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While care should be taken to avoid them, complications should be identified and treated in a timely and accurate manner.

Purpose This study aimed to evaluate the 10-year adherence to and identify the predictors of dropout from continuous positive airway pressure (CPAP) treatment for patients with moderate-to-severe obstructive sleep apnea (OSA). Methods We retrospectively analyzed the continuity, dropout, or other behaviors of 181 patients who initiated CPAP treatment at the Tokyo Dental College Ichikawa General Hospital from January 2003 to June 2005. Results Among a total of 181 patients, 56 (30.9%) dropped out of the treatment. Among the 125 patients who did not dropout, 54 continued CPAP treatment for > 10 years, 16 completed the treatment with OSA improvement, and 7 could not complete the treatment owing to unavoidable reasons such as death, dementia, hospitalization for serious illness, or migration to other countries. Further, 47 patients moved to another facility, whereas 1 patient purchased a CPAP device and stopped visiting our facility. Among the 56 patients who dropped out, approximately 50% of the patients dropped out within a year, and all dropped out within 76 months. Comparing demographics, OSA parameters, and CPAP parameters between the patients who did and did not drop out of the treatment, Cox regression analysis indicated that body mass index (BMI) and the first-month utilization rate were clinical variables that were independently associated with discontinuation of CPAP treatment.Conclusion The results of this study show that BMI and the first-month utilization rate of CPAP treatment are the predictors of the long-term adherence to this treatment.

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Behavioral problems were significantly improved following AT in ASD children with OSA. Early detection and treatment of children with OSA is essential to prevent behavioral problems and to support mental development.

We have used the technique of open septorhinoplasty since in combined surgery in collaboration with ENT surgeons, as to improve nasal function and esthetics. This approach covers a wide variety of nasal pathologies including nasal valve obstruction, post-traumatic nasal obstruction, caudal septal deviation, and post-conventional septoplasty with worsening of nasal obstruction. Here, we describe the importance of manipulating the caudal septum in treatment of caudal septal deviation. Operation: Thorough a transcolumellar incision with infra-cartilagenous extension, the interdomal ligament was divided to approach the anterior angle of the septal cartilage to obtain access for sub-mucoperichondrial dissection. Septoplasty and conchal surgery are performed as needed by an ENT surgeon. If caudal deviation is moderate, it can be straightened by freeing the septum from the upper lateral cartilages. If the posterior angle of the septum is dislodged from the anterior nasal spine ANS , the posterior septal angle is freed, trimmed and sutured to the ANS. If the posterior septal angle is toward the ANS, the length of the caudal septum can be adjusted in the middle and reinforced with a batten graft. Discussion: The pathologies of the anterior septal angle without dislocation from the anterior nasal spine are relative overload on the caudal septum from the dorsal cartilaginous component of the nose, which includes a frail septum, misbalance of the septal cartilage and surrounding bony structures, and intrinsic torsional memory of the cartilage. If septal cartilage is dislodged from the ANS, the pathology is more likely to be due to a previous trauma. Understanding the pathology of caudal septal deviation is essential in straightening and centralizing the septal cartilage.