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103 results found

Is surgery in obese children with obstructive sleep apnoea effective?

The authors present the results of their literature review and meta-analysis of studies examining adenotonsillectomy, uvulopalatopharyngoplasty (UPPP), supraglottoplasty, tongue base surgery or a combination in obese children with obstructive sleep apnoea (OSA). The one study investigating effects of UPPP was...

Association of childhood OME with obesity

Many factors influence the development of otitis media with effusion (OME) in children, some of them being increased plasminogen factor inhibitor (PAI-1) levels, eustachian tube obstruction and gastro-oesophageal reflux. These factors are also associated with obesity. Sixty children with mean...

Factors determining success of adenotonsillectomy in paediatric obstructive sleep apnoea

Patient selection is important for any successful surgical procedure. Adenotonsillectomy for obstructive sleep apnoea secondary to adenotonsillar hypertrophy is no exception. This retrospective Taiwanese study attempts to find preoperative factors that have a positive influence for this commonly performed operation....

Velopharyngeal insufficiency after adenotonsillectomy

The authors retrospectively reviewed the clinical records of 320 paediatric patients who underwent either tonsillectomy, adenoidectomy or adenotonsillectomy, under a single paediatric ENT surgeon. Patients with pre-existing velopharyngeal insufficiency (VPI) were excluded, as assessed by preoperative testing for nasal air...

How should I excise sinonasal tumours, open or endoscopic? En bloc or piecemeal?

Sinonasal tumours often present late because initial symptoms mimic benign disease. They tend to produce more unilateral nasal symptoms, and patients with advance disease often describe paraesthesia and other cranial neuropathies. They only account for approximately 3% of upper aerodigestive...

Robotic surgery for ventral skull base malignancy

The use of transoral robotic surgery (TORS) in the head and neck area has been shown to be a safe and effective technique, achieving good oncological clearance of the oropharynx, hypopharynx, supraglottis and glottic area. However, robotic surgery for the...

External auditory canal carcinoma

Although uncommon, primary malignant tumours of the external auditory canal (EAC) are associated with a poor prognosis as they often present late. In this study the authors evaluate the clinical and pathological factors associated with treatment and outcome of EAC...

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...

How to deliver bad news better

Delivering bad news well takes experience and time. The Ida team recommend the SPIKES protocol; providing structure for relaying bad news, giving confidence to those delivering it, and leaving recipients feeling cared for and informed. It’s among the most distressing...

Clinical Practice Guideline on Tympanostomy Tube in Children Update (AAO-HNS)

The American Academy of Otolaryngology–Head and Neck Surgery Foundation’s ‘Clinical Practice Guideline: Tympanostomy Tubes in Children (Update)’ has been recently published - an update of the original 2013 guideline. This article forms an executive summary to accompany the full guideline....

A medical student’s perspective on the future of obstructive sleep apnoea management

Obstructive sleep apnoea remains an immensely challenging condition to treat. Many treatments have been used over the years, but no single management strategy has proven significantly better than the others. We hear about some technological innovations in the field of...

Finding the right balance: remote dizzy patient consultation during a pandemic

During the COVID pandemic, all our working patterns have changed. One significant impact had been on the management of outpatient consultations and the increase in telephone consultations and enhanced vetting. In this article the authors share their experience of managing...