Obstructive sleep apnoea (OSA) is a common problem affecting almost 4% of the population. Although continuous positive airway pressure (CPAP) is considered the standard of care, the patient compliance for long term use is poor. Clinicians have explored surgical options for cure with varying success. Uvulopalatopharyngoplasty was considered as a standard of surgical care but long-term results were not satisfactory. Surgical researchers have explored newer techniques to improve outcomes in the past decade with less morbidity and better quality of life outcomes. One of such development is Barbed Reposition Pharyngoplasty (BRP). We would like to discuss the technique of BRP for OSA patients step by step.
<p class="abstract"><strong>Background:</strong> Concha bullosa is the pneumatisation of middle turbinate which causes crowding and obstruction of the middle meatus. This is associated with contralateral septal deviation. The objective of this study is to evaluate, if a concha bullosa turbinoplasty has any added value in improving nasal symptoms when performed as adjunct with septoplasty.</p><p class="abstract"><strong>Methods:</strong> Retrospective analysis of the hospital database was done and details of patients who underwent septoplasty along with concha bullosa turbinoplasty was collected and the patients were telephonically contacted to record their symptom improvement. </p><p class="abstract"><strong>Results:</strong> Details of nineteen patients who underwent concha bullosa turbinoplasty with septoplasty were studied, mean age of the patients was 31.26 years and the mean follow up period was 22 months. All patients had improvement in symptoms with most completely asymptomatic, the others had mild to moderate symptoms.</p><p class="abstract"><strong>Conclusions:</strong> Concha bullosa turbinoplasty as an adjunct to septoplasty does alleviate the symptom of nasal obstruction.</p>
Background: The second wave of the COVID-19 pandemic in India was associated with an increased incidence of rhino-orbital-cerebral mucormycosis. The objective of this paper was to prospectively explore the epidemiology, management, and results of 18 months follow-up of patients presenting with COVID associated mucormycosis at a tertiary referral centre in India. Methods: Patients presenting with symptoms suggestive of COVID-associated mucormycosis over two months were included in the study. Patients were staged based on the extent of the disease. Surgery was the primary modality of treatment except in those with intracranial spread, altered sensorium, and poor prognosis. A combination of liposomal amphotericin B and posaconazole was used as adjunct medical treatment. Patients were followed up and outcomes at one year of treatment were recorded. Results: Out of a total of 26 patients who were diagnosed with COVID associated mucormycosis, 21 patients underwent bimodality treatment (medical and surgical). The extent of surgery was based on the stage of the disease. Six eyes received retrobulbar injections of Amphotericin B to salvage vision. The overall mortality was 38.46% and 23.8% in those where the intent of treatment was curative. At the end of one year, 16 of 21 operated patients survived with mild to severe sequelae. Conclusions: Mucormycosis is a deadly fungal infection with high mortality. Early diagnosis and prompt, aggressive treatment is paramount in preventing mortality. A multidisciplinary approach is useful for effective management. Continuous follow up is paramount to identifying and treating complications.
<p><strong>Background: </strong>Fractures of the orbital floor can occur as a part of maxillofacial trauma and be associated with prolapse of orbital contents into maxillary sinus. It may be associated with entrapment signs mandating surgical repair of the orbital floor. Aim of the study was to study the role of a composite graft in the repair of orbital floor fractures in a tertiary care center.</p><p><strong>Methods: </strong>Retrospective chart review of 16 patients who underwent orbital floor repair in a tertiary care center was undertaken. All patients underwent surgical repair with a composite graft made of cartilage and polypropylene mesh by subciliary approach.</p><p><strong>Results: </strong>Post-operatively, none of the patients had restriction of mobility, diplopia, or globe asymmetry. Mild entropion was noted in two patients but did not require any intervention. No extrusion of the implant was seen.</p><p><strong>Conclusions: </strong>Conchal cartilage and polypropelene mesh composite graft is a reliable and easily available material for the repair of orbital floor defects in almost all kinds of orbital floor fractures.</p>
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