Background: Resulting from the rough flow of air through the nose and throat during sleep, snoring can arise from transitory obstruction at various levels, rendering the sufferer feeling sleep deprived. A relatively new method using radiofrequency technology, called PALATOPLASTY (somnoplasty), can be used to reduce the size of obstructive tissues in the nose and throat. In this study, we assess radiofrequency PALATOPLASTY in the treatment of snoring.Methods: This nonrandomized prospective quasi-experimental study included 28 patients who snored at a level considered bothersome to their bed partner. Snoring and drowsiness were each subjectively scored using 20-point visual analogue scales before and after treatment. Radiofrequency energy was delivered to the soft palate either at the midline or in the lateral soft palate; 21 patients were treated once and seven patients twice with an interval of at least seven weeks.Results: The mean age of the patients was 47 (SD=10.7) years, with a range of 25-65 years, 57% were men, and the mean body mass index was 29 (SD=4.5). Sleep apnea in these patients was subjectively rated mild to moderate. After seven weeks of treatment, snoring was improved in 71.4% of patients (p<0.005). The tongue versus pharyngeal size was improved in 34.4% (p<0.005). The mean patient snoring score was significantly improved from 17.39 (SD=3.02) to 11.50 (SD=6.46) (p<0.005). The mean drowsiness score was also significantly reduced from 6.8 (SD=6.9) to 3.93 (SD=4.19) (p<0.005). No persistent negative impact was observed in speech or swallowing. Pain and bleeding was limited.Conclusions: Radiofrequency PALATOPLASTY is effective in the treatment of snoring and its consequent drowsiness.

Introduction: Simple Snoring is low frequency sound without obstructive sleep apnea, produced mainly from vibration of the upper airway wall in the soft palate; it can be bothersome and may causes social problems. So the aim of this study is an attempt for relieving simple snoring though, stiffening the soft palate via transoral diode laser PALATOPLASTY. Materials and Methods: Forty six adult patients with socially troublesome snoring were recruited in this stuy. Adequately history was taken to rule out witnessed evidence of obstructive sleep apnea. Then full otolaryngological examination, with soft palate vibration grading assessment by Muller maneuver were followed, consequently the eligible patients were underwent transoral 810 nm diode laser PALATOPLASTY under local anesthesia and followed-up 6 months post-operatively. Results: The loudness of subjective snoring assessed by visual analogue score (VAS) was relieved from 6. 6 to 2. 4 and by Muller maneuver was improved from 2. 7 to 1. 9, and for the frequency from 2. 1 Hz to 0. 3 Hz, and from 2. 4 Hz to 0. 55 Hz for the duration pre to post-operative with P value of 0. 75 to 0. 023 respectively, So the overall frequencies of improvement of snoring loudness results had revealed a total improvement (no snoring) were detected in 4 patients, and moderate improvement had been found in 30 patients, while mild improvement of snoring had been seen in 10 patients, however about 2 patents got no benefit from the surgery. Conclusion: Stiffening of the soft palate by diode laser had shown to be significantly beneficial in relieving the snoring intensity as it had a positive impact on its subjective loudness, frequency and duration.

Background: Children with cleft lip and palate experience many problems such as feeding problems, hearing disorders, and speech and language disorders. The purpose of this study was to determine the prevalence of middle ear diseases, hypernasality, and compensatory errors following primary PALATOPLASTY in children with cleft palate with or without cleft lip; and to assess the effect of middle ear problems on speech production in these children.Methods: A retrospective file review of 120 patients with different kinds of orofacial clefts, who coming to Isfahan cleft palate team in Alzahra (SA) hospital in 2005 to 2007, was performed and the prevalence of middle ear problems, hypernasality and compensatory errors of 38 3-6 year old children with cleft palate with or without cleft lip was calculated. Moreover, the associations between the history of middle ear problems and hypernasality and compensatory errors were studied.Findings: 47.4% of patients experienced repeated episodes of otitis media. Also, compensatory errors and some degrees of hypernasality were observed in 78.9% and 71% of our sample, respectively. These speech disorders were not associated with middle ear status of children (P>0.05). But hypernasality was related to articulation disorders, significantly (P=0.001).Conclusion: In current study, the high prevalence of accompanying problems with cleft palate, especially hypernasality and compensatory errors were observed. Therefore in order to achieve better outcomes in children with cleft palate, we should improve our surgical treatment techniques and another intervention through appropriate multidisciplinary team management.

