Objective: Some studies have shown the atherogenic dyslipidemia as being sometimes independent of the obesity; however, with a close relation to the obstructive sleep apnea (OSA). The aim of this study was to investigate a relationship between parameters defining the quality of sleep and the standard lipid profile despite the obesity. Methods: The data of 211 patients with suspected OSA were analyzed prospectively. The following tests were performed: polysomnography, morphometric assessment and serum lipid levels. Results: Value of AHI showed a positive correlation with TG, TG/HDL ratio, BMI, plasma atherogenic index (API), circumference of neck, waist, and hip, and WHR. A negative correlation was found between AHI and HDL. The patients with severe OSA (AHI>30) differ significantly from the patients with moderate and mild OSA in terms of TG, and the ratio of TG /HDL and API and they are, therefore, in the group of much higher risk of cardiovascular disease. Significant predictors of the severity of sleep apnea are as follow: the ratio of TG/HDL, BMI and the neck circumference. The arousal index was the only parameter of the sleep quality significantly associated with the level of TG. Conclusion: The most important parameters of the quality of sleep that determine atherogenic risk are AHI and arousal index that are significantly correlated with TG/HDL ratio. Particularly, high risk of cardiologic problems applies to patients with AHI>30 who substantially differ in terms of lipid profile from the patients with mild or moderate OSA. Arousal index significantly distinguishes patients with AHI> 30 from the other groups of patients.
The nasal septal deviation coexistent with turbinate hypertrophy is considered one of the most common causes of nasal patency disorders. There is no doubt that septoplasty in most such cases is a proper treatment method. It is more difficult to clearly identify indications and predict the consequences of septoconchoplasty. The main aim of this study is to compare the impact of each of these procedures on subjective and objective measures of nasal patency. The authors retrospectively reviewed 132 medical records of patients treated in the Department of Otolaryngology, Medical University of Warsaw in the period from March 2012 to January 2013 due to nasal obstruction. Each patient had septoplasty or septoconchoplasty performed. Before treatment, each patient responded to questions in a standardized questionnaire SNOT 20. In addition, each patient was performed upon for anterior rhinomanometry before and after shrinking the nasal mucosa. Finally, the study involved a group of 30 people - 15 after septoplasty (group A) and the same number after septoconchoplasty (group B), who attended control examination carried out by the same scheme 6 weeks and 6 months after surgery. SNOT 20 poll was repeated 6 months after surgery. Analysis of the rhinomanometry results showed no statistically significant differences between the two treatment groups. Average values of the nasal resistance after surgery as compared to their baseline values in all measurements were smaller in each of the groups but the differences were also not statistically significant. However, comparing the results of the subjective assessment of nasal patency and associated signs and symptoms showed statistically significant differences between pre and postoperative results in both groups and the patients of group B felt more improvement than patients in group A. The study authorizes the conclusion that in justified cases septoconchoplasty gives better results than septoplasty.
Draf III procedure is alternative for external approach that can be used for treatment of chronic rhinosinusitis and benign frontal sinus tumors of different size.
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