Sleep apnoea and snoring, including non-surgical techniques

Author(s):  
Joseph Deatherage ◽  
Peter Waite
2020 ◽  
Vol 47 (4) ◽  
pp. 354-362
Author(s):  
Naurine Shah ◽  
Peter D Waite ◽  
Chung H Kau

Obstructive sleep apnoea (OSA) is a prevalent condition and has been extensively managed with orthognathic surgery using a variety of surgical techniques. This case report describes the successful management of a 56-year-old Caucasian woman with a bimaxillary retrusive profile and macroglossia complicated by OSA and the combined use of orthodontics and orthognathic surgery to improve Apnoea-Hypopnoea Index while maintaining facial aesthetics. The non-extraction treatment plan included: (1) pre-surgical orthodontic treatment to maximise aesthetics and functional occlusion after surgery; (2) maxillomandibular advancement using down fracture of the maxilla (Le Fort 1 osteotomy) with counter-clockwise rotation as well as bilateral sagittal split osteotomy with septoplasty to aid increase in airway function; and (3) post-surgical orthodontic finishing and alignment with self-ligating fixed appliances. Optimum aesthetic and functional results as well as an increase in the airway volume were achieved, without compromising facial aesthetics, with the cooperation of two specialties and the use of state-of-the-art technology during the surgical planning stages.


Swiss Surgery ◽  
2003 ◽  
Vol 9 (3) ◽  
pp. 131-134
Author(s):  
Röthlin

Anhand der Pseudozysteneinteilung nach D'Egidio und Schein werden die verschiedenen chirurgischen Techniken der Pseudozystendrainage und -resektion diskutiert. Die Möglichkeiten und Grenzen der laparoskopischen Technik werden dargestellt. Auf die "Konkurrenz" der endoskopischen und interventionellen Therapien wird lediglich am Rand verwiesen. Prognostisch hängt der weitere Verlauf nach Pseudozystenoperation weniger von der Operationstechnik, als vom natürlichen Verlauf der Erkrankung (chron. Pankreatitis) und vom Sistieren, bzw. Weiterbestehen der zugrundeliegenden Noxe ab.


Swiss Surgery ◽  
2003 ◽  
Vol 9 (2) ◽  
pp. 55-62 ◽  
Author(s):  
Bartanusz ◽  
Porchet

The treatment of metastatic spinal cord compression is complex. The three treatment modalities that are currently applied (in a histologically non-specific manner) are surgery, radiotherapy and the administration of steroids. The development of new spinal instrumentations and surgical approaches considerably changed the extent of therapeutic options in this field. These new surgical techniques have made it possible to resect these tumours totally, with subsequent vertebral reconstruction and spinal stabilization. In this respect, it is important to clearly identify those patients who can benefit from such an extensive surgery. We present our management algorithm to help select patients for surgery and at the same time identifying those for whom primary non-surgical therapy would be indicated. The retrospective review of surgically treated patients in our department in the last four years reveals a meagre application of conventional guidelines for the selection of the appropriate operative approach in the surgical management of these patients. The reasons for this discrepancy are discussed.


1999 ◽  
Vol 82 (S 01) ◽  
pp. 109-111 ◽  
Author(s):  
Raymond Verhaeghe

SummaryIntra-arterial thrombolytic therapy has replaced systemic intravenous infusion of thrombolytic agents as a treatment modality for arterial occlusion in the limbs. Several catheter-guided techniques and various infusion methods and schemes have been developed. At present there is no scientific proof of definite superiority of any agent in terms of efficacy or safety but clinical practice favours the use of urokinase or alteplase. Studies which compared thrombolysis to surgical intervention suggest that thrombolytic therapy is an appropriate initial management in patients with acute occlusion of a native leg artery or a bypass graft. Underlying causative lesions are treated in a second step by endovascular or open surgical techniques. Severe bleeding is the most feared complication: the risk of hemorrhagic stroke is 1-2%.


1992 ◽  
Vol 05 (02) ◽  
pp. 85-89
Author(s):  
P. K. Shires ◽  
T. L. Dew

SummaryThis report has documented the repair and healing of two ilial fractures in dogs which were compounded by the presence of a cemented acetabular prosthesis. While specific recommendations can not be made from such a small number of cases, the information presented herein suggests that such fractures will heal without complication if aseptic surgical techniques and standard methods of internal fixation are employed. The authors strongly recommend the prophylactic use of intravenous antibiotics and the placement of cancellous bone graft when the repair of such fractures is attempted.Two traumatic ilial fractures involving the cement/bone interface of acetabular prostheses were repaired using lag screws, cerclage wires, and autogenous bone grafts. The fractures healed and ambulatory function was regained.


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