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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...

Is it worth paying for group therapy?

Group therapy for post-stroke communication difficulties has been described in the research literature for more than 50 years and is generally considered an efficacious approach. Yet these authors express concern that the American Medicare system is less willing to fund...

Investigation of the role of KPNA2 biomarker in oral SCC invasiveness

This edition of Head and Neck has a strong focus on studies using immunohistochemistry (IHC) to elucidate potential roles of various cell-signalling molecules in both HNSCC and thyroid cancer. The ‘cellular-protein heavy’ title of this article may be off-putting to...

Head injury and prolonged bed rest, but not inner ear disease, predict poorer outcome after Epley manoeuvre in posterior semicircular canal benign paroxysmal positional vertgo (P-BPPV)

This Japanese study included 197 patients with P-BPPV treated over a two and a half year period. The vast majority had idiopathic BPPV (n=157). The remaining 40 had secondary BPPV, eight following head trauma, 14 due to prolonged bed rest...

Clinical features of BPPV in Meniere’s disease

It is an observation that BPPV appears to be commonly associated with Meniere’s disease (MD). This five-year study compared features and treatment outcomes between patients presenting with MD in conjunction with unilateral BPPV and a group of BPPV patients without...

The degree of barbecue rotation matters in horizontal canal BPPV

Treatment of horizontal canal BPPV (Hc-BPPV) is not without controversy due to the several repositioning manoeuvres advocated for its treatment. Among the many, barbecue rotation (Br) is perhaps the most commonly used for canalithiasis of Hc-BPPV. Should the rotation be...

Imaging of the parathyroid glands in primary hyperparathyroidism: where do we stand?

Primary hyperparathyroidism (PHPT) refers to an intrinsic parathyroid gland abnormality that produces excessive secretion of parathyroid hormone. PHPT is diagnosed biochemically, and surgical excision of the abnormal parathyroid tissue represents the only definitive cure. Historically, the standard operative management of...

The debate: endoscopic vs microscopic ear surgery – meta-analysis of outcomes

Although the endoscopic approach to ear surgery has become more common in clinical practice, the debate about its role versus the traditional microscopic approach continues in many ENT units. This meta-analysis from the Mount Sinai ENT department in New York...

Rhinotillexomania - how bad can nose picking get?

This is a fascinating first case report of rhinotillexomania associated with empty nose syndrome (ENS). Rhinotillexomania encompasses compulsive, pathological nose picking and is a variant of self-harm. Tranchito and Chhabra describe an elderly patient presenting with longstanding symptoms of nasal...

Enhanced recovery following surgery for head and neck cancer – the current evidence

Enhanced recovery after surgery (ERAS) programmes are now well established in