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Diagnosis of obstructive sleep apnoea hypopneoa syndrome (OSAHS) without sleep studies

Polysomnography is considered the ‘gold standard’ in the diagnosis of sleep apnoea but it is expensive and difficult to perform in children. Diagnosis based on subjective judgement is often inaccurate. An accurate diagnostic scale based on clinical parameters could obviate...

The Impact of sleep endoscopy for paediatric obstructive sleep-disordered breathing

Paediatric obstructive sleep apnoea (OSA) is not always resolved or improved with adenotonsillectomy. Persistent or complex cases of paediatric OSA may be due to sites of obstruction in the airway other than the tonsils and adenoids. Investigation of paediatric obstructive...

Medical trends in sleep disordered breathing

This duo provide an eloquent outline of sleep disordered breathing in general, with particular emphasis on the medical impact and associations of the condition. The increasing prevalence of the condition is described, with increasing worldwide obesity, increased association of cardiac...

Surgical management of sleep disordered breathing

Snoring and sleep-disordered breathing are often described as multi-level problems, and different surgical procedures are required to treat the various sites of airway narrowing and/or collapse. Jonathan Hobson gives us an eloquent run-through the various options available to the ENT...

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...

Stimulation for a good night’s sleep

This article was an interesting read. It is an update from the authors’ original paper printed in the NEJM in 2014 regarding the results of an implantable pulse generator (IPG) for stimulating the hypoglossal nerve in response to respiration. This...

Sleep apnoea in children with craniofacial syndromes

Whilst snoring and obstructive sleep apnoea are relatively common diagnoses in paediatric ENT, children with craniofacial syndromes take the problem to the next level. Robert Nash and Michelle Wyatt describe the Great Ormond Street multidisciplinary approach to treating this complex...

TORS for patients with sleep-disordered breathing

Transoral robotic surgery is now a well-accepted technique in malignant tumours of the tongue base. Here the team from St Mary’s and the Royal National Throat Nose & Ear Hospital in London describe its use in carefully selected patients with...

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...

Sleep before and after nasal polyposis surgery

This prospective French study looked at the change in nasal symptoms related to sleep, in a questionnaire before and after nasal polyposis surgery. Sixty-three patients who underwent endoscopic sinus surgery completed the DyNaChron questionnaire before, at six weeks and at...

Should human beings sleep in the prone position?

Are we poised for a ‘sleep prone’ campaign to reduce nocturnal apnoeas? Prof Armin Moniri presents a fascinating account of how sleeping position can affect obstructive sleep apnoea. Inspired by sleeping position of other mammals, a new mattress and pillow...

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...