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The modern management of Ménière's disease
In this article, John Phillips considers the evolution of management options for Ménière’s disease. Treatment options past and present are discussed, together with an insight into future developments regarding the role of intratympanic steroids. Ménière's disease can be the source...First UK hypoglossal nerve stimulation implant in the treatment for moderate to severe OSA
Obstructive sleep apnoea has been treated in many different ways over the years. We hear from Yakubu Karagama about one of the latest surgical developments. Introduction Obstructive sleep apnoea (OSA) is by far the most common sleep disorder, affecting all...
Reactive lesions of the contralateral vocal cord – excise or leave?
It is well recognised that benign lesions of one vocal cord can give rise to reactive lesions of the contralateral vocal cord directly opposite to the primary lesion. These contralateral reactive lesions (CRLs) are thought to arise due to impact...Functional Endoscopic Sinus Surgery (FESS) - Part 2
In the first of this two-part series, Martyn Barnes and colleagues discussed indications for functional endoscopic sinus surgery (FESS), the surgical objectives and techniques, patient expectations and the risks of surgery [1]. In this second and final part, the authors...
Curettage adenoidectomy impairs eustachian tube function
Adenoidectomy is a common procedure undertaken for obstructive sleep apnoea and nasal obstruction. Curettage is the most common technique but is associated with complications (mucosal trauma, bleeding) that may cause eustachian tube dysfunction (ETD). This study analysed changes in middle...
Take a breath between mouthfuls
Pulse oximetry provides a measure of the percentage of oxygen in the blood. The usual range of readings on pulse oximetry is 97-99%. Older people may have lower pulse oximetry readings than younger people, and young women have higher readings...
Does endoscopic sinus surgery for chronic rhinosinusitis improve COPD?
Chronic rhinosinusitis (CRS) can be associated with asthma, with a reported frequency of asthma in patients with CRS of up to 44%. COPD is another lung condition that can be associated with CRS. This longitudinal study reviewed the nasal and...
Pulsatile tinnitus, one more piece in the jigsaw
Pulsatile tinnitus (PT) is a common ENT symptom. It can generally be divided into venous and arterial. Arterial PT might be investigated with a CT scan while a venous one with an MRI or an MRV (MRI Venogram). Anecdotally, arachnoid...
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...
What to do if adenotonsillectomy does not cure sleep apnoea in children?
This article reviews the management of children with persistent obstructive sleep apnoea (OSA) following adenotonsillectomy (AT). Risk factors for patients to have persistent disease include obesity, being Afro-Caribbean and existing co-morbidities such as craniofacial and neuromuscular disorders. Initial assessment of...
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...
