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Effectiveness of oral pressure therapy in obstructive sleep apnoea: a systematic analysis

Oral pressure therapy (OPT) is a relatively new form of therapy for obstructive sleep apnoea (OSA). Paradoxically it seems to work even though it creates a vacuum in the oral cavity as opposed to the gold standard of continuous positive...

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...

BPPV duration as a predictor for therapy

Benign paroxysmal positional vertigo (BPPV) is one of the most common vestibuar disorders encountered in the neurotology clinic. The majority of cases of BPPV are due to vestibuar lithiasis in the posterior semicircular canal, but there are reports of cases...

Sialendoscopy assisted excision of parotid stones

This is a retrospective paper from China that looks to assess the efficacy and safety of sialendoscopy with a combined transoral or transcutaneous approach for the removal of parotid stones. Sialolithiasis is known to be a cause for obstructive parotid...

Treating keloid scarring with pressure clips following excision: does it work?

Keloid scars can pose a difficult management problem. Whilst not harmful in themselves they can be cosmetically unappealing and lead to social embarrassment and resulting isolation, and following surgical excision they often reoccur. Mechanical pressure is an adjuvant to surgical...

Surgical voice restoration after laryngopharyngectomy

Voice restoration is one of the key rehabilitative steps after laryngectomy or total laryngopharyngectomy (TLP). Patients who undergo TLP require reconstruction – increasingly commonly with microvascular free flaps. Despite their advantages in terms of fistula rates and swallowing outcomes, these...

Patient reported outcomes improve if antibiotic choice is directed from endoscopic culture results in chronic rhinosinusitis

The use of antibiotics in chronic rhinosinusitis (CRS) has been established as part of the EPOS guidelines, as has the role of taking swabs for microbiology culture. There has not been much literature however on whether tailoring antibiotics in response...

Postop follow up of oral squamous cell carcinoma: a new protocol

Oral and oropharyngeal cancers together are the sixth most common malignancy in the world, with an increasing incidence of oral squamous cell carcinoma (OSCC). The recurrence rate of OSCC is reported to be approximately 10-26%. About two-thirds of all recurrent...

New diagnostic criteria for Ménière’s disease – an international consensus

Most readers are familiar with the American Academy diagnostic criteria for Ménière’s disease (MD) but a significant minority will be aware of other criteria from Japan and Korea. This new effort is a collaboration between these three bodies and the...

CSF leak – endoscopic or open repair?

Cerebrospinal fluid (CSF) rhinorrhoea is well known to the ENT surgeon. It commonly occurs secondary to a predisposing event such as accidental or iatrogenic trauma. When it occurs spontaneously, it can be associated with benign intracranial hypertension. The commonest CSF...

Mitomycin in adjuvant treatment of laryngotracheal stenosis

Laryngotracheal stenosis (LTR) is a difficult condition to manage, and the effectiveness of surgical treatment is limited by the tendency of scar tissue to reform. Mitomycin has been used as a controversial adjuvant to surgical treatment for many years. Drawbacks...