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Columellar strut grafts versus septal extension grafts – which is better?

Rhinoplasty is a commonly performed procedure that, while often pursued for cosmetic enhancement, can also significantly influence nasal airway function. This seven year retrospective cohort study performed at a tertiary centre in Australia compares two well established techniques for nasal...

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...

Do adhesions actually cause nasal blockage?

All of us who perform nasal surgery are familiar with the disappointing presence of nasal adhesions (NA) or synechiae in our postop patients. These can often lead to patients deriving less perceived benefit from their surgery than that which they...

Effects of air pollution and climate change on the upper airways

Dr Alexander Simidchiev is a specialist in internal medicine, pulmonary medicine and public health. He is the Co-Founder and President of Air for Health, a non-profit organisation aimed at educating medical professionals about the impact of air pollution and climate...

Anaesthesia under fire

Kate Prior is an anaesthetist who has, quite literally, been there, done that. In this article she manages to use words on a page to bring to life some of the conditions and challenges she faced as a member of...

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...

Beware of GPA as a cause of subglottic stenosis

Up to 92% of patients with granulomatosis with polyangiitis (GPA) have concurrent ENT manifestations of the disease. Whilst we are familiar with sinonasal and middle ear presentations of GPA, subglottic stenosis (SGS) is another important and potentially life threatening manifestation....

Laryngotracheal stenosis

Airway stenosis has been an enormous challenge to laryngologists since the dawn of the sub-specialty. Careful evaluation is essential, as this will determine the best treatment. We hear more from one of the UK’s leading airway centres. Until the advent...

Coblation tongue channelling

After uvulopalatoplasty, the tendency is to focus on the tongue base as the next anatomical area to address in the management of snoring and sleep-disordered breathing. In this article, Glen Burgess describes the technique of tongue channelling, to reduce the...

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...

Lower respiratory involvement in allergic rhinitis and chronic sinusitis

The recent ARIA (Allergic Rhinitis and its Impact on Asthma) project has generated interest in simultaneous involvement of the lower respiratory airway in cases of chronic rhinosinusitis and allergic rhinitis. This study takes into account the extent of pulmonary function...

Preoperative planning of the surgical patient

This article covers the need to effectively optimise patient status preoperatively to help maximise postoperative outcomes. The article is well written and emphasises close liaison with anaesthetic colleagues particularly regarding airway assessment and nausea and vomiting. As is becoming common...