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How useful is AHI?
There is a growing unease in the sleep medicine world about the usefulness of the apnoea-hypopnoea index (AHI). Most of our objective evidence about obstructive sleep apnoea (OSA) is in some way related to the AHI, and the respiratory physicians...
The initial electroneuronography result after temporal bone trauma related facial palsy may be misleading
It is taught that a complete facial nerve (FN) palsy after temporal bone (TB) trauma should be conservatively managed if electroneuronography (ENoG) shows a less than 90% degeneration of response compared to the contralateral side. This small study from the...
How do you solve a problem like Dysphagia?
When a patient is referred to a speech and language therapist for the management of swallowing difficulties, multiple options are available to address these issues. The choice is based on a detailed assessment of the patient’s swallowing physiology and function....
Can WhatsApp aid surgical team communication?
This plastic surgery team discuss their experience with using WhatsApp instant messaging over the last three years. WhatsApp is now commonplace amongst surgical teams in hospitals, for both social and business interactions. In the authors’ experience, WhatsApp allows team discussions...
Use of topical steroids and antibiotics, compared to systemic antibiotics in the treatment of acute rhinusinusitis
Acute rhinusinusitis is mainly initiated by viral infections. Bacterial infection is usually superadded. The inflammatory cascade upregulates the pro-inflammatory mediators resulting in pain, nasal obstruction and nasal discharge. Local application of steroids and antibiotics could provide a higher concentration of...
The push towards scarless parotid surgery
When dealing with benign parotid pathology, high expectations are placed on the operating surgeon to preserve key neurovascular structures, especially the animating facial nerve, through meticulous dissection. With time, there has been a greater emphasis on improving cosmesis in parotid...
Type 2 diabetes and BPPV
Previous research has shown an association between BPPV and certain medical conditions such as hypertension, hyperlipidaemia and type 1 diabetes. The authors in this retrospective observational study investigated the interaction between BPPV and type 2 diabetes by examining the ‘role...
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...
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...
Measuring is understanding: an unsupervised PROM clustering of CRS patients
It has been clear for quite some years, at least for anyone dealing daily with chronic rhinosinusitis (CRS) patients, that CRS is an ‘umbrella’ diagnosis. There are significant differences between patients, including different demographic data, different endoscopic and radiographic images,...
Effect of peripheral and central vestibular dysfunction on sense of direction
Sense of direction (SOD) is the ability to orientate ourselves and to determine the locus of objects in our environment. The vestibular system plays a key role in spatial orientation by encoding angular acceleration in the absence of visual cues...
