Journal Reviews
Implications of tonsillectomy in very young children
This is a comprehensive study comprising 157 children who underwent tonsillectomy below the age of two years, mainly for sleep-disordered breathing (86.6%) and recurrent tonsillitis (7%). With relatively recent understanding of OSAS, the indications for tonsillectomy in children under two...
Long-term effectiveness of sleep surgery for obstructive sleep apnoea
n this study, 39 patients from Turkey with obstructive sleep apnoea (of varying severity) underwent an expansion sphincter pharyngoplasty. This operation was devised by Prof Kenny Pang in Singapore and involves using the palatopharyngeus muscle and partly relocating it laterally...
Can surgery make you a better driver?
Obstructive sleep apnoea is a condition that can have far reaching health, economic and safety implications for the individual inflicted with the condition, as well as those in their immediate and wider surroundings. Having the freedom to drive taken away...
OSA is neuroprotective!
This interesting study supports the hypothesis of the protective effects of obstructive sleep apnoea (OSA) against ischemic events like stroke. The authors evaluated the impact of OSA with the presentation, hospital course and outcomes of patients with subarachnoid haemorrhage (SAH)....
RCT: tongue retaining devices vs CPAP for OSA
This study compared the effect of a tongue retaining device versus the use of CPAP in 27 patients within a crossover RCT design. Tongue retaining devices (also known as tongue stabilising devices), are similar in appearance to a plastic tongue-sized...
OSA – do the parents know best?
The difficulty in using the history and examination to determine the severity of sleep disordered breathing in children is well established. The relative prevalence of sleep disordered breathing symptoms in children, and the relative paucity of capacity and restrictive cost...
Do parents sleep better after paediatric adenotonsillectomy?
Paediatric adenotonsillectomy for sleep disordered breathing (SDB) is amongst the commonest surgical procedures performed in ENT. In the outpatient clinic, parents routinely express their concern about their child’s breathing but the impact of sleep disordered breathing on the parent is...
An alternative device for obstructive sleep apnoea
Continuous positive airway pressure (CPAP) is the first-line treatment for obstructive sleep apnoea (OSA), primarily due to the vast amount of short-term evidence in the medical literature it has accrued. The enduring obstacle to CPAP from becoming a treatment option...
Hypoglossal nerve stimulation for OSA
Hypoglossal nerve stimulation has been lauded as the great new surgical treatment panacea for obstructive sleep apnoea (OSA). This meta-analysis includes 12 studies with a total of 350 patients, including the five-year follow-up data from the STAR trial which was...
DISE as a rationalising tool for sleep apnoea surgery
This retrospective study on 85 adult obstructive sleep apnoea (OSA) patients provides further interesting information for sleep surgeons. These patients were all investigated with polysomnography (PSG) and drug induced sleep endoscopy (DISE). They all then underwent a simple uvulopalatoplasty with...
Double suspension sutures for obstructive sleep apnoea
This study examines the benefit of an operation that targets the lateral pharyngeal wall. The double suspension sutures are, in essence, a suture through the palatopharyngeus muscle which is then tied around the hamulus in the retro molar area. This...
A review of significant issues in the management of obstructive sleep apnoea in children
There are considerable variations in the management of obstructive sleep apnoea in children and this suggests a need for more research and evidence-based information. In this review article, the authors address four key issues. Literature compares tonsillectomy with tonsillotomy, the...