic palatine tonsils play a role in the blockage of the upper airway, one of the known causes of Obstructive Sleep Apnea (OSA). Therefore, it is possible that there is an association between tonsil size and the success of pharyngeal surgery during OSA treatment. The main objective of this study was to evaluate the relationship between tonsil grade and volume, as well as to establish whether a relationship exists between tonsil size and the success rate of pharyngeal surgery (tonsillectomy and pharyngoplasty with barbed sutures). METHODS: This retrospective study includes forty-four adult patients who underwent tonsillectomy and pharyngeal surgery with barbed sutures for the treatment of simple snoring and OSA between January 2016 and September 2019. Patients who had been previously tons illectomized or those for whom tonsil volume measurement was lacking were excluded. All patients underwent a pre-operative physical exploration at the clinic exam room and a sleep study. Prior to surgery a Drug Induced Sleep Endoscopy (DISE) was performed. Tonsil volume was measured intraoperatively using the water displacement method. The same sleep study was repeated six months following surgery. RESULTS: A significant correlation was found between tonsil grade and volume and between such measurements and the blockage observed at the level of the oropharynx during the DISE. Moreover, an association was observed between tonsil volume, but not tonsil grade, and the success of tonsillectomy and pharyngoplasty with barbed sutures. A tonsil volume greater than 6.5 cm3 was linked to success during pharyngeal surgery. CONCLUSION: A correlation exists between tonsil grade and tonsil volume. A bigger tonsil volume is associated with a greater success rate of orophary ngeal surgery during treatment of OSA. LEVEL OF EVIDENCE: Level 3, non-randomized cohort study. PMID:35184978 | DOI:10.1016/j.bjorl.2021.12.002 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cricotracheostomy in a patient with severe kyphosis: A case report

xlomafota13 shared this article with you from Inoreader Cricotracheostomy in a patient with severe kyphosis: A case report Via ear nose throat Ear Nose Throat J. 2022 Feb 21:1455613221077596. doi: 10.1177/01455613221077596. Online ahead of print. ABSTRACT Cricotracheostomy is a useful surgical procedure for opening the airway in cases where conventional tracheotomy is difficult. This is a safe and easy technique involving removal of the anterior portion of the cricoid cartilage. Herein, we report the case of a patient with difficulty in neck extension due to severe kyphosis, who underwent cricotracheostomy. A 65-ye ar-old woman developed dyspnea and was transported to our hospital. SpO2 was 60% (room air) and endotracheal intubation was performed. She was managed on ventilator. However, weaning off the ventilator was difficult, and endotracheal intubation was prolonged. Subsequently, the patient was referred to us for a tracheostomy. The patient was unable to maintain the supine position due to severe kyphosis, and computed tomography revealed that the brachiocephalic artery was running just below the thyroid gland. Therefore, conventional tracheostomy was difficult to perform, and we performed cricotracheostomy instead. After the cricotracheostomy, there were no tracheal problems, such as tracheal stenosis and stomal hemorrhage. Cricotracheostomy can be performed in cases where multiple anatomical difficulties may be faced in the tracheostomy site, as in this case. Furthermore, cricotracheostomy is beneficial for long-term airway management because it causes fewer complications com pared to conventional tracheotomy. PMID:35188407 | DOI:10.1177/01455613221077596 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.