Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
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Otolaryngol Head Neck Surg · Sep 2000
Endoscopic management of foreign bodies in the tracheobronchial tree: predictive factors for complications.
We reviewed the records of 504 patients admitted to the American University of Beirut Medical Center during a 10-year period for treatment of aspiration of a foreign body into the tracheobronchial tree. All underwent rigid fiberoptic bronchoscopy for removal of the foreign body. Complications occurred in 42 patients (8%) and were classified as intraoperative (7 patients), postoperative (25 patients), and failure to retrieve the foreign body by bronchoscopy (9 patients). ⋯ The most important variables that were of value in predicting the occurrence of complications were the history of previous bronchoscopy, the duration of the procedure, and the type of foreign body. Age, sex, delay in diagnosis and treatment, and intraoperative use of corticosteroids, while important, had no predictive value. Detailed results with guidelines for prevention and management are presented.
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Otolaryngol Head Neck Surg · Sep 2000
Efficacy of uvulopalatopharyngoplasty in unselected patients with mild obstructive sleep apnea.
Uvulopalatopharyngoplasty (UPPP) is widely used as a first-step procedure for the surgical management of obstructive sleep apnea (OSA) syndrome but best manages obstruction occurring at the level of the oropharynx alone and not the hypopharynx. Previous publications have noted mediocre results with use of this procedure in unselected patients with OSA, but less clear is the effectiveness of this procedure in the unselected patient with mild OSA (respiratory event index [REI] 5-25). Using objective and subjective criteria, we retrospectively analyzed the results of UPPP in patients with mild OSA. ⋯ Overall, these results indicate that UPPP alone in the unselected patient provides little benefit in the management of mild OSA, similar to findings for more severe OSA. Surgeons must use great care in discerning the level of obstruction in the patient with mild OSA to tailor the appropriate retropalatal and/or retrolingual procedures and thereby achieve excellent surgical outcomes.