Objective: oral appliances are one of the treatments of obstructive sleep apnea hypopnea syndrome. They all have dental anchoring points, causing potential changing in the dental occlusion with time. The aim of the study was to evaluate dental displacement induced by Narval® oral appliance in the treatment of the adult mild to severe obstructive sleep apnea hyponea syndrome. Material and methods: The study was based on 15 adults with mild to severe obstructive sleep apnea hypopnea syndrome treated with a Narval® oral appliance for more than one year. Before oral appliance delivery and more than one year after oral appliance delivery, dental impressions were performed and digitized by a 3D scanner. The dental positions were calculated by the software 3D Reshaper® and compared. Results: The mean wearing time of the Narval® oral appliance was 13.5 months (±2.1). The mean mandibular advancement was 6mm (±2). For the maxillary arch, there was a significant distalization of molar and premolar-canine blocks from 0.12 to 0.20mm (all p<0.05) and a significant proclination of incisal blocks of 0.18mm (p<0.05). For the mandibular arch, there was a significant mesialization of the molar and premolar-canine blocks of 0.14 to 0.25 mm (p<0.05) and a non-significant retoclination of the incisors of 0.09 mm. Conclusions: The Narval® oral appliance produced minimal but significant teeth movements on the maxillary and mandibular at the short and medium term.

Positive airway pressure (PAP) therapy is well established as the standard of care for most patients with obstructive sleep apnea (OSA), however, up to 50% are not successfully treated with this approach and their further care remains a challenge. The value of engaging a multidisciplinary team in the diagnosis and management of OSA has been well recognized for over 30 years; however, the difficulty has been translating this principle into clinical practice. We present a series of selected patients with a diagnosis of OSA who initially failed PAP therapy but were successfully treated using a multidisciplinary and evidence-based approach that is reproducible at other sleep centers.

Pleomorphic adenomas represent 80% of the salivary gland’s benign tumors. They are most often found in the parotid gland or in the submandibular gland. Pleomorphic adenomas of the nasal cavity are rare, with less than fifty cases reported to date. There are no treatment or follow up guidelines. The purpose of this article is to review the cases already described in the literature and to share our clinical experience. We describe the case of a 38-year-old woman with a history of a slow growing intranasal tumor with recurrent epistaxis, obstruction, and aesthetic deformation. The pre-operative assessment suggested a benign tumor, but the biopsies were inconclusive. The decision was taken to perform an open rhinoplasty to have an en bloc resection with margins control. The diagnosis of pleomorphic adenoma was established on the excised tumor. There were no post-operative complications. The early follow-up showed no signs of recurrence. We decided to closely follow the patient with frequent clinical examinations and yearly enhanced-MRIs for at least five years due to the recurrence and malignant transformation risks.

Aim: The aim of this study is to spot the light on palatal diseases and their prevalence in adults from otolaryngologists point of view. Materials and Methods: This is an observational study that was conducted on adult patients presented to otolaryngology department of Cairo university hospital in the period from January 2016 to January 2018. Patients were routinely examined by the author however the chief complaint either related to palate or not. Results: Out of 4800 patients have been examined over 2 years, 289 cases have been affected by palatal disease or lesion either primary or secondary. It was clearly noted that the most common pathology affecting the palate is the gastric reflux, 248 patients; the remaining 41 cases have been affected by different diseases of variable etiologies. Conclusion: The palate is a part of routine examination by otolaryngologists. It may carry signs of different diseases and lesions which are not uncommon. The author observed palatal diseases in 6% of the studys sample. Prevalence of those diseases has been entailed in this study.