MSM has several predisposing factors such as chronic sinusitis, previous surgery, allergic rhinitis and nasal trauma. However, some patients have no identifiable cause. The disease can present with a variety of symptoms which are usually related to their expansion and subsequent pressure on the surrounding structures. Trans-nasal endoscopic approach is an effective and safe method for treatment of the lesion.

Objective: The goal of rhinoplasty is not exclusively aesthetic and the nasal function should always be considered. Several rhinoplasty techniques can participate in nasal valve dysfunction (eg, dorsal hump reductions). Therefore, mid-nasal vault reconstruction by spreader grafts or flaps is mandatory in these cases. To date, there is a literature gap in comparing both techniques objectively. This study shows an objective comparison between spreader grafts and flaps for mid-nasal vault reconstruction. Material and Methods: This study was a double-blind randomized controlled trial including 40 patients who were randomly divided into 2 groups. Group 1 (20 patients) underwent spreader grafts insertion, whereas group 2 (20 patients) underwent spreader flap placement technique. Pre-operative active anterior rhinomanometry measurements were compared to 6-month post-operative measurements. Data were summarized as mean (standard deviation) for the quantitative variables. Comparisons between the 2 groups were done using unpaired t test. Results: In both groups, a significant decrease in nasal resistance was noted in both the right and left sides 6 months post-operatively ( P < .001). However, the comparison between the 2 both groups showed no statistical significance. Conclusion: Both spreader grafts and flaps, which are used for the mid-nasal vault reconstruction, have comparable and effective results in reducing the nasal resistance as evidenced by active anterior rhinomanometry measurements.

Adenotonsillectomy is an effective method for the treatment of OSA in children with DS. However, the condition may persist in some children who usually have airway narrowing at multiple levels.

Velopharyngeal surgical procedures may have adverse effect on the airway of the patients with velopharyngeal insufficiency (VPI). The aim of this study was to evaluate the polysomnographic parameters (PSG) in patients who underwent corrective surgery for treatment of VPI. The study included 39 patients who underwent 1 of 3 velopharyngeal surgical techniques; Furlow palatoplasty (12 patients), pharyngeal flap (18 patients), and sphincter pharyngoplasty (9 patients). The patients were subjected to PSG, and they were considered to have obstructive sleep apnea (OSA) with apnea-hypoapnea index (AHI) >1.Comparison of PSG parameters of patients showed insignificant difference regarding the total sleep time, sleep efficiency, arousal index, desaturation index, and minimum oxygen saturation. Significant difference was detected regarding peak end-tidal CO2 and AHI. Pharyngeal flap was detected as the most surgical technique that worsened the PSG parameters with OSA in 78% of patients, followed by sphincter pharyngoplasty with OSA in 56% of patients. Furlow palatoplasty was detected as the least impacting technique on the airway in 25% of patients who demonstrated OSA. In conclusion, velopharyngeal surgery has a variable impact on the PSG; pharyngeal flap has the most worsening effect followed by sphincter pharyngoplasty, while Furlow palatoplasty has the least adverse effect.

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Background: Several approaches for the maxillary sinus were described. Currently, endoscopic Middle Meatal Antrostomy (MMA) is the gold standard for managing maxillary sinus lesions. Unfortunately, there are some limitations especially in hidden areas. This research elucidates the advantages and disadvantages of adding IMF to the MMA for managing maxillary sinus lesions. Patients and Methods: This study was a randomized controlled trial, conducted on sixty patients, divided into 2 groups: Group (A) included 30 patients underwent IMF after MMA, while group (B) involved 30 patients subjected to MMA only for managing the maxillary sinus. Patients were assessed for the accessibility of the antero-inferior area of the maxillary sinus, residual lesion after performing IMF and evidence of recurrence. Results: The antero-inferior area accessibility in group (A) was difficult in 10 patients (33%) compared to 20 patients (66%) of group (B) (P =0.004). Residual was detected after performing the IMF in 12 patients (40%). Postoperative 1 year Lund Mackay score comparison between both groups was statistically insignificant (P=0.6). Recurrence was noted in 4 cases of group (A) and 2 cases of group (B), (P=0.7). Conclusion:Inferior meatal window with mucosal flap is helpful approach to maxillary sinus hidden areas when added to standard MMA. It is best suited for complete removal of small hidden lesions (e.g. foreign bodies, fungal ball and odontogenic cysts) which could be hardly handled through MMA.