Conclusion: Hypertrophy of lingual tonsils can be safely and effectively managed by transoral robotic surgery via a minimally invasive approach. The operating costs can be relatively high although the advantages to patients seem to justify the procedure. Transoral robotic surgery can represent the definitive treatment in hypertrophy of the lingual tonsils. Objective: The purpose of this work was to assess the feasibility, safety, and outcomes of transoral robotic surgery for lingual tonsillar hypertrophy in adults with obstructive sleep apnea. Methods: Retrospective medical records of six patients who underwent tongue base resection using the da Vinci Surgical Robotic System from September, 2012 through December, 2013 in a tertiary care hospital were evaluated. Demographic data, preoperative and postoperative polysomnography and Epworth Sleepiness Scale (ESS) scores, robot docking time, operative and postoperative aspects including surgical time, amount of bleeding, and early and late complications were collected and analyzed. Results: All patients successfully underwent lingual tonsillectomy using the da Vinci Surgical system. Transnasal endotracheal entubation was performed in all patients and they were all extubated before leaving the operation room. No tracheotomies were performed perioperatively for airway management. The patients were discharged on the fifth postoperative day. Operative time, estimated blood loss, and postoperative complication profiles were within the expected and acceptable limits for lingual tonsillectomy. There was a statistically significant decrease in apnea hypopnea index (AHI) (mean AHI from 27.5 to 6.3) and ESS scores (from 14.1 to 7.1).

Background: Pistacia atlantica Desf. (Anacardiaceae) has various applications for dietetic and medicinal purposes.Objective: The aim of the present study was to evaluate antioxidant, antiproliferative and anticholinesterase activities of different extracts from leaf and stem of Pistacia atlantica Desf.Methods: The antioxidant activity was performed by four methods: DPPH, ABTS, CUPRAC and reducing power assays. Anti-cholinesterase activity was performed against acetylcholinesterase (AChE) and Butyrylcholinesterase (BuChE) enzymes. Antiproliferative assays were investigated against HeLa cell lines using xCELLigence RTCA instrument. The secondary metabolites composition was established by HPLC-TOF/MS analysis.Results: In DPPH, reducing power and in ABTS .+ scavenging activity, all the extracts showed strong inhibitory activity compared to synthetic antioxidants such as butylated hydroxytoluene (BHT) and butylated hydroxyanisole (BHA), in which the activities were almost equal to the two standards. The results were less significant in CUPRAC assay. The ethyl acetate (EtOAc) extracts exhibited the best antioxidant activity in all tests. Moreover, P. atlantica extracts inhibited AChE and BChE activities in a dose-dependent manner. The strongest AChE and BuChE inhibition activities were obtained for EtOAc extract of the stem (IC50 values 15.14±0.74 and 24.01±0.21 μg/mL, respectively) compared to galantamine (IC50 values 6.27±1.15 and 34.75±1.99 μg/mL, respectively). P. atlantica extracts also showed significant antiproleferative activity against HeLa cell lines, the best antiproleferative activity was obtained for the methanol and EtOAc extracts. The observed biological activities can be attributed to the presence of phenolic compounds and flavonoids in the extracts. The HPLC-TOF/MS analysis identified the presence of 22 phytochemicals. Gallic acid and rutin were the main compounds detected. Cichoric, gentisic, vanillic, protocatechuic and rosmarinic acids as well as catechin and quercetin were also present.Conclusion: This study demonstrated good antioxidant, anticholinesterase and antiproliferative activities of P. atlantica extracts, which opens up new possibilities for pharmaceutical and food industries.

BACKGROUND: Sore throat and hoarseness are common complications after surgery. Flurbiprofen spray has been successfully used for treatment of oral inflammations, but its effects on postoperative sore throat and hoarseness are unknown. We conducted this study to evaluate the effectiveness of flurbiprofen spray on postoperative sore throat and hoarseness, by comparing it with benzydamine hydrochloride spray and placebo. METHODS: One hundred fifty patients who were scheduled to undergo elective ear surgery were enrolled. Patients were randomized to three groups of 50 patients each; flurbiprofen oral spray, benzydamine hydrochloride oral spray and placebo spray groups. Patients received sprays just before intubation, and the incidence and severity of postoperative sore throat and hoarseness were evaluated by a blinded investigator at 0, 1, 6 and 24-hour post extubation. Patients were also questioned for possible side effects at all time points. RESULTS: The sore throat severity scores were significantly lower in treatment groups when compared to placebo group at all time points (P=0.003/10(8)). Similarly, the incidence of sore throat was significantly lower in both of the treatment groups (P=0.007/10(4)). The incidence of hoarseness and hoarseness scores were significantly lower in treatment groups when compared to placebo group (P=0.006/10(5) and P=0.005/10(4), respectively). While none of the patients complained of any adverse effects in flurbiprofen group, only two patients in benzydamine hydrochloride group experienced numbness. CONCLUSIONS: Both oral flurbiprofen and benzydamine hydrochloride sprays were found to be more effective than placebo in decreasing the incidence and severity of postoperative sore throat and hoarseness, with no adverse effects.