No abstract

Adult tonsillectomy alone has beneficial effect in OSA management, particularly in young overweight men with large tonsils, moderate OSA, and low Friedman stage.

The efficacy of a controversial treatment, using colored filters to remediate reading disabilities, was measured empirically, with colored overlays placed over reading material on white paper. Irlen's (1983) method is to prescribe specific tinted filters as lenses that she claims filter specific light frequencies and remove a range of perceptual disorders that adversely affect reading and related learning performance. Irlen calls this condition "scotopic sensitivity" and claims it is a significant factor in a high percentage of people with learning disabilities. Ninety-two children with significant reading disabilities were classified as either scotopic or nonscotopic using the Irlen Differential Perceptual Schedule, and were randomly assigned to one of six treatment groups using colored or clear overlays. Reading performance (rate, accuracy, and comprehension) as measured by the Neale Analysis of Reading Ability (Neale, 1987) and the Formal Reading Inventory (Wiederholt, 1986) improved significantly when the scotopic children read with the preferred colored overlay filter compared to clear or different-colored overlay filters. Nonscotopic children showed no change.

The objective is to determine if apnea-hypopnea index (AHI) and lowest oxygen saturation (LSAT) improve after transpalatal advancement pharyngoplasty (TPAP) with obstructive sleep apnea (OSA) in adults, using a systematic review and meta-analysis. Nine databases, including PubMed/MEDLINE, were searched through April 1, 2016. All studies that included patients who underwent TPAP alone were included in this analysis. Fifty-six studies were potentially relevant, 37 were downloaded and five studies met criteria with 199 patients (age: 42.5 ± 9.7 years and body mass index: 29.0 ± 4.0 kg/m). The grand mean (M) and standard deviation (SD) for AHI (199 patients) pre and post-TPAP decreased from 54.6 ± 23.0 [95 % CI 51.4, 57.8] to 19.2 ± 16.8 [95 % CI 16.9, 21.5] events/h (relative reduction: 64.8 %). Random effects modeling demonstrated a mean difference (MD) of -36.3 [95 % CI -48.5, -24.1], overall effect Z = 5.8 (p < 0.00001), and I = 85 % (significant inconsistency). The standardized mean difference (SMD) for TPAP demonstrated a large magnitude of effect for AHI -1.76 [95 % CI -2.4, -1.1]. For LSAT (70 patients), the pre and post-TPAP M ± SD improved from 81.9 ± 8.1 [95 % CI 80.0, 83.8] to 85.4 ± 6.9 [95 % CI 83.8, 87.0], with a MD of 3.55, overall effect Z = 1.79 (p = 0.07). Thus far, few studies have evaluated transpalatal advancement pharyngoplasty; therefore, we recommend additional studies, especially prospective studies. Research comparing TPAP to pharyngoplasty procedures without palatal advancement would help determine the optimal role for this procedure.