Cases reported "Snoring"

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1/25. Polysomnographic and urodynamic changes in a case of obstructive sleep apnea syndrome with enuresis.

    A 53-year-old female patient with obstructive sleep apnea syndrome was reported. She had complained of enuresis as well as a 15-year history of snoring, but she had no complaint of sleep and awake disturbance. Polysomnographic study showed repeated obstructive apnea and hypopnea with an apnea/hypopnea index of 52.6, and severe oxygen desaturation during sleep. On cystometography during sleep, the changing amplitude of the spike wave corresponds to the changes of respiratory efforts against a closed upper airway. The patient was treated successfully with imipramine and acetazolamide for the obstructive sleep apnea and enuresis. apnea/hypopnea index, nocturnal oxygen desaturation, and sleep architecture were improved, and enuresis completely disappeared. Cystometrography during sleep showed that the average amplitude of the spike wave tended to be low. Percentage urinary volume during sleep compared with 24 h volume was significantly reduced. We considered that the enuresis was mainly related to increased intra-abdominal pressure produced by respiratory efforts and enhanced nocturnal urine production.
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2/25. Hypersomnia following uvulopalatopharyngoplasty for snoring.

    This report describes three cases who underwent uvulopalatopharyngoplasty for severe snoring and who subsequently developed progressive excessive daytime sleepiness. All three cases were shown to have sleep fragmentation as a result of non-apnoeic episodic upper airway narrowing. These cases raise the possibility that increased upper airway resistance during sleep may be exacerbated or even caused by uvulopalatopharyngoplasty. Ideally, sleep-disordered breathing should be carefully excluded before this surgery is offered as treatment for severe snoring.
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keywords = airway
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3/25. Furlow palatoplasty to restore velopharyngeal competence following tonsillectomy avulsion of a pharyngeal flap.

    OBJECTIVE: We report the successful use of a Furlow palatoplasty to salvage velopharyngeal competence following iatrogenic avulsion of a pharyngeal flap that had been previously established to treat velopharyngeal insufficiency associated with a submucous cleft palate. INTERVENTION: A tonsillectomy, conducted by a surgeon unaffiliated with a cleft palate team, was used to remove enlarged tonsils that had developed after pharyngeal flap surgery and extended into the lateral ports causing nasal obstruction and hypernasality because of mechanical interference with port closure. A posttonsillectomy evaluation revealed avulsion of the pharyngeal flap, which was successfully treated using a Furlow palatoplasty. CONCLUSIONS: To our knowledge, this is the first report of iatrogenic avulsion of a pharyngeal flap caused by tonsillectomy. Based on a review of the literature and this case experience, we would conclude that tonsillectomy should not be regarded as a routine procedure in patients previously treated with a pharyngeal flap. If required, it should be performed by a skilled otolaryngologist, preferably one affiliated with a multidisciplinary cleft palate team who is familiar with pharyngoplasty surgery. Finally, our experience would suggest that the Furlow palatoplasty is sufficiently robust to be used as a secondary salvage procedure to restore velopharyngeal sufficiency following iatrogenic avulsion of a pharyngeal flap.
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ranking = 0.21845747512852
keywords = obstruction
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4/25. prader-willi syndrome with sleep disordered breathing: effect of two years nocturnal CPAP.

    We report a case of a 3-year-old child with prader-willi syndrome who had severe sleep disordered breathing with daytime hypersomnolence. His daytime blood gases showed type II respiratory failure. He was effectively treated with continuous positive airway pressure (CPAP) and has used this form of therapy for 2 years now with improvement in daytime somnolence, improved mental acuity and normalisation of daytime blood gases.
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keywords = airway
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5/25. Primary nasopharyngeal tuberculosis in a patient with the complaint of snoring.

    Isolated nasopharyngeal tuberculosis is a rare condition, even in endemic tuberculosis areas. The most common presentation of nasopharyngeal tuberculosis is with a cervical lymphadenopathy followed by nasal discharge or obstruction. Here we present a 58-year-old patient with nasopharyngeal tuberculosis whose only complaint was snoring. Her oropharyngeal and anterior rhinoscopic examination was normal. On endoscopic examination, mucosal oedema and hyperaemia of the nasopharynx was observed. There was no cervical lymphadenopathy. The tuberculin skin test was positive and histopathological examination of the biopsy taken from posterior nasopharyngeal wall supported the diagnosis of tuberculosis. After anti-tuberculosis therapy, the snoring stopped and the nasopharyngeal examination was normal.
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ranking = 0.21845747512852
keywords = obstruction
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6/25. Genioglossal advancement--a simple surgical procedure for sleep apnea. Case report and literature review.

    Although the use of a standard nasal continuous positive airway pressure device to combat obstructive sleep apnea is often effective, it is neither curative nor universally well tolerated. Thus, surgical intervention is often inevitable. We describe a simple, conservative surgical procedure performed on a patient with profound mandibular retrognathia (dolichofacial type), accompanied by sleep apnea. The procedure resulted in a significant pharyngeal airway enlargement of 53 and 87% at the mandible angle and hyoid bone levels, respectively, increased oxygen saturation, reduction in the respiratory disturbance index by 50%, and improved sleep quality. We present a procedure for patients whose sleep apnea is due to extensive mandibular retrognathism with concomitant retrolingual narrowing and collapse.
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ranking = 2
keywords = airway
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7/25. Primary Hodgkin's disease of the nasopharynx: a rare but bona fide disease.

    We report an uncommon case of Hodgkin's disease confined to the nasopharynx. An isolated polypoid mass of the nasopharynx was observed in a 41-year-old man presenting with increasing bilateral nasal obstruction. Histological study revealed a mixed cellularity type of Hodgkin's disease. Immunohistochemical analysis revealed CD30 and LMP1 expression and a lack of reactivity to CD15, CD3 and CD20. Serological tests excluded recent infection with Epstein-Barr virus. HD of nasopharynx is rare, but has to be recognized as such in view of appropriate treatment.
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ranking = 0.21845747512852
keywords = obstruction
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8/25. Obstructive sleep apnoea/hypopnoea as the initial presentation of relapsing polychondritis.

    Relapsing polychondritis (RP) is a relatively rare rheumatological condition, which can affect the upper airway and prove potentially life threatening. We report the first case of RP presenting initially as the obstructive sleep apnoea/hypopnoea syndrome, discuss management and review the extant literature.
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keywords = airway
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9/25. Orofacial complications associated with forward repositioning of the mandible in snore guard users.

    snoring and obstructive sleep apnea (OSA) result from a collapse of the tongue, soft palate, and pharynx, causing temporary airway blockage. Acrylic mandibular advancement splints and Herbst appliances are used to relieve snoring and mild OSA. Repositioning the mandible forward may have an adverse effect on the orofacial and dentoalveolar structures of susceptible individuals. This article reports two cases in which orofacial complications developed following the utilization of snore guard appliances.
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keywords = airway
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10/25. Blocked nose and snoring in a 6-year-old boy.

    nasal obstruction, mouth-breathing, snoring and deafness are common symptoms seen in children presenting to the otorhinolaryngology clinic. The aetiopathologies are frequently due to adenotonsillar hypertrophy and otitis media with effusion. Rarely however, nasal obstruction and snoring may be associated with more sinister pathology. We report a case of a child with nasopharyngeal B-cell Non-Hodgkin's lymphoma whose initial symptoms were of nasal obstruction and snoring.
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ranking = 0.65537242538556
keywords = obstruction
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