Cases reported "Snoring"

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1/66. 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. ( info)

2/66. 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. ( info)

3/66. lipoma in fossa of Rosenmuller.

    We report the first case of a lipoma originating in the fossa of Rosenmuller. Although lipomas are a common benign tumour in the body, lipomas of the nasopharynx are rare. ( info)

4/66. Bilateral styloid chain ossification: case report.

    The styloid chain is defined as the styloid process of the temporal bone, the stylohyoid ligament and the lesser cornua of the hyoid bone. Unusually long, incidental bilateral styloid chain ossification is described. This paper is presented for its unusual incidence, unusual length, the presence of ossification rather than calcification and its embryological correlation. Brief mention is made on the embryology and clinical significance of this condition. ( info)

5/66. 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. ( info)

6/66. 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. ( info)

7/66. Detection of insomnia in primary care.

    Insomnia is a widespread condition with diverse presentations. Detection and diagnosis of insomnia present a particular challenge to the primary care physician. patients seldom identify their sleep habits as the source of the complaints for which they are seeking treatment. Insomnia may be the result of many different medical or psychiatric illnesses or the side effects of medications or legal or illegal recreational drugs. Insomnia has a serious impact on daily activities and can cause serious or fatal injuries. With ever-increasing competition with sleep from 24-hour television broadcasts from hundreds of channels and the internet, as well as more traditional distractions of late-night movies, clubs, and bars, we have become a society that sleeps 25% less than our ancestors did a century ago. We have no evidence, however, that we require less sleep than they did. This article presents strategies for detecting and diagnosing insomnia. ( info)

8/66. 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. ( info)

9/66. Le Fort III distraction osteogenesis of midface-retrusion in a case of Hajdu Cheny syndrome.

    Le Fort III maxillary distraction osteogenesis using the RED system and advancement genioplasty was successfully performed for the midfacial retrusion and to eliminate severe snoring during sleep in a rare case of Hajdu Cheny syndrome. This syndrome is characterized by slowly progressive systemic osseous dysplasia, exhibiting craniofacial disfigurements and other skeletal deformity, but no description is found in a plastic surgical treatment up to now. A rare entity of this syndrome is also presented. ( info)

10/66. Rapid eye movement-localized apnea in a female patient with chronic insomnia.

    A middle-aged female patient with chronic insomnia showed rapid eye movement (REM)- localized obstructive sleep apnea. She visited the sleep disorders Clinic and complained of insomnia with loud snoring. Once, in the past, her sleep complaints had disappeared after weight reduction but, 6 months later, she complained of excessive daytime sleepiness. Overnight polysomnography revealed REM-localized apnea. Careful follow up is strongly recommended for a female patient with chronic insomnia who shows REM-localized apnea. ( info)
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