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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...

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...

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...

Beware the skinny patient…

The adverse health impacts of an excessive BMI are well known. This study highlights one laryngeal pathology for which a low BMI appears to be a significant risk factor. The records of 28 patients treated for arytenoid cartilage dislocation were...

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...

Long-term effectiveness of sleep surgery for obstructive sleep apnoea

n this study, 39 patients from Turkey with obstructive sleep apnoea (of varying severity) underwent an expansion sphincter pharyngoplasty. This operation was devised by Prof Kenny Pang in Singapore and involves using the palatopharyngeus muscle and partly relocating it laterally...

Role of maxillary sinus irrigation as an adjuvant to current management of chronic rhinusitis without polyposis

Several decades have passed since irrigation of maxillary sinuses generally became a treatment of the past. A more recent concept of biofilms may have evoked new interest in this past procedure, fraught with its own issues. In this study, the...

In conversation with Reza Rahbar

Reza Rahbar is professor of otolaryngology at Harvard Medical School and associate otolaryngologist-in-chief at Boston Children’s Hospital. He initiated and leads IPOG, the International Pediatric Otolaryngology Group. I met up with him to ask more about it. Reza Rahbar DMD,...

Impact of COVID-19 on ear surgeries

The authors review the impact of the coronavirus pandemic on the practice of ear surgeries in this article. The pandemic has changed how we practise medicine and introduced new guidelines to ensure safety of healthcare personnel. Studies have demonstrated COVID-19...

Surgical technology and operating room safety failures: lessons from vascular and general surgery

Background – surgical technology and otolaryngology An estimated 234 million major surgical procedures are performed annually worldwide. This requires the interaction of multidisciplinary teams with varying contributions of surgical technology and therefore makes surgical procedures prone to multiple sources of...

The role of macrolide antibiotics in chronic rhinosinusitis

The use of long-term antibiotics in the treatment of chronic rhinosinusitis is a contentious issue, not only because of the increasing problem with antibiotic resistance but also because of the potential cardiac risks, including sudden death. In this article, Anders...

Surgical challenges in advanced or recurrent thyroid malignancy

The management of thyroid malignancy and extent of surgery is controversial, especially considering the limitations of preoperative diagnosis. Neil Tolley provides guidance and reminds us of our responsibility not to over-treat. In the UK, 16% of thyroidectomies are performed for...