Search

Objectives: Expansion sphincter pharyngoplasty is a well-known palatal correction surgery applied for obstructive sleep apnea patients. Even though high success rates are reported, in some patients, the desired outcome cannot be achieved. Therefore, patient selection is crucial to avoid undesirable outcomes. In this study we present our results with expansion sphincter pharyngoplasty, and we aim to show the difference between supine and non-supine apnea in terms of their response to the surgery, in order to utilize position dependency for selection of surgical candidates.Methods: Pre- and post-operative polysomnography results of patients who underwent expansion sphincter pharyngoplasty were analyzed retrospectively. Total AHI, supine AHI, non-supine AHI, supine/non-supine AHI ratio and surgical success values are compared.Results: 85 patients were included to the study. Mean AHI significantly decreased from 48.7 ± 27.99 to 26.37 ± 21.16 with the surgery. Surgical success rate was found to be 51.8%. Both supine and non-supine apnea decreased significantly with the surgery, but the decrease was significantly higher in non-supine apnea (20.6% to 39.1% respectively, p = 0.016). There was significant negative correlation between pre-operative supine to non-supine AHI ratio and the change in AHI, showing that supine dominant patients had less improvement with the surgery (r = 0.274, p = 0.01).Conclusion: Expansion sphincter pharyngoplasty is an effective surgery which achieves significant improvement in AHI. Non-supine respiratory events respond better to the surgery than supine events. [ABSTRACT FROM AUTHOR]

We discuss a case of lower lip carcinoma which presented with atypical symptoms; facial paralysis, conductive type hearing loss, and ophthalmoplegia. Due to an earlier resection, no mass was evident on the primary examination. Diagnostic imaging revealed a mass originating from the lower lip, the perineural spread of the tumor along the left inferior alveolar nerve to the left infratemporal fossa and the left foramen ovale. Through a retrograde course from the foramen ovale, the tumor extended the ipsilateral cavernous sinus, Meckel's cave, and cisternal portion of the CN V. This atypical spread pattern of the tumor caused symptoms that may be attributed to a diagnosis related to the ear. The biopsy confirmed squamous cell carcinoma, and the patient was referred for chemotherapy and radiotherapy. [ABSTRACT FROM AUTHOR]