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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...

Method of delivery: all topical nasal corticosteroids are not made equal

There is an increasing body of evidence that the role of surgery for chronic rhinosinusitis is to facilitate the delivery of topical medical treatment – most notably, topical corticosteroids. Two recent studies, one using flow dynamics and another one examining...

Paediatric obstructive sleep apnoea

As tonsillectomy rates for recurrent sore throats have declined, there has been increasing recognition of the importance of OSA in children. Not always diagnosed early – or in some cases at all – and with continuing debate as to how...

Cytomegalovirus (CMV) and the vestibular system: a case study

This team of audiologists from Cincinnati Children’s Hospital Medical Centre discuss an eight year old with congenital CMV, a neonatal infection which is usually asymptomatic, and provide guidance on how to recognise the signs in the paediatric population, and screen...

Mindfulness and tinnitus: a path to peace in the present

How does training the mind to be present in the here and now help patients with troublesome tinnitus? James Jackson discusses mindfulness and its place in tinnitus management. Although definitions can be more complex, tinnitus is the perception of sound...

Safeguarding Physician Wellbeing: Using Checklists for Personal, Professional and Psychological Safety

‘Checklists’ in the operating room make for safer surgery, better handovers and improved patient care. Can we apply the principles we have learned since Atul Gawande and the WHO pioneered this approach to surgery to our own wellbeing as doctors,...

Sleep apnoea in children with craniofacial syndromes

Whilst snoring and obstructive sleep apnoea are relatively common diagnoses in paediatric ENT, children with craniofacial syndromes take the problem to the next level. Robert Nash and Michelle Wyatt describe the Great Ormond Street multidisciplinary approach to treating this complex...

Reflections on virtual teaching

In a situation where we cannot meet our students (whether they be medical professionals or non-medical), how do we maintain their education? Peter Samuel has been speaking to some colleagues on how they have risen to the challenge. The COVID-19...

Thyroid nodules – time for a rational imaging approach

“The more you know, the harder it is to take decisive action. Once you become informed, you start seeing complexities and shades of gray. You realize that nothing is as clear as it first appears. Ultimately, knowledge is paralyzing.” Calvin,...

In conversation with Professor Claire Hopkins

There can be few ENT surgeons who have had such a pivotal role in the COVID pandemic as Claire Hopkins. She has been instrumental in changing the diagnostic criteria, and has been a frequent presence in the media, as Sean...

A diagnosis-based scoring system to predict outcomes in necrotising otitis externa

Patients admitted with necrotising otitis externa have increased six-fold in the last 10 years. The prognosis is variable and dependent on co-existing morbidities. Charlston Comorbidity Index (CCI) is a weighted comorbidity scoring method, based on the presence or absence of...

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...