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The apnea-hypopnea index (AHI) is an important objective measure used in the diagnosis of sleep-disordered breathing. In affected patients, the AHI has been reported to vary across successive nights. We conducted a multichannel home sleep study on 44 patients with sleep-disordered breathing to determine whether the AHI does indeed vary and, if so, to quantify the degree of night-to-night variability. Of this group, 23 patients were tested for 3 consecutive nights and 21 were tested for 2 consecutive nights. Among the group as a whole, we found no statistically significant change in AHI across nights, although we did identify variations among individual patients. [ABSTRACT FROM AUTHOR]

Sleep disordered breathing, including obstructive sleep apnea, is a common and morbid health problem. Traditionally, sleep disordered breathing is diagnosed by complex sleep studies. However, newer, easy-to-use, highly sensitive, and highly specific home sleep study equipment is now available. The present study was undertaken to determine whether an otolaryngologist could easily and effectively dispense home sleep equipment from the office. We used a portable AutoSet home sleep machine. Our experience with the first 100 consecutively presenting patients was recorded and analyzed under institutional review board approval. Ninety-nine of the 100 tests were completed successfully on the first attempt; the one failure was successful on the second attempt. Our results were consistent with those reported from in-house polysomnogram sleep studies; 71% of our patients had an apnea-hypopnea index (AHI) of 15 or higher, and 93% had an AHI of at least 5. We conclude that an otolaryngologist, using state-of-the-art home sleep testing equipment, can accurately and cost-effectively prescribe home sleep studies. [ABSTRACT FROM AUTHOR]

As otolaryngologists play increasingly important roles in the evaluation and treatment of sleep disordered breathing, it is important that all practitioners systematically study the field of sleep. The curriculum outlined in this article has been developed for resident training at the University of California, San Diego, School of Medicine. It is divided into goals and objectives, curriculum, differential diagnosis of sleep disordered breathing, international classification of sleep disordered breathing, a glossary of sleep terms, and a list of resources. [ABSTRACT FROM AUTHOR]

Describes two cases of unilateral sinonasal opacification on sinus computed tomography (CT) scan at the University of California San Diego (UCSD) Nasal Dysfunction Clinic. Review of the sinus computed tomography (CT) findings of six common unilateral sinonasal conditions; Significance of clinical appearance and salient sinus CT features.

Presents the case of a patient with acute frontal sinusitis managed through endoscopic surgery. History of illness; Physical examination results; Diagnostic and therapeutic regimen; Surgical intervention; Indications for surgical management of frontal sinusitis.

Studies endoscopic sinus surgery (ESS) literature. Improvement rate; Results reported by patients; Patients requiring revision surgery; Percentage of patients with complications; Objective evaluation of the efficacy of ESS.

Describes the various extended indications for endoscopic sinus surgery. Cerebrospinal fluid (CSF) leaks; Graves' disease with resultant exophthalmus; Orbital cellulitis and abscess; Optic nerve compression; Dacryocystorhinostomy; Inverting papillomas; Mucocles; Osteomas; Persistent sinus disease; Sphenoid sinusitis; Posterior epistaxis.

Obstructive sleep apnea (OSA) is often associated with reduced pharyngeal muscle tone and an anatomically narrowed pharyngeal airspace. We describe 2 cases of aberrant internal carotid arteries that were diagnosed during evaluations of patients with suspected OSA. It is possible that these anatomic anomalies contributed to airspace narrowing in these patients. These 2 cases represent an interesting presentation of sleep apnea, and they provide a reminder of the importance of clinically recognizing carotid artery aberrations in order to avoid arterial damage during routine oropharyngeal procedures. [ABSTRACT FROM AUTHOR]

Presents a case of a patient with sphenoethmoid osteoma managed by endoscopic surgery. History of illness; Physical examination results; Diagnostic and therapeutic regimen; Results of surgical intervention; Review of the literature.

Deals with a survey of otolaryngologists at all Veterans Administration and Department of Defense hospitals in the United States concerning the nature and scope of their treatment of sleep-disordered breathing. Frequency of sleep tests in the hospitals; Procedures preferred by otolaryngologists for treating snoring; Treatment of sleep apnea patients.

Discusses sleep disordered breathing (SDB) and the roles and responsibilities of otolaryngologists to SDB patients. Definition of obstructive sleep apnea (OSA); Services that otolaryngologists can offer to patients with snoring and OSA.