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Biomedical subjects

D N Fairbanks

Publications and source records attributed to D N Fairbanks.

At least 19 recordsLinked to original sources
PubMed1999

Operative techniques of uvulopalatopharyngoplasty.

Uvulopalatopharyngoplasty is, for the most part, both safe and effective as a surgical treatment for obstructive sleep apnea and severe snoring. Most complications can be avoided with proper surgical technique. Palatal dysfunction can be avoided if the shortening of the soft palate in the midline (uvula) area is minimized. Nasopharyngeal stenosis can be avoided with minimization of the posterior pillar resection and by avoidance of pharyngeal undermining. The effectiveness of surgery can be improved by placing emphasis 1) on opening the nasopharynx widely in the lateral port areas and 2) on tissue removal deep in the inferior tonsillar poles (and hypopharynx) with mucosal advancement and suturing.

Humans↗
PubMed1993

Inflammatory diseases of the sinuses: bacteriology and antibiotics.

This article provides an overview of the antimicrobial agents most commonly employed against the bacteria that cause infections in the ear, nose, throat, head, and neck. Because new bacterial resistances appear so regularly, as do new antibiotics, the reader is encouraged to supplement the information provided within this article with current information from the available literature. Specific treatment strategies for both acute and chronic sinusitis also are reviewed.

Anti-Bacterial Agents↗
PubMed1993

Uvulopalatopharyngoplasty: strategies for success and safety.

Management of snoring and/or obstructive sleep apnea patients may include uvulopalatopharyngoplasty, a surgical operation that occasionally generates complications. The most serious are perioperative airway problems and palatal dysfunction. Strategies to minimize risks and maximize efficacy are discussed.

Humans↗
PubMed1993

Neurostimulation for obstructive sleep apnea: investigations.

Neurostimulation of the upper airway muscles (accessory muscles of respiration) was accomplished in anesthetized dogs and sleeping humans by electrical stimulation of the hypoglossal nerves. Such stimulations relieved partial airway obstructions in dogs. They also aborted (shortened) obstructive sleep apnea events in humans who suffer with obstructive sleep apnea syndrome. In one subject, stimulations delivered in advance of apneic events (by automatic cycling) prevented apneas. Neurostimulation for obstructive sleep apnea may be an important concept for future research and development.

Animals↗
PubMed1991

Predicting the effect of nasal surgery on snoring: a simple test.

The Nasal Spray Test, as herein described, is a simple, reliable, no-cost, self-administered test for assessment of the nasal component in several combined etiologies of snoring and obstructive sleep apnea. A topical decongestant is sprayed into the nose on alternate nights for one week. Spray-nights are compared to non-spray nights for the severity of snoring and apnea. Improvement on the spray-nights implies that nasal obstruction is a causative factor in snoring and that relief of that obstruction will also improve the snoring problem. The test helps the physician decide when nasal surgery should or should not be performed for the complaint of snoring.

Administration, Intranasal↗
PubMed1990

Uvulopalatopharyngoplasty complications and avoidance strategies.

Reports of uvulopalatopharyngoplasty complications were elicited from 72 locations in the United States. We asked physicians to report all complications that had occurred in the 9 years since the operation was introduced. Sixteen fatalities were reported; respiratory distress was the most common cause. Forty-six cases of nasopharyngeal stenosis were reported and 42 cases of palatal incompetence were reported. Hemorrhages and wound dehiscences were also reported. A retrospective analysis of the complications was made and diagnostic-therapeutic strategies are discussed with respect to prevention of complications.

Aphasia↗
PubMed1989

Nasal symptoms associated with cocaine abuse during adolescence.

