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Biomedical subjects

Y Shvilli

Publications and source records attributed to Y Shvilli.

5 recordsLinked to original sources

Reconstruction of the soft palate by uvulopalatal flap.

Surgical removal of the soft palate in cases of neoplastic disease has a functionally detrimental effect on the patient, resulting in rhinolalia and nasal regurgitation. The authors describe their original surgical technique for repairing the lateral soft palate defect using a uvulopalatal flap. The flap is readily available and the procedure is single staged and without sequela. The aim of this reconstructive procedure is to obtain a diminished soft palate defect by primary surgery. In five patients who underwent a partial excision of the soft palate, the surgical defect was corrected at the time of initial surgery by a uvulopalatal flap. In this technique, the surface of the defect was diminished, postoperative rhinolalia and regurgitation were unremarkable, and sometimes an obturator was obviated. Using a local myomucosal flap, the procedure is simple, safe, and effective.

Adult↗

Surgical treatment of obstructive sleep apnea. Technical variations.

OBJECTIVE: To determine the effectiveness of the two basic surgical types of uvulopalatopharyngoplasty (UPPP), as classified by us. The two basic surgical variations of UPPP differ for the width of the anteroposterior palatal resection, being 1 to 2 cm (type 1) and 0.5 to 1.0 cm (type 2). DESIGN: Randomized, retrospective study. PATIENTS: Eighty-seven patients with obstructive sleep apnea hospitalized in our department from 1983 to 1991. All patients had a complete preoperative and postoperative polysomnographic evaluation. RESULTS: The operation was found to be an effective treatment of obstructive sleep apnea in most patients. Snoring improvement was found in 95% (29/31) of patients with type 1 UPPP and in 96% (54/56) of the patients with type 2 UPPP, whereas, apnea index improvement was detected in 65% (20/31) of the patients with type 1 UPPP vs 64% (36/56) of the patients with type 2 UPPP. Postoperative dysphagia was found in 94% (29/31) vs 79% (44/56), P = .0025; nasal reflux was found in 81% (25/31) vs 11% (6/56), P = .0001; and hypernasality was found in 100% (31/31) vs 13% (7/56), P = .0001, in type 1 and type 2 UPPP operations, respectively. Chi-square analysis shows highly significant differences. CONCLUSIONS: Type 2 UPPP is the recommended surgical procedure of obstructive sleep apnea, mainly due to the minimal postoperative morbidity.

Deglutition Disorders↗

Ozena revisited.

Primary atrophic rhinitis or ozena is a chronic nasal disease characterized by progressive atrophy of the nasal mucosa and underlying bone, accompanied by the formation of foul smelling, thick, dry crusts in the greatly enlarged nasal cavities. Although the incidence of ozena is greatly diminished in the western world, it is still encountered rarely and merits the attention of the ENT specialist. Hereditary, infectious, developmental, endocrine and nutritional factors have been implicated but the etiology of ozena still remains enigmatic. Numerous surgical and non-surgical methods have been advocated for treatment of ozena. We review our experience with 17 ozena patients in the past 20 years and discuss different modes of treatment. The relevant literature is reviewed.

Adolescent↗