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Botulinum toxin injection for bilateral recurrent laryngeal nerve paralysis

All traditional surgical treatments for bilateral recurrent laryngeal nerve (RLN) paralysis are essentially a balance between maximising airway patency and ensuring adequate phonation / airway protection. This paper highlights the potential role of botulinum toxin (Botox) injection into the cricothyroid...

Curettage adenoidectomy impairs eustachian tube function

Adenoidectomy is a common procedure undertaken for obstructive sleep apnoea and nasal obstruction. Curettage is the most common technique but is associated with complications (mucosal trauma, bleeding) that may cause eustachian tube dysfunction (ETD). This study analysed changes in middle...

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...

What to do if adenotonsillectomy does not cure sleep apnoea in children?

This article reviews the management of children with persistent obstructive sleep apnoea (OSA) following adenotonsillectomy (AT). Risk factors for patients to have persistent disease include obesity, being Afro-Caribbean and existing co-morbidities such as craniofacial and neuromuscular disorders. Initial assessment 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...

Take a breath between mouthfuls

Pulse oximetry provides a measure of the percentage of oxygen in the blood. The usual range of readings on pulse oximetry is 97-99%. Older people may have lower pulse oximetry readings than younger people, and young women have higher readings...

Does endoscopic sinus surgery for chronic rhinosinusitis improve COPD?

Chronic rhinosinusitis (CRS) can be associated with asthma, with a reported frequency of asthma in patients with CRS of up to 44%. COPD is another lung condition that can be associated with CRS. This longitudinal study reviewed the nasal and...

Pulsatile tinnitus, one more piece in the jigsaw

Pulsatile tinnitus (PT) is a common ENT symptom. It can generally be divided into venous and arterial. Arterial PT might be investigated with a CT scan while a venous one with an MRI or an MRV (MRI Venogram). Anecdotally, arachnoid...