BACKGROUND AND OBJECTIVES: Laser-assisted uvulopalatoplasty is well established and relatively successful operation in the treatment of snoring and obstructive sleep apnea (OSA). But, there have been no reports about snoring sound of patients who had been performed LAUP. This study was performed to evaluate the results of LAUP analysing preoperative snoring sounds. MATERIALS AND METHODS: There were 38 patients who were diagnosed as OSA by polysomnography and had been performed LAUP between Mar, 1998 and July, 2002. Preoperative and postoperative snoring sounds were recorded during sleep and we performed an acoustic analysis using spectrogram (SPG), which was classified. And postoperative subjective satisfaction of bed time partner was compared in each type and the degree of satisfaction was measured by VAS (visual analogue scale) score. According to previous study, types of spectrogram of snoring sounds were classified as palatal, tongue base and mixed. RESULTS: In postoperative analysis, snoring loudness was most decreased in palatal type, and snoring pitch was only increased in tongue base type. The average satisfaction of bed time partner was highest at palatal type and lowest at tongue base type. CONCLUSION: Preoperative analysis of snoring sounds can aid the prediction of the loudness and pitch of snoring sounds and the subjective satisfaction of patients after LAUP.
Acoustics ; Humans ; Laser Therapy ; Palate ; Polysomnography ; Sleep Apnea, Obstructive ; Snoring* ; Sound Spectrography ; Tongue

BACKGROUND AND OBJECTIVES: Overcorrection is defined as obvious deviation of the septum to the opposite direction after septoplasty and it is not infrequently developed in young patients. We investigated the rate of its incidence, especially in relation to age. MATERIALS AND METHODS: We retrospectively studied 1,124 patients undergoing septoplasty operation for septal deviation between 1994 and 1999. The operations and postoperative observation were performed by a single surgeon. We reviewed the medical records for age, sex, symptoms, combined operations, direction of deviation before and after septoplasty. RESULTS: Out of 1,124 patients, 22 (2.0%) had their septum overcorrected after septoplasty and 21 (95%) complained of nasal obstruction of the newly deviated side. The incidence of overcorrection was 7.3% (16/218) in teens, 1.7% (5/294) in twenties, 0.4% (1/250) in thirties, and 0% in older ages. The incidence in teens and early twenties was 5%. Patients of teenagers revealed significantly higher incidence as compared to other age groups (p<0.05). CONCLUSION: Overcorrected septum as a complication of septoplasty develops at the incidence rate of 5% in patients of teens and early twenties. Authors suggest that the depth of cross-hatching incision on the cartilage should be superficial or half-thickness to avoid overcorrection in young patients. And the possibility of overcorrection or revision septoplasty should be informed preoperatively.
Adolescent ; Cartilage ; Humans ; Incidence ; Medical Records ; Nasal Obstruction ; Retrospective Studies

BACKGROUND AND OBJECTIVES: Voice therapy is proven to be effective, but patients are reluctant to receive the therapy when physicians recommend it. This phenomenon may due to patients'lack of trust in or low satisfaction level of the therapy. This study aimed to evaluate patients'satisfaction level after voice therapy and identify factors that could increase the satisfaction. MATERIALS AND METHODS: First, the fraction of patients who were recommended voice therapy ahead and completed it was studied, and survey was conducted on those who finished ten voice therapy sessions. The patients'1) satisfaction level during the therapy, 2) satisfaction level about physician's explanation about the therapy, 3) willingness to recommend, 4) satisfaction level about the results were assessed, and was correlated with overall satisfaction level. In each category, patients' gender-, age-, and disease type-related differences were analyzed. RESULTS: Patients under 19 years old were most satisfied during the voice therapy; patients above 40 years old showed statistically significantly higher satisfaction level regarding satisfaction with physician explanation about treatments and with treatment results compared to other ages groups. Patients above 40 also showed the highest willingness to recommend. 26.5% of patients either refused to or discontinued voice therapy. 84.3% were satisfied with treatment results. Considering variabilities among factors, patients'satisfaction with physician explanation about treatment and willingness to recommend had positive correlation. CONCLUSION: Though 26.3% of patients received voice therapy when physicians recommended, patients who completed the therapy were overall satisfied.
Humans ; Voice Disorders* ; Voice*

BACKGROUND AND OBJECTIVES: Various phonation patterns yield various voice characteristics. Voice therapy using nasal stimulatory sounds seems to facilitate phonation in voice disodered patients. Under the hypothesis that nasalance may be influenced by the pattern of phonation, we studied the relationship between nasalance and voice disorders by observing abnormal supraglottic movements and vocol cord gaps in phonation. SUBJECTS AND METHOD: There were 143 patients who complained of voice problems and showed abnormal false vocal cord movements under stroboscopy. In addition to the four previously described types of MTD (muscle tension dysphonia), we described two more types of MTD (V: false vocal cord contracted posteriorly, VI: false vocal cord dilated laterally). We measured the vocal cord gaps in phonation and analyzed nasalance. RESULTS: Among those groups showing the pattern of false vocal cord (MTD 1, 2, 4), the vocal cord gaps in phonation were increased and nasalance was significantly decreased in MTD types, III and IV, and showed a tendency to decrease in MTD types, II and V, compared to the normal group. CONCLUSION: The supraglottis has a tendency to contract as the vocal cord gap in phonation increases, and this movement reduces nasalance.
Dysphonia ; Humans ; Phonation* ; Stroboscopy ; Vocal Cords ; Voice ; Voice Disorders

