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...

OSA – do the parents know best?

The difficulty in using the history and examination to determine the severity of sleep disordered breathing in children is well established. The relative prevalence of sleep disordered breathing symptoms in children, and the relative paucity of capacity and restrictive cost...

An alternative device for obstructive sleep apnoea

Continuous positive airway pressure (CPAP) is the first-line treatment for obstructive sleep apnoea (OSA), primarily due to the vast amount of short-term evidence in the medical literature it has accrued. The enduring obstacle to CPAP from becoming a treatment option...

Lingual tonsils and obstrucive sleep apnoea syndrome (OSAS)

Obstructive sleep apnoea can be due to narrowing of the retrolingual space by hypertrophic lingual tonsils. The authors studied 11 patients (five males and six females with a mean age of 44.3 years and a mean BMI of 28.6). All...

Maxillomandibular advancement for sleep apnoea

This is a meta-analysis compiled from India. Of the initial 103 publications, 20 were analysed. Surgical cure was defined as postsurgical AHI of fewer than five events per hour. Of the 251 patients assessed for AHI, 12 were considered normal,...

Double suspension sutures for obstructive sleep apnoea

This study examines the benefit of an operation that targets the lateral pharyngeal wall. The double suspension sutures are, in essence, a suture through the palatopharyngeus muscle which is then tied around the hamulus in the retro molar area. This...

A review of significant issues in the management of obstructive sleep apnoea in children

There are considerable variations in the management of obstructive sleep apnoea in children and this suggests a need for more research and evidence-based information. In this review article, the authors address four key issues. Literature compares tonsillectomy with tonsillotomy, the...

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...

Modern surgical treatment for obstructive sleep apnoea indicate suppression of inflammatory cytokines

This study comprises 57 patients, 29 of which were treated by anterior palatoplasty procedure, expansion sphincter pharyngoplasty and submucosal minimal invasive lingual excision techniques and 27 by CPAP therapy. Parameters to determine success were AHI, VAS score, ESS score, mean...

Diagnosis of obstructive sleep apnoea hypopneoa syndrome (OSAHS) without sleep studies

Polysomnography is considered the ‘gold standard’ in the diagnosis of sleep apnoea but it is expensive and difficult to perform in children. Diagnosis based on subjective judgement is often inaccurate. An accurate diagnostic scale based on clinical parameters could obviate...

Surgery for snoring

The prevalence of sleep-disordered breathing is rapidly increasing. There is variable evidence for surgical treatments for snoring currently. This Belgian study was a retrospective review of 84 patients who underwent surgery for snoring between May 2011 and December 2015. A...

The sleep nasendoscopy learning curve

There seems to be no accepted way of surgically assessing patients with sleep disordered breathing (SDB). Because of this, clinicians fall roughly into three camps: those who just use one operation for all patients, those who have given up surgery...

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