-
[show abstract]
[hide abstract]
ABSTRACT: Obstructive sleep apnea (OSA) is a common condition, increasing in incidence along with obesity in Americans. This review looks at skeletal surgery to treat sleep apnea and recent advancements.
Skeletal surgery for OSA has improved with recent advancements in surgical genioplasty now able to advance the genioglossus as well as inferior mandible muscles without changing aesthetics. Some investigators have called for maxillomandibular advancement to be considered as a first-line therapy over continuous positive airway pressure.
Maxillomandibular advancement appears safe and effective for consideration as a first-line therapy for select patients with OSA.
Current opinion in otolaryngology & head and neck surgery 06/2011; 19(4):307-11.
-
The Laryngoscope 10/2010; 120(10):2018-21. · 1.75 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We conducted a prospective observational study of tracheostomy tubes with three primary goals: (1) to identify the presence and location of bacterial biofilms on adult tubes, (2) to determine how soon after insertion of a tube the presence of a biofilm could be identified, and (3) to identify the bacterial organisms that formed the biofilms on these tubes. Our study materials consisted of 7 adult tracheostomy tubes that had been changed during a routine outpatient clinic visit or hospital consultation. The tubes were examined for the presence of biofilms on the posterior aspect of the outer cannula; also, specimens were obtained from the posterosuperior aspect of the cuff on the 3 tubes that had a cuff. Samples of 2 to 3 mm were taken from each site and analyzed by scanning electron microscopy. Bacterial biofilms were found on 4 of the 7 tubes; they were present on the outer cannula of 3 cuffless tubes that had been inserted 14 days, 4 months, and 2 years previously and on the cuff of 1 tube that had been inserted 10 days previously. The biofilms were composed of gram-positive cocci in pairs that were likely consistent with Staphylococcus epidermidis.
Ear, nose, & throat journal 10/2010; 89(10):496-504. · 0.66 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Examine the incidence of positive intradermal tests after a negative skin prick test for 24 inhalant antigens.
Retrospective study. Charts from patients who underwent modified quantitative testing (MQT) over a 3-year period were reviewed. Patients were initially tested with Multi-Test II. Subjects with negative wheals to a specific allergen were then tested with a 1:500 weight:volume intradermal injection of that allergen.
One hundred thirty-three patients underwent MQT for 24 antigens. Allergens with the highest incidence of positive intradermal wheals after negative prick testing were Dermatophagoides pteronyssinus and Dermatophagoides farinae at 26.67%. Allergens with elevated incidence of positive intradermals included fusarium, cockroach, cocklebur, rough marsh elder, and ragweed, all with incidences of 16% to 19%.
Positive intradermal responses after negative prick testing occur commonly. Future study is needed to determine the generalizability and clinical significance of these findings. EBM rating: C-4.
Otolaryngology Head and Neck Surgery 09/2006; 135(2):232-5. · 1.72 Impact Factor
