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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...

Low risk options following failure of intratympanic gentamicin for Meniere’s

This article is a useful summary of the options available when intratympanic gentamicin (ITG) fails to adequately control vertigo episodes in Meniere’s patients. The authors describe the anatomical reasons that may impede drug delivery to the round window with the...

A multidisciplinary approach to the management of frontal sinus fracture

Frontal sinus fractures account for about 5% of all facial trauma. Fractures of the posterior wall may result in cerebrospinal fluid (CSF) leak and meningitis, while obstruction of the outflow tract can cause sinusitis and mucocele formation. However, there are...

Is it possible to fix condylar neck fractures with one plate?

Fractures of the condylar neck are fairly common and account for over 25% of all mandible fractures. Over the years a number of modalities have been used to fix these fractures. Direct reduction is complicated by the overlying proximity of...

Differing types of pharyngeal pouch

This article raised an eyebrow on the grounds that apparently more than one type of pharyngeal pouch exists! They differ in terms of aetiology, site and approach to treatment, therefore awareness of them is advised to ensure the appropriate surgical...

Persistent dysphonia due to cricothyroid muscle dystonia – should we be requesting laryngeal EMGs for non-resolving ‘functional’ dysphonia?

This article is an interesting report of a case of persistent voice problems affecting a 43-year-old physician that significantly compromised her ability to converse and communicate at work. Specifically, she had a fluctuating voice quality that would ‘choke off’, combined...

Clinical assessment in OSA

This paper divides the assessment up into anatomical (nasal and oropharyngeal), endoscopic and imaging. It points out the salient features to look out for in OSA patients with regards the nasal valve and also oropharyngeal anatomy, with tonsil hypertrophy grading...

Botulinum toxin and drooling – how much, how often and where?

This was an incredibly useful article covering all aspects of the use of botulinum toxin as a treatment modality in sialorrhoea. The article starts by outlining why treating sialorrhoea is important and describes the non-pharmacological and pharmacological options, highlighting that...

Combined endoscopic and transcutaneous approach for removal of parotid stones

The authors describe a small case series (n=8) of patients with obstructive symptoms from sialolithiasis of the parotid gland. A combined endoscopic and transcutaneous approach was used. The position of the stone in Stensen’s duct was identified by endoscopic transillumination....