Purpose: To compare the clinical outcomes of XEN45 gel stent implantation surgery (ab externo, open conjunctiva) with those of trabeculectomy. Methods: We retrospectively reviewed electronic medical record of 57 patients (62 eyes) treated with XEN implantation surgery (ab externo, open conjunctival approach) between April 1, 2021, and July 31, 2023, by the same surgeon. Preoperative clinical data including intraocular pressure (IOP), the number of glaucoma medications, and visual acuity were collected from 1 day to 12 months postoperatively. These data were compared and analyzed with those of 67 patients (78 eyes) received trabeculectomy between February 1, 2017, and April 30, 2022, by the same surgeon. Statistical analyses were performed with p < 0.05 as significant. Results: Complete surgical success rate was 33.9% and 57.7% of the XEN and trabeculectomy groups, respectively (p = 0.005). The qualified success rate was 79.0% and 93.6%, respectively (p = 0.011). Postoperatively, the XEN group used more glaucoma medications than the trabeculectomy group (1.21 ± 1.05 vs. 0.69 ± 0.90, p = 0.003 at postoperative month 12). After postoperative month 1, the XEN group had a higher IOP (15.77 ± 5.07 mmHg vs. 13.17 ± 3.81 mmHg; at postoperative month 12, p = 0.001) and lower corneal astigmatism than the trabeculectomy group (1.32 ± 0.79 diopters vs. 1.88 ± 1.45 diopters, p = 0.020 at postoperative month 6). There was no significant difference in preoperative and postoperative best-corrected visual acuity (logMAR) between the groups at any of the follow-up period (favorable visual acuity subgroup; logMAR < 0.7). Postoperative complications were 0 cases of XEN group and 13 cases of trabeculectomy group (0% vs. 16.7%, p = 0.001). Also, XEN surgery (24 minutes 40 seconds ± 6 minutes 26 seconds) had a shorter operation time than the trabeculectomy (40 minutes 18 seconds ± 8 minutes 27 seconds, p < 0.001). Conclusions Compared to trabeculectomy, XEN surgery (ab externo, open conjunctiva) showed relatively lower effectiveness (surgical success rate, IOP reduction). However, it demonstrated advantages as a minimally invasive glaucoma surgery, including a surgical success rate approaching about 80%, stability in inducing corneal astigmatism, fewer postoperative complications, and shorter operation times.

Background and Objectives: The purpose of this study was to compare and analyze the 18- year change in the relative value scale (RVS) in otolaryngology in relation to other surgical departments so as to help make future policy decisions.Subjects and Method Data on RVSs and addition rates, the deparments of main managed care, frequency of practice, and number of specialists were collected for all surgeries and procedures conducted in 2004, 2008, 2013, 2018, and 2022. Among these, an analysis was conducted for nine surgical departments. The number of surgeries and procedure items, the median value of the RVS, and the usage amount (i.e., RVS of all items multiplied by the frequency of surgeries and procedures) were calculated. Results: Over the past 18 years, the increase in the number of surgeries, procedure items and RVS in otolaryngology has grown smaller than that in other surgical departments, and the usage has decreased very sharply; in essence, the usage per specialist has actually decreased compared to 18 years ago. Conclusion Compared to other departments, RVS in otorhinolaryngology has shown very little change over the past period of 18 years. It is necessary to reasonably increase the currently undervalued RVS in otorhinolaryngology, particularly focusing on surgeries and procedures.

Polysomnography (PSG) remains an essential diagnostic tool for sleep disorders in children as it provides a comprehensive assessment of physiological parameters, enabling accurate diagnosis, effective treatment planning, and the evaluation of therapeutic interventions such as continuous positive airway pressure, tonsillectomy and adenoidectomy. In addition to respiratory disorders, PSG also plays a pivotal role in managing pediatric patients with neuromuscular disorders, chronic lung diseases, parasomnias, restless legs syndrome, and excessive daytime sleepiness. This review highlights the primary indications for pediatric PSG, with a focus on its utility in diagnosing obstructive sleep apnea syndrome, central apnea, and other sleep-related disorders.