Background and Objectives: Cleft palate is one of the most common congenital anomalies. Usually during PALATOPLASTY surgeons put a mesh mixed with antibiotic at the lateral space of relaxing incisions and remove it 3-5 days postoperatively. It seems that it increases the postoperative pain decreases fluid intake risk of aspiration of mesh. Also it seems that it lead to expose of bare bone and probably maxillary growth retardation. The aim of this study was to compare the extent of bleeding, hospitalization length, analgesic and sedative drug treatment, feeding, and dehiscence between those closed without mesh and those with mesh.Materials and Methods: At this study 37 patients with cleft palate with or without cleft lip operated with two flap PALATOPLASTY technique and lateral spaces closed without inserting mesh case group. Those cases were compared with 35 patients with cleft palate who operated with the same technique with inserting antibiotic mesh in lateral spaces.Results: The length of hospitalization, extent of postoperative hemorrhage, prescription of analgesic & sedative drugs in both groups has significant differences and they were more prevalent in case group. Fluid intake in study group was much better than control.Conclusion: Because of high prevalence of adverse effect of mesh placement after cleft palate surgery we prefer to close the lateral spaces without mesh.

Introduction: cleft palate is one of the commonest congenital obnormalities and requires to repair at early ages. These patients often suffer from co-abnormalities, swallowing disorders, aspiration and upper respiratory infections, so anesthesia and surgeryare more sensitive. Frequent cases of upper abway obstruction caused by lingual swelling following the use of mouth gag has been reported after PALATOPLASTY. This study compare two methods, continuosly applied and intermittently relieved, mouth gag, in prevention of macroglossia and airway obstruction. Methods: During this clinical trial, two groups of patients compared with each other. In group A, gag has been applied continuously all over the operation and in group B, gag has been relieved for 1 minutes to let circulation and venous drainage.Results: Twenty patients were studied in group A and upper airway obstruction was observed in 5 cases (4 relative and 1 complete obstruction), whereas in group B, included 40 patients, there was no obstruction and Macroglossia.Conclusion: With due attention to the necessity of careful and gentle manner in such cases, it seemes that intermittently gag relief method is more effective intervention of lingual edema and prevention of upper airway obstruction.

Background and Objectives: Snoring is a common symptom or disorder involving 19% of population. Snoring occurs mainly at velopharyngeal area. It belongs to a spectrum of sleep disorders which varies from habitual snoring to sleep apnea syndrome. This study presents a simple surgical technique for the relief of snoring.Materials and Methods: This study was conducted on 8 patients with a chief complaint of snoring. Data consisting history, physical and anatomic characteristics were obtained through a questionnaire. The results of operation were recorded as complete, significant, minor and non recovery at a period of 2 months follow-up. Diagnosis and follow-ups were done on a clinical basis. In this technique mucosal soft palate was resected elliptically and the consequent defect repaired with some sutures. Results: in 62.5% of patients complete or significant recovery occured. The results in patients with low BMIs were better. The postoperative complications were pain (%100) and uvular protrution (25%).Conclusion: This is a simple and cost-effective technique which lacks important complications. It’s successful results are at the limit of other procedures such as laser, cautery assisted and snare PALATOPLASTY.

