Norman Trieger

Edema in the upper airway in patients with obstructive sleep apnea syndrome

OBJECTIVE The purpose of this study was to investigate the histologic alterations in the upper airway in patients with obstructive sleep apnea syndrome. STUDY DESIGN Surgical specimens were obtained during non-laser-assisted uvulopalatopharyngoplasty from 5 adult patients (4 male and 1 female) with polysomnographically confirmed obstructive sleep apnea syndrome. RESULTS In all of the specimens, interstitial edema was present with mild inflammatory reaction. Fat was not at all prominent. CONCLUSIONS It is confirmed histologically that there is edema present in the upper airway in patients with obstructive sleep apnea syndrome. It is uncertain whether this edema is one of the causative mechanisms of the obstruction or a consequence of the syndrome.

The effect of arthrocentesis of the temporomandibular joint in patients with rheumatoid arthritis

PURPOSE This study evaluated the objective and subjective changes in a group of rheumatoid arthritic (RA) patients with temporomandibular joint (TMJ) complaints who were subjected to joint lysis and lavage. PATIENTS AND METHODS Twelve females with previous documented RA underwent baseline assessment with erythrocyte sedimentation rate, physical examination of TMJ function, and a visual analog pain scale (VAPS). The VAPS and jaw function changes were recorded at 2-week intervals for 6 weeks after lysis and lavage under local anesthesia in an ambulatory setting. RESULTS All patients showed statistically significant post-treatment improvement in their pain, and function was enhanced. CONCLUSION TMJ arthrocentisis is a useful adjunct in the short-term management of the symptoms of rheumatoid arthritis.

A mini-residency program in orthognathic surgery.

A method of teaching major orthognathic surgical techniques is presented. One hundred hours of instruction in laboratory, practical, clinical, and operating room experiences were presented over two months, on alternate weekends. These intervals allowed for assimilation of new didactic material, readings, and study and laboratory exercises at home. Four teams of three oral and maxillofacial surgeons rotated to the operating rooms during each weekend session to experience hands-on training. The protracted period of follow-up observations enabled participants to witness most cases from start to finish and learn to anticipate and manage sequellae. Experienced oral and maxillofacial surgeons demonstrated a quick grasp of newer techniques of orthognathic surgery, and most translated the mini-residency experience into their practices.