Journal Reviews
Hypoglossal stimulation for OSA
Continuous positive airway pressure (CPAP) is a highly effective treatment for moderate-to-severe obstructive sleep apnoea (OSA), but suffers significantly from poor patient adherence. This paper reports the three-year outcomes of a prospective multicentre cohort study examining the effect of hypoglossal...
The evidence for various treatments of autoimmune ear disease
The difficulty with this disease entity is that it is a heterogeneous group of conditions affecting the ear and a widely accepted diagnostic criteria does not exist. It is therefore difficult to conduct a well controlled trial and this systematic...
Darn it! It’s going to take longer to get good at stapes surgery!
Traditionally, it has been said the learning curve for a particular operation lies between 20 and 30 cases. In stapedotomy, a surgeon is deemed successful and perhaps competent if closure of the air-bone gap (ABG) is reached to within 10dB...
Nasal steroids do not cause ocular problems
This excellent, high quality and detailed systematic review from Australia dispels the myth propagated recently by some poorly designed studies that intranasal corticosteroids cause intraocular problems. A 40 year review of the usual databases found 665 articles and 19 were...
Smoking and immunotherapy – does it worsen outcome?
This interesting study aimed to address the issue of smoking in patients who had their allergic rhinits treated by sublingual immunotherapy (SLIT). Assessment was with validated quality of life questionnaires. There were 163 patients recruited in Greece who had completed...
Leisure listening does not affect the hearing of young people
The existing literature highlights concerns regarding the possibility of leisure activities involving listening to music on portable music players causing hearing loss. However, there is much speculation regarding actual effect. This article outlines a project involving young persons aged between...
“Rhinosweetometry”
An article that elicits a wry smile from the reader is worth drawing attention to particularly in the winter months. This account of brave self-experimentation is unlikely to lead to a future Nobel prize but nonetheless reinforces the important principle...
Does a labyrinthine fistula in cholesteatoma surgery lead to hearing loss?
Thirty-five patients with labyrinthine fistula related to cholesteatoma were studied retrospectively. All patients underwent CT scans and preoperative hearing tests 1-2 weeks prior to surgery (averaged at 0.5, 1, 2, 3, 4, 8 kHz). All 35 patients underwent mastoid surgery,...
A spoonful of sugar… helps the operated sinuses calm down?
Ottoviano et al. present a prospective double-blinded RCT to assess the effect of a nasal gel containing silver sucrose octasulfate (Silsos Gel) on wound healing after endoscopic sinus surgery. The placebo used was a glycol gel. Thirty-four consecutive patients were...
Salivary gland blues…
Intravenous methylene blue is a well-described method to assist in intraoperative localisation of parathyroid glands. The technique does come with challenges as anybody will know who has had to run adjacent to a theatre-bound trolley to ensure that the infusion...
Adenotonsillectomy can improve ADHD and nocturnal enuresis
The link between chronic adenotonsillar hypertrophy (CAH) and behavioural disturbance is well recognised. Several studies have found that CAH has been associated with attention deficit hyperactivity disorder (ADHD) and treatment of CAH may diminish symptoms of ADHD in a subset...
The middle way: treating idiopathic facial nerve palsy
Whilst the causes of recurrent facial nerve palsy are numerous, in many cases it may be idiopathic. There is no clear consensus on treatment of this condition and conservative management alone may condemn patients to gradually worsening facial nerve function...
