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Hypoglossal nerve stimulation for OSA

Hypoglossal nerve stimulation has been lauded as the great new surgical treatment panacea for obstructive sleep apnoea (OSA). This meta-analysis includes 12 studies with a total of 350 patients, including the five-year follow-up data from the STAR trial which was...

Risks of tracheostomy in head and neck cancer

Tracheostomy is associated with several complications, with rates quoted as high as 8-45%, including: bleeding; displacement; obstruction; surgical emphysema; pneumothorax; fistulae and failure to decannulate. There are now many studies that confirm the increased length of stay and complications of...

The effects of paediatric tracheostomy

Paediatric tracheostomy is usually an essential procedure to preserve life, or to allow a patient to function in the community. However, the effect of tracheostomy on the developing child - care requirements, lack of voice, impaired swallow, constant risk of...

RCT: tongue retaining devices vs CPAP for OSA

This study compared the effect of a tongue retaining device versus the use of CPAP in 27 patients within a crossover RCT design. Tongue retaining devices (also known as tongue stabilising devices), are similar in appearance to a plastic tongue-sized...

Are quinsies worth draining?

Recent data is providing accumulating evidence that treatment failure in the management of peritonsillar abscesses (PTAs, aka ‘quinsies’) is similar when these are managed with medical treatment (MT) alone versus MT plus surgical drainage (M+ST). However, in the absence of...

How best can we manage Samter’s Triad/AERD?

The classic ‘Samter’s Triad’ of asthma, chronic rhinosinusitis with nasal polyposis (CRSwNP), and aspirin sensitivity is now referred to as aspirin-exacerbated respiratory disease (AERD) or non-steroidal anti-inflammatory-exacerbated respiratory disease. We often come across in our rhinology setting, patients with recalcitrant...

What does an Olympic medal and surgery have in common?

Competing against female Eastern Bloc athletes in the 1980s was a thankless task, demanding a mulish tenacity in an often futile cause. Ideal preparation for a career in surgery? My path to medicine was unusual, in that I left school...

Incoming RSM Presidents share their plans for a year like no other!

It is a great honour for me to take on the Presidency of the Section of Laryngology and Rhinology at the Royal Society of Medicine. We have a very interesting, thought-provoking and educational programme ahead.

Laryngeal transplantation: is it a thing?

Few organs could be said to be more complex than the larynx when it comes to transplantation. Martin Birchall looks at past challenges, current issues and future prospects. I am not clear exactly why I chose to spend a life...

Roshna Rose Paul: interview between trainee and senior surgeon

Professor Paul has been heavily involved with training and educating multiple cohorts of ENT trainees over the years, since 2010. In this article, Mr Reid (a current ENT registrar from the West Midlands) picks her brains. Prof Roshna Rose Paul....

TORS for patients with sleep-disordered breathing

Transoral robotic surgery is now a well-accepted technique in malignant tumours of the tongue base. Here the team from St Mary’s and the Royal National Throat Nose & Ear Hospital in London describe its use in carefully selected patients with...

First UK hypoglossal nerve stimulation implant in the treatment for moderate to severe OSA

Obstructive sleep apnoea has been treated in many different ways over the years. We hear from Yakubu Karagama about one of the latest surgical developments. Introduction Obstructive sleep apnoea (OSA) is by far the most common sleep disorder, affecting all...