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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...

Postoperative complications in OSA patients

This well researched meta-analysis describes the various complications obstructive sleep apnoea (OSA) patients may acquire after surgery. These American reviewers found that OSA patients after non-upper airway operations, were more like to suffer (compared to non-OSA patients), from the following...

European position paper on drug induced sedation endoscopy (DISE)

DISE is a controversial topic but a practice that is largely accepted in the UK. There has been much variation about the technique, and how to interpret the results. For this reason, a collection of European DISE bigwigs aimed for...

Implications of tonsillectomy in very young children

This is a comprehensive study comprising 157 children who underwent tonsillectomy below the age of two years, mainly for sleep-disordered breathing (86.6%) and recurrent tonsillitis (7%). With relatively recent understanding of OSAS, the indications for tonsillectomy in children under two...

A review of DISE classification systems

This article looks at the wide variety of classification systems currently available for interpreting drug induced sleep endoscopy (DISE).The fact that there are so many classification systems, suggests that there is: A) a lot of disagreement about how DISE should...

Cascading communication skills to help children with autism

Inadequate workforce resource is an ongoing difficulty across the health professions. This study proposes a train the trainer model, with the ultimate goal of improving the communication skills of children with autism. The study describes an intervention called naturalistic developmental...

Outcome of TORS to tongue base and epiglottis in patients with OSA intolerant of conventional treatment

The use of transoral robotic surgery (TORS) in ENT is rather controversial, but the use of robotic surgery for obstructive sleep apneoa (OSA), makes it doubly so. Previous studies on TORS in OSA have been performed with other types of...

Paediatric obstructive sleep apnoea

As tonsillectomy rates for recurrent sore throats have declined, there has been increasing recognition of the importance of OSA in children. Not always diagnosed early – or in some cases at all – and with continuing debate as to how...

Voice outcomes following extended laser resections for laryngeal cancer

It is now widely accepted that the oncological and voice outcomes following transoral laser microsurgery for early T1a glottic cancers are equivalent to, if not superior to, traditional radiotherapy. Voice outcomes following more extensive resections have not been as frequently...

Linking tooth extraction and snoring

One of the more contemporaneous theories about OSA is that extraction of teeth or other orthodontic treatment during the development of the facial skeleton leads to alteration of bony growth and therefore alteration of the final result. There is evidence...

Singing and COVID-19 – research on aerosols and singing

Early in the COVID-19 pandemic, clusters of disease occurred in choirs. This led to an assumption that singing was inherently ‘dangerous’ and governments around the world rapidly banned singing. The ban was then extended to...

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...