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INTRODUCTION: Obstructive sleep apnoea (OSA) is a growing problem as more and more consequences of the condition become unveiled owing to continued research on the subject. It is essential to establish relevant, fast and accurate screening options, both in the primary sector and for preoperative screening in hospitals if we are to diagnose and treat this condition and thereby avoid the consequences of the untreated disease. METHODS: We have translated the Stop-Bang Questionnaire (SBQ) into Danish (SBQD) according to the guidelines presented by Guillemin et al in 1993. A validation study was performed including 43 consecutive patients. RESULTS: Most of the patients were men (79%). The overall median age was 54 years (range: 21-83 years). The median SBQD score for the group with an Apnoea Hypopnoea Index value (AHI) > 5 SBQD was 4 (range: 2-5), AHI > 15 SBQD score 5 (range: 4-7) and AHI > 30 SBQD score 7 (range: 4-8). Setting the SBQD cut-off at three, thereby defining scores 0-2 as normal as proposed by the authors, we observed the following sensitivity: AHI > 5 = 96.6%, AHI > 15 = 100% and AHI > 30 = 100%. The area under the curve was calculated and significant p-values achieved. CONCLUSIONS: The translation of the SBQ into Danish was validated as the results achieved were comparable to those reported from other studies and as acceptable sensitivity and specificity were observed. To avoid too many false positives, we recommend that the SBQD cut-off is set to ≥ 3 when screening preoperative patients and to ≥ 5 at primary physicians when screening high-risk patients. FUNDING: none. TRIAL REGISTRATION: not relevant.

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INTRODUCTION: Surgical closure of nasal septal perforations is a challenging procedure. Several approaches and techniques have been described with different levels of success. We report our experience in nasal septal perforation surgery. MATERIAL AND METHODS: We reviewed a sample of 19 patients who underwent surgical closure of nasal septal perforations. The perforations varied in size from 3 mm to 25 mm (mean 13 mm). Outcome was assessed on the basis of a comparison of the preoperative and final follow-up assessment of perforation size and symptoms. The surgical technique is based on an endonasal approach with dissection of bilateral bipedicled mucoperichondrial/-periosteal advancement flaps and interposition of a septal or conchal cartilage graft. RESULTS: Symptomatic resolution was documented for 18 of the 19 patients (95%). Complete closure was accomplished in 16 patients (84%) without major complications. We observed no graft donor site morbidity. CONCLUSION: The technique described uses recognized surgical principles to reconstruct the original nasal architecture and physiology. The results achieved sustain that the method offers both durability and strength. The endonasal approach leaves no scars, reduces risk of tip-rotation and offers sufficient view and space for instrumentation. We conclude that this method is suitable for treatment of perforations up to a vertical height of at least 25 mm.

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INTRODUCTION: Chronic rhinosinusitis (CRS) and polyposis cavi nasi (PCN) are two frequently occurring, disabling diseases. Many international studies have obtained very good results with the functional endoscopic sinus surgery (FESS) technique in cases of resistance to conservative treatment. This is the first study in Denmark that attempts to compare Danish results with international results. MATERIALS AND METHODS: The study included 31 patients operated on in the period 1 January-31 December 2002 in the ENT Department, Aarhus University Hospital. After a retrospective journal study, all patients were followed up on by means of a postoperative cross-sectional examination, with a questionnaire and endoscopic inspection of the nasal cavity. RESULTS: We found significant improvement as regarded sense of smell, degree of nasal obstruction, rhinorrhoea and facial pain. The endoscopic inspections showed a significant reduction in nasal polyps. Eighty-six percent of the patients said they would recommend the same kind of surgery to a similar patient. CONCLUSION: The study showed good results using functional endoscopic sinus surgery on Danish patients with CRS and PCN. The Danish population of those suffering from CRS and PCN undergoing surgery was not comparable to those in international studies. The study raised questions concerning the lack of national references and database programme.

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OBJECTIVE: In spite of declining prevalence chronic suppurative otitis media without cholesteatoma (CSOM) still poses a significant health problem. Randomized clinical trials comparing medical and surgical intervention are not available. Hence, the treatment of CSOM is almost exclusively based on empirical experience. The purpose of the present study was to evaluate the long-term effects of mastoidectomy combined with myringotomy and exploration of the middle ear in children with CSOM. METHODS: 47 children with CSOM underwent surgery including mastoidectomy. Ear status was investigated peri-operatively and at a long-term follow-up (5-21 years post-operatively). MAIN OUTCOME MEASURES: Final success rate, FS (dry ears for several years) and the optimal final success rate, OFS (dry ears for several years without re-operations and without retractions/perforations) were estimated. RESULTS: No serious surgical complications occurred. Post-operatively re-mastoidectomy was performed in 13% and re-myringoplasty/tympanoplasty in 21%. At the long-term follow-up the FS rate was 94% and the OFS rate was 61%. CONCLUSIONS: Surgery alone did not entirely cure CSOM which may justify randomized studies comparing conservative treatment and myringoplasty with/without mastoidectomy. Finally, mastoidectomy in these patients must be considered as a last resort when intense conservative treatment fails.

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