BACKGROUND AND OBJECTIVES: Infections account for much of the morbidity and nearly half of the mortality in renal transplant recipient. Recently there has been a marked increase in the number of renal transplantation and preoperative screening test for chronic paranasal sinusitis. Authors analyzed the clinical manifestations and postoperative courses after the endoscopic sinus surgery in the patients with end stage renal disease. MATERIALS AND METHODS: 1,175 patients had been consulted to the otolaryngology department for routine evaluations about the presence of acute and chronic paranasal sinusitis prior to kidney transplantation between Jun. 1989 to Aug. 1998. Among them, 30 patients were diagnosed as significant chronic paranasal sinusitis and 5 patients were treated with endoscopic sinus surgery. Medical records and radiographs of the 30 patients were reviewed retrospectively. RESULTS: The prevalence of chronic paranasal sinusitis in patients with end stage renal disease was 2.5%. Twelve patients were asymptomatic and chief complaints of symptomatic patients were nasal obstruction (55.6%), rhinorrhea (27.8%), and postnasal drip (16.7%). Eleven patients had nasal polyps and twelve patients showed purulent discharge. All the patients who were surgically treated experienced postopertive bleeding and 2 of them required transfusion. CONCLUSION: The presence of asymptomatic sinusitis among the patients with end stage renal disease necessitates diagnositc screening tests for chronic paranasal sinusitis. The incidence of postoperative bleeding after endoscopic sinus surgery in patients with end stage renal disease is much higher than that of otherwise healthy sinusitis patients.
Hemorrhage ; Humans ; Incidence ; Kidney Failure, Chronic* ; Kidney Transplantation ; Mass Screening ; Medical Records ; Mortality ; Nasal Obstruction ; Nasal Polyps ; Otolaryngology ; Prevalence ; Retrospective Studies ; Sinusitis* ; Transplantation

BACKGROUND AND OBJECTIVES: Infections account for much of the morbidity and nearly half of the mortality in renal transplant recipient. Recently there has been a marked increase in the number of renal transplantation and preoperative screening test for chronic paranasal sinusitis. Authors analyzed the clinical manifestations and postoperative courses after the endoscopic sinus surgery in the patients with end stage renal disease. MATERIALS AND METHODS: 1,175 patients had been consulted to the otolaryngology department for routine evaluations about the presence of acute and chronic paranasal sinusitis prior to kidney transplantation between Jun. 1989 to Aug. 1998. Among them, 30 patients were diagnosed as significant chronic paranasal sinusitis and 5 patients were treated with endoscopic sinus surgery. Medical records and radiographs of the 30 patients were reviewed retrospectively. RESULTS: The prevalence of chronic paranasal sinusitis in patients with end stage renal disease was 2.5%. Twelve patients were asymptomatic and chief complaints of symptomatic patients were nasal obstruction (55.6%), rhinorrhea (27.8%), and postnasal drip (16.7%). Eleven patients had nasal polyps and twelve patients showed purulent discharge. All the patients who were surgically treated experienced postopertive bleeding and 2 of them required transfusion. CONCLUSION: The presence of asymptomatic sinusitis among the patients with end stage renal disease necessitates diagnositc screening tests for chronic paranasal sinusitis. The incidence of postoperative bleeding after endoscopic sinus surgery in patients with end stage renal disease is much higher than that of otherwise healthy sinusitis patients.
Hemorrhage ; Humans ; Incidence ; Kidney Failure, Chronic* ; Kidney Transplantation ; Mass Screening ; Medical Records ; Mortality ; Nasal Obstruction ; Nasal Polyps ; Otolaryngology ; Prevalence ; Retrospective Studies ; Sinusitis* ; Transplantation

