ObjectiveCharacterize complications following uvulopalatopharyngoplasty (UPPP) for obstructive sleep apnea.Study designRetrospective chart review.Subjects and methodsCharts of patients undergoing UPPP at an academic teaching hospital from 1999 to 2005 were reviewed.Results345 consecutive patients (248 inpatients; 97 outpatients) were studied. The most common post-operative complication in the entire study was oxyhemoglobin desaturation (12.8%). Three patients suffered major complications (airway obstruction, pulmonary edema, arrhythmia). Regarding complications limited to the post-anaesthetic care unit alone, only 8.2% of patients had oxyhemoglobin desaturation after discontinuation of oxygen supplementation. Inpatients requiring supplemental oxygen on the ward had significantly higher mean AHI (37.4 vs. 31.4; p=0.05) and BMI (32.3 kg/m2 vs. 28.9 kg/m2; p=0.004) than those who did not. Those inpatients who were obese (BMI > 30 kg/m2) with an AHI≥22 were associated with an increased risk of requiring oxygen on the ward (odds ratio = 3.48, 95% CI = 1.56 – 7.78).ConclusionThe incidence of post-UPPP complications is much lower than the literature has historically suggested. Selected patients should be able to safely undergo outpatient UPPP. Patients with higher AHI, higher BMI, or multiple comorbidities are at higher risk for postoperative complications and are most appropriate for overnight monitoring.

CAI is a feasible, effective, and efficient means of enhancing self-directed learning as supplementation to the pre-clerkship undergraduate otolaryngology curriculum.

Importance: Dermal filler use in aesthetic clinics, are now widespread and although complications are rare, the formation of granulomas or abscesses and subsequent defects can be devastating to the patient. Design: Retrospective chart review of 4 cases over the period of 10 years, from 2002-2012 were examined from The Nasal and Facial Plastic Cosmetic Surgery Institute. Results: Four female patients experienced delayed onset reactions (>2 weeks) with sterile abscess formation and eventual resolution with serial drainage and macrolide antibiotics were observed over a prolonged period until resolution occurred. Only 1 case identified an organism (streptococci) on culture after 8 months, however, the initial culture still showed only sterile abscess. All 4 had a history of previous injectable fillers, 2 patients had evidence of pre existing autoimmune disorders. Conclusions and Relevance: Since the treatment of all of these patients, there is new evidence that infections may present as delayed onset sterile abscesses due to biofilm formation. Fluorescent in situ hybridization (FISH) test has shown to be as specific in identifying responsible organisms in biofilm infections as simple culture but is more sensitive; thus preventing misdiagnosis of sterile abscess. Counter intuitively steroid injection may promote abscesses, while hyaluronidase may be useful.

(RFVR). One was operated on by LAUP 5 years before. Two patients were operated using SST twice. RESULTS: After a mean follow-up of 9.5 months, 11 of 15 patients reported significant decrease in snoring and sleep apnea. Two patients reported some improvement. Two patients were out of contact. Patients had little pain and normal diet on the next day after surgery. There were minimal postoperative complications of SST: no nasopharyngeal regurgitation, much less pain, almost no bleeding and exposure, no disconnection of knots, no foreign body sense and no foreign body reaction. CONCLUSION: SST has the merits of both resection(widening of naso/oropharyngeal spaces) and no resection(safe, ease, less pain, short recovery time and minimal complications). SST with RFVR is a safe and effective palatal snoring procedure for snoring and sleep apnea. SIGNIFICANCE: SST is a new effective snoreplasty. It is possible to combine SST with other snoring operations. SST may be helpful to decrease the pressure of CPAP in sleep apnea.