Background: Cleft lip and cleft palate are one of the most common congenital craniofacial abnormalities in the skull and face. We aimed to investigate the prevalence of complications after primary cleft palate repair surgery, performed on patients referred to a children's hospital, and to use the information and results obtained from it to reduce the complications and improve the results of these surgeries. Methods: In this cross-sectional-analytical study, using a census sampling method, the medical records of 94 consecutive cleft palate patients treated in Abuzar Hospital in Ahvaz, southern Iran, in the years 2019 to 2021 were studied. The rate of postoperative complications during the first week in terms of wound opening and flap necrosis and one month later in terms of fistula formation after surgery were also extracted from the files. Results: Ninety-four patients with congenital cleft palate (57.4% male and 42.6% female) were enrolled. The gap width in all studied patients was 14 ± 5 mm. The frequency of complications of surgical wound opening, flap necrosis, oronasal fistula and hypernasality in von Langenbeck group was 9.5%, 0.15% and 28.1% respectively, and in Bardach group was 9.5 %, 15% and 33.3% respectively. Conclusion: There were no significant differences between the two surgical methods in terms of postoperative complications. Besides, what is important in choosing a surgical method is the patient's clinical condition, the surgeon's experience and skill, and his choice.

Background: Tranexamic acid (TXA) is an inexpensive therapy effective at minimizing perioperative blood loss and transfusion. However, it remains underutilized due to safety concerns. Cleft lip and cleft palate are among the most frequent congenital anomalies, accounting for 65% of head and neck anomalies, and 15000 neonates are born with these anomalies annually. Objectives: This study aimed to investigate the effect of preoperative intravenous TXA on hemorrhage in patients undergoing cleft palate reconstruction surgery in the Khatam Al-Anbia Hospital, Zahedan, Iran. Methods: This clinical trial was conducted on 60 patients undergoing PALATOPLASTY in the Khatam Al-Anbia Hospital. The patients were randomly assigned into two groups: TXA receivers and controls. Data were collected using information forms and then analyzed using SPSS ver. 22. Results: The mean age of the participants was 21. 42, 9. 46 months, and of the 60 patients, 31 were boys, and 29 were girls. The mean bleeding volume was 11. 73, 4. 42 milliliter in the TXA receiving group and 17. 36, 4. 99 milliliters in the control group, and the mean duration of surgery was 41. 90, 8. 00 and 49. 93, 11. 37 minutes in the TXA receiving and control groups, respectively. The mean PT, PTT, and Hb were not significantly different before and after surgery in the two groups. Conclusions: Tranexamic acid causes a significant reduction in the duration of surgery and mean bleeding volume in palatoplasties, but it has no effects on PT, PTT, and Hb levels before and after surgery.

Introduction: The best strategy to treat otitis media with effusion in cleft lip/palate patients is still under debate. This research aimed to evaluate the otologic outcomes in children at least five years post-repair. Materials and Methods: A retrospective study was conducted on 40 children who underwent PALATOPLASTY between January 1, 2012, and January 1, 2014, at Children’, s Medical Center (Tehran, Iran). Patients had intervelar veloplasty under magnification (Sommerlad’, s Technique). Based on patients’,charts, their age, gender, cleft type, date of PALATOPLASTY, as well as the date and the frequency of ventilation tube (VT) insertion, were recorded. Furthermore, otomicroscopy, middle ear status, and tympanometry were assessed five years postoperatively. Results: There was no significant difference in middle ear status between children with complete and incomplete cleft palates. The mean age at the time of study and the mean follow-up duration were significantly higher in the normal middle ear group, compared to the abnormal middle ear group (7. 7±, 1. 6 vs. 6. 8±, 0. 9, P=0. 03 and 6±, 1. 15 vs. 5. 42±, 0. 9, P=0. 04, respectively). Middle ear status was not significantly different between early or late PALATOPLASTY patients. In addition, the frequency and timing of VT insertion were not significantly different between the two groups. Conclusions: Middle ear status improved as patients grew older,however, the age of PALATOPLASTY and the frequency of VT insertion were not significant prognostic factors in patients who underwent intervelar veloplasty under magnification.