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...

Can obstructive snoring affect the snorer’s ears as well?

Patients with obstructive sleep apnoea (OSA) often show severe nasal obstruction, chronic sinusitis and/or a deficit of nasal mucociliary clearance with nasopharyngeal stagnation of secretions possibly predisposing to eustachian tube dysfunction (ETD). This clinical prospective study investigates ETD, nasal resistance...

Predicting postoperative respiratory complications following paediatric adenotonsillectomy

This systematic review aimed to compare the presence of clinical features versus the polysomnography results in predicting major postoperative respiratory complications in children undergoing adenotonsillectomy for OSA. The study was prepared according to the PRISMA checklist. Overall 22 studies met...

Can telemetry predict sleep apnoea in Pierre Robin sequence?

The aim of this study was to see if telemetry data gathered on patients with Pierre Robin sequence (PRS) correlated with sleep study data. A retrospective review of 46 patients from a tertiary referral centre were included in the study....

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...

Polysolmnography and laryngomalacia severity

Laryngomalacia represents the single most common cause of stridor in infants. Most cases are self-resolving, but a proportion of children will require surgical intervention. This group aimed to analyse the efficacy of polysomnography in determining the severity of laryngomalacia in...

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...

Comparison of outcomes after septoplasty

For this prospective study, the authors assessed the quality of life (QoL) with the rhinosinusitis SNOT-20 (Sino-Nasal Outcome Test-20) questionnaire and the symptoms on a visual analogue scale (VAS) in all patients undergoing nasal septal surgery. The patients reported the...

Surgical options for children with OSA

This paper looks at the surgical management of OSA in children and approaches the method of patient selection initially. They discuss the role of polysomnography in that it is part of the AAOHNS criteria in those patients with OSA symptoms...

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...

Stimulation for a good night’s sleep

This article was an interesting read. It is an update from the authors’ original paper printed in the NEJM in 2014 regarding the results of an implantable pulse generator (IPG) for stimulating the hypoglossal nerve in response to respiration. This...

Effectiveness of oral pressure therapy in obstructive sleep apnoea: a systematic analysis

Oral pressure therapy (OPT) is a relatively new form of therapy for obstructive sleep apnoea (OSA). Paradoxically it seems to work even though it creates a vacuum in the oral cavity as opposed to the gold standard of continuous positive...