Instrument assessment preferable over standard beside swallow to determine prevalence of aspiration

Aspiration does not trigger the protective cough response in some patients. The patient’s response may vary according to fluid viscosities and volume. The authors of this prospective study investigated the prevalence of aspiration and response to aspiration of different viscosities...

DISE as a rationalising tool for sleep apnoea surgery

This retrospective study on 85 adult obstructive sleep apnoea (OSA) patients provides further interesting information for sleep surgeons. These patients were all investigated with polysomnography (PSG) and drug induced sleep endoscopy (DISE). They all then underwent a simple uvulopalatoplasty with...

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...

Evidence for diagnostic role of narrow band imaging in the outpatient setting for head and neck squamous cell carcinoma

Narrow band imaging (NBI) uses light in the blue and green spectrum to differentiate areas of carcinoma from normal or inflammatory tissue. This tertiary referral head and neck unit in Spain used white light endoscopy as initial screening for all...

A beginner’s guide to endoscopic ear surgery (EES)

For some, this article will not provide them with anything new with respect to EES – in particular, the advantages of the technique and how to achieve them. However, for those surgeons who are debating whether to embark on the...

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...

Describing the most useful OSA assessment?

This article sets out to comprehensibly describe drug induced sleep endoscopy and its role in determining the level of obstruction in patients with OSA. The advantages described include the fact that other techniques, including Muller’s manoeuvre, have significant variation in...

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...

Variations in obstructive level with increasing depth of sedation in DISE

This study highlights some of the controversies surrounding DISE (Drug Induced Sedation Endoscopy, or otherwise known as sleep nasendoscopy in the UK). On one hand it provides some evidence that the BIS (BiSpectral Index), recordings of patients while they are...

Surgery for hypopharyngeal obstruction causing OSA

Surgical treatments for OSA are evolving with improved diagnostic accuracy of the level(s) involved. Where the collapsing segment lies below the soft palate, a variety of surgical techniques to correct the affected segment(s) are emerging. This article concentrates on one...

The Impact of sleep endoscopy for paediatric obstructive sleep-disordered breathing

Paediatric obstructive sleep apnoea (OSA) is not always resolved or improved with adenotonsillectomy. Persistent or complex cases of paediatric OSA may be due to sites of obstruction in the airway other than the tonsils and adenoids. Investigation of paediatric obstructive...