PURPOSE: To evaluate the changes of anterior chamber depth (ACD), Axial length (AXL) after combined vitrectomy and cataract surgery and to analyze the association with refractive errors. METHODS: In 22 eyes who underwent combined vitrectomy and cataract surgery (PPV-Phaco group), 20 eyes who underwent vitrectomy-only (PPV-only group) and 28 eyes who underwent uncomplicated cataract surgery (Phaco-only group), ACD and AXL were measured with IOL master (Carl Zeiss Jena, Germany) preoperatively and 3 months postoperatively. We compared the preoperative desired refraction and postoperative 3 months refraction. RESULTS: ACD were increased in PPV-Phaco group and Phaco-only group (all, p < 0.001) and this change was more prominent in PPV-Phaco group (p = 0.030). In PPV only group, ACD was decreased (p < 0.001). The AXL after surgery was not significant different from the preoperative AXL in PPV-Phaco and PPV only groups (p = 0.612, p = 0.090). But the AXL was decreased in Phaco-only group (p = 0.022). Hyperopic shifting were noticed in PPV-Phaco and phaco-only groups, but myopic shifting was noticed in PPV-only group. However, these changes were not statistically significant (p = 0.292, p = 0.251, p = 0.068). CONCLUSIONS: ACD was increased after combined vitrectomy and cataract surgery. AXL was not changed. The hyperopic shifting was noticed after combined vitrectomy and cataract surgery, but was not statistically significant.
Anterior Chamber ; Cataract ; Eye ; Refractive Errors ; Vitrectomy

PURPOSE: To investigate the relationship between photoreceptor inner/outer segment (IS/OS) integrity and macular sensitivity after epiretinal membrane (ERM) surgery using spectral-domain optical coherence tomography combined with microperimetry. METHODS: 20 eyes of 20 patients with idiopathic ERM who underwent pars plana vitrectomy for ERM removal were prospectively reviewed. The IS/OS defect diameter, BCVA, macular sensitivity, and fixation stability were measured using spectral-domain optical coherence tomography combined with microperimetry. The correlation of these factors was analyzed. RESULTS: The macular sensitivity improved after successful ERM surgery (p < 0.001), but the IS/OS defect diameter has not improved. The preoperative and postoperative macular sensitivity were negatively correlated with preoperative IS/OS defect diameter (p = 0.035, p = 0.006). The fixation stability was not correlated with preoperative IS/OS defect diameter. CONCLUSIONS: Macular sensitivity showed significant correlation with IS/OS defect diameter. Macular sensitivity is vital functional parameter allows subjective quantification of the retinal function and reflects morphologic changes.
Epiretinal Membrane ; Eye ; Humans ; Prospective Studies ; Retinaldehyde ; Tomography, Optical Coherence ; Vitrectomy

OBJECTIVES: Obstructive sleep apnea (OSA) is a sleep-related breathing disorder that is characterized by repetitive collapse or partial collapse of the upper airway during sleep in spite of ongoing effort to breathe. It is believed that OSA is usually worsened in REM sleep, because muscle tone is suppressed during REM sleep. However, many cases showed a higher apnea-hypopnea index (AHI) during NREM sleep than during REM sleep. We aimed here to determine the characteristics of REM sleep-dependent OSA (REM-OSA) and NREM sleep-dependent OSA (NREM-OSA). METHODS: Five hundred sixty polysomnographically confirmed adult OSA subjects were studied retrospectively. All patients were classified into 3 groups based on the ratio between REM-AHI and NREM-AHI. REM-OSA was defined as REM-AHI/NREM-AHI > 2, NREM-OSA as NREM-AHI/REM-AHI > 2, and the rest as sleep stage-independent OSA (IND-OSA). In addition to polysomnography, questionnaires related to subjective sleep quality, daytime sleepiness, and emotion were completed. Chi-square test, ANOVA, and ANCOVA were performed. RESULTS: There was no age difference among subgroups. The REM-OSA group was comprised of large proportions of mild OSA and female OSA patients. These patients experienced poor sleep and more negative emotions than other two groups. The AHI and oxygen desaturation index (ODI) were lowest in REM-OSA. Sleep efficiency and N3 percentage of REM-OSA were higher than in NREM-OSA. The percentage of patients who slept in a supine position was higher in REM-OSA than other subgroups. IND-OSA showed higher BMI and larger neck circumference and abdominal circumference than REM-OSA. The patients with IND-OSA experienced more sleepiness than the other groups. AHI and ODI were highest in IND-OSA. NREM-OSA presented the shortest total sleep time and the lowest sleep efficiency. NREM-OSA showed shorter sleep latency and REM latency and higher percentage of N1 than those of REM-OSA and the highest proportion of those who slept in a lateral position than other subgroups. NREM-OSA revealed the highest composite score on the Horne and Östberg questionnaire. With increased AHI severity, the numbers of apnea and hypopnea events during REM sleep decreased, and the numbers of apnea and hypopnea events during NREM sleep increased. The results of ANCOVA after controlling age, sex, BMI, NC, AC, and AHI showed the lowest sleep efficiency, the highest AHI in the supine position, and the highest percentage of waking after sleep onset in NREM-OSA. CONCLUSION: REM-OSA was associated with the mild form of OSA, female sex, and negative emotions. IND-OSA was associated with the severe form of OSA. NREM-OSA was most closely related to position and showed the lowest sleep efficiency. Sleep stage-dependent characteristics could provide better understanding of OSA.
Adult ; Animals ; Apnea ; Female ; Horns ; Humans ; Neck ; Oxygen ; Polysomnography ; Respiration ; Retrospective Studies ; Sleep Apnea, Obstructive* ; Sleep, REM ; Supine Position