A questionnaire on cocaine-use patterns and associated adverse effects on the nasal passages was completed by 464 adolescents. The respondents were abusers of various nonintravenous drugs enrolled in seven modified outpatient treatment facilities for alcohol and other drug abuse in five geographic regions of the country. Three hundred thirty-six respondents (72%) noted that they had used cocaine one or more times prior to their entry into the treatment program. The 336 recovering cocaine users were divided into three groups: those who had used cocaine fewer than 25 times (203 [60%]); those who had used cocaine between 25 and 99 times (107 [32%]); and those who had used the drug daily plus at least 100 times total use of the drug (26 [8%]). Statistically, we found a highly significant difference between the first group and the other two groups for cocaine-associated symptoms, such as frequent sniffing, "sinus" problems, and diminished olfaction. Approximately 30% of those who had "snorted" cocaine at least 25 times but less than daily, vs 47% of those who used the drug daily, recalled that they had nasal membrane irritation with nasal crusts or scabs, recurrent nosebleeds, or both. The astute otolaryngologist should consider cocaine abuse as a cause of puzzling or recalcitrant rhinitis, even during teenage years.

Administration, Intranasal↗
PubMed1989

Nonsurgical treatment of snoring and obstructive sleep apnea.

Self-help remedies, such as exercise, weight loss, sleep positioning, avoidance of sedatives, and use of anti-snore devices may be helpful in mild snorers, but are of limited use in patients with obstructive sleep apnea. Drug therapy with stimulants is also for mild cases and side effects are limiting factors. CPAP is highly effective in patients whose apnea is severe enough to enforce compliance. In all these nonsurgical treatments, the prospect of a lifetime of drug therapy or mechanical ventilation is quite disheartening; when given a reasonable hope for a more permanent cure, most patients will opt for surgical management.

Humans↗
PubMed1986

Snoring: not funny--not hopeless.

Snoring means obstructive breathing during sleep, and its most exaggerated form is obstructive sleep apnea. Mild snoring may respond to simple self-help remedies. Heavy snoring responds well to the surgical removal or reconstruction of obstructive elements in the hypopharynx, nasopharynx or nasal passages.

Adult↗
PubMed1985

Effect of nasal surgery on snoring.

When 113 patients who had had nasal surgery for chronic obstruction were questioned about their snoring habits before and after operation, 42% said they had snored before nasal surgery. Of that group, 77% had either elimination or improvement of snoring after nasal surgery. Nasal obstruction is one of several factors contributing to snoring; surgery that relieves nasal airway impairment may also relieve or decrease the severity of snoring.

Airway Obstruction↗
PubMed1984

Snoring: surgical vs. nonsurgical management.

Eighteen children were treated for snoring. Surgical removal of enlarged tonsils and/or adenoids resulted in prompt and total elimination of snoring in 17 of these patients. One child required nasal and sinus surgery to gain relief from snoring. Eighty-three adults were interviewed, examined, and treated for snoring. Correction of anatomical abnormalities in the nose, soft palate, uvula, and pharynx achieved elimination of snoring in 72% of surgically treated cases. By contrast, nonsurgical remedies achieved snoring elimination in only 5% of patients (controls). Tracheostomy was required in 10% of snoring adults--those who proved to have severe obstructive sleep apnea syndrome. Snoring is due to the combined effect of several anatomic and physiologic abnormalities in the nasal and pharyngeal segments of the airway. It may be amenable to surgical therapy when the severity of the problem warrants it.

Adenoidectomy↗
PubMed1983

Cocaine uses and abuses.

Cocaine is a time-honored topical anesthetic for intranasal surgery. It combines superb anesthesia with constriction of nasal vasculature and patient euphoria, which facilitates surgery and enhances its tolerability to the patient. Dosages of 200 mg (2 ml of 10% solution) are considered safe and effective for surgical anesthesia. Central nervous system excitability is the predominant toxic reaction followed by convulsions and apnea, which require respiratory support. Intravenous diazepam effectively averts this reaction. Cardiovascular toxicity appears at higher dosages (such as with ingestion for concealment during smuggling) or when epinephrine is concurrently used with cocaine. Cocaine is also damaging to nasal membranes and the nasal septal cartilage, due to its vasoconstrictive effect and the irritative effects of its diluting contaminants. Its major psychological effect is stimulation similar to that of the amphetamines. Prolonged recreational use may lead to paranoia and violent, antisocial behavior, including homicide and suicide.

Administration, Intranasal↗