Purpose: This study aims to evaluate a new method for the five times sit to stand test (FTSST), crucial for addressing frailty in an aging population. It utilizes a smart insole for plantar pressure analysis and a marker-less motion capture device for head height analysis. Materials and Methods: Thirty-five participants aged 50 years or older underwent FTSST assessment using three methods: manual measurement with a stopwatch (FTSST-M), plantar pressure analysis with smart insoles (FTSST-P), and head height analysis with a marker-less motion capture device (FTSST-H). Simultaneous measurements using three methods were done. Correlation between results of these methods were analyzed using intraclass correlation coefficient (ICC) and κ coefficient. Comprehensive clinical examinations were conducted with ethical approval. Results: Participants’ mean scores for FTSST-M, FTSST-P, and FTSST-H were 2.43±1.20, 2.43±1.29, and 2.37±1.31, respectively. Correlations of the times and corresponding scores between FTSST-P and FTSST-M, as well as FTSST-H and FTSST-M, exceeded 0.9 (ICC and κ coefficients, p<0.001). Using an FTSST score of 3 or less to indicate vulnerability, the κ value for vulnerability classification between two measurements was 0.886 (p<0.001). Conclusion This study showed strong correlation between FTSST results using smart insoles and marker-less motion capture, compared to conventional methods. These findings highlight the potential of these technologies for precise FTSST measurements, offering convenience and cost-effectiveness. Simultaneous use of these devices enables diverse analyses, enhancing our understanding of frailty.

Purpose: To compare the clinical outcomes of XEN45 gel stent implantation surgery (ab externo, open conjunctiva) with those of trabeculectomy. Methods: We retrospectively reviewed electronic medical record of 57 patients (62 eyes) treated with XEN implantation surgery (ab externo, open conjunctival approach) between April 1, 2021, and July 31, 2023, by the same surgeon. Preoperative clinical data including intraocular pressure (IOP), the number of glaucoma medications, and visual acuity were collected from 1 day to 12 months postoperatively. These data were compared and analyzed with those of 67 patients (78 eyes) received trabeculectomy between February 1, 2017, and April 30, 2022, by the same surgeon. Statistical analyses were performed with p < 0.05 as significant. Results: Complete surgical success rate was 33.9% and 57.7% of the XEN and trabeculectomy groups, respectively (p = 0.005). The qualified success rate was 79.0% and 93.6%, respectively (p = 0.011). Postoperatively, the XEN group used more glaucoma medications than the trabeculectomy group (1.21 ± 1.05 vs. 0.69 ± 0.90, p = 0.003 at postoperative month 12). After postoperative month 1, the XEN group had a higher IOP (15.77 ± 5.07 mmHg vs. 13.17 ± 3.81 mmHg; at postoperative month 12, p = 0.001) and lower corneal astigmatism than the trabeculectomy group (1.32 ± 0.79 diopters vs. 1.88 ± 1.45 diopters, p = 0.020 at postoperative month 6). There was no significant difference in preoperative and postoperative best-corrected visual acuity (logMAR) between the groups at any of the follow-up period (favorable visual acuity subgroup; logMAR < 0.7). Postoperative complications were 0 cases of XEN group and 13 cases of trabeculectomy group (0% vs. 16.7%, p = 0.001). Also, XEN surgery (24 minutes 40 seconds ± 6 minutes 26 seconds) had a shorter operation time than the trabeculectomy (40 minutes 18 seconds ± 8 minutes 27 seconds, p < 0.001). Conclusions Compared to trabeculectomy, XEN surgery (ab externo, open conjunctiva) showed relatively lower effectiveness (surgical success rate, IOP reduction). However, it demonstrated advantages as a minimally invasive glaucoma surgery, including a surgical success rate approaching about 80%, stability in inducing corneal astigmatism, fewer postoperative complications, and shorter operation times.

Background and Objectives: The purpose of this study was to compare and analyze the 18- year change in the relative value scale (RVS) in otolaryngology in relation to other surgical departments so as to help make future policy decisions.Subjects and Method Data on RVSs and addition rates, the deparments of main managed care, frequency of practice, and number of specialists were collected for all surgeries and procedures conducted in 2004, 2008, 2013, 2018, and 2022. Among these, an analysis was conducted for nine surgical departments. The number of surgeries and procedure items, the median value of the RVS, and the usage amount (i.e., RVS of all items multiplied by the frequency of surgeries and procedures) were calculated. Results: Over the past 18 years, the increase in the number of surgeries, procedure items and RVS in otolaryngology has grown smaller than that in other surgical departments, and the usage has decreased very sharply; in essence, the usage per specialist has actually decreased compared to 18 years ago. Conclusion Compared to other departments, RVS in otorhinolaryngology has shown very little change over the past period of 18 years. It is necessary to reasonably increase the currently undervalued RVS in otorhinolaryngology, particularly focusing on surgeries and procedures.

Polysomnography (PSG) remains an essential diagnostic tool for sleep disorders in children as it provides a comprehensive assessment of physiological parameters, enabling accurate diagnosis, effective treatment planning, and the evaluation of therapeutic interventions such as continuous positive airway pressure, tonsillectomy and adenoidectomy. In addition to respiratory disorders, PSG also plays a pivotal role in managing pediatric patients with neuromuscular disorders, chronic lung diseases, parasomnias, restless legs syndrome, and excessive daytime sleepiness. This review highlights the primary indications for pediatric PSG, with a focus on its utility in diagnosing obstructive sleep apnea syndrome, central apnea, and other sleep-related disorders.

PURPOSE: The aim of this study was to evaluate the clinical performance and survival rate of implant-supported zirconia-lithium disilicate (Zr-LiSi) bilayered ceramic prostheses over 3 years. MATERIALS AND METHODS: This study included 71 patients, including 34 with implant-supported metal-ceramic prostheses (control group) and 37 with implant-supported Zr-LiSi bilayered ceramic prostheses (test group). The implant survival rate and incidence of prosthetic and biological complications (veneer fractures, dislodgement of screw-access hole filling material, screw loosening, peri-implant mucositis and peri-implantitis, and marginal bone loss) were investigated. The survival rate was analyzed using Kaplan-Meier survival curves, and the identity between two groups was confirmed by the log-rank test. RESULTS: Both groups showed a 100% survival rate, whereas the prosthetic survival rates were 77% and 73% for the metal-ceramic and Zr-LiSi groups, respectively. Biological complications did not appear in the metal-ceramic group, and 16.2% of peri-implant mucositis occurred in the Zr-LiSi group, which was significant (P < .05). Prosthetic complications occurred in 5.8% of the metal-ceramic group with veneer fractures and did not occur in the Zr-LiSi bilayered ceramic group. CONCLUSION This study revealed that posterior Zr-LiSi bilayered ceramic implant prostheses showed high survival rates and similar survival rates to metal-ceramic implant prostheses; however, additional consideration should be given to avoid overcontouring. Zr-LiSi bilayered ceramic implant prostheses may be an option for posterior implant-supported prosthetic treatment.

Patients with ectodermal dysplasia often have atrophied alveolar bone and an inadequate maxillomandibular relationship owing to congenital edentulism.Accurate implant placement that can overcomes anatomical limitations and orthognathic surgery to improve the maxillomandibular relationship is necessary for creating implant-supported prosthesis for these patients. Implant placement and provisional prosthesis fabrication before orthognathic surgery can provide critical fixed reference points and ensure accuracy during orthognathic surgery.In our patient, a digital system was used to design a surgical guide that considered the predictable position of the definitive prosthesis, allowing the placement of implants to overcome anatomical limitations and the creation of fixed reference points via the delivery of a provisional prosthesis for effective orthognathic surgery. The lack of compensation during orthognathic surgery was considered in the definitive prosthesis. As a result, a prosthesis with a minimal anterior cantilever was fabricated. This study aimed to determine the appropriate sequence of multidisciplinary collaborations that would, result in the best functional and aesthetic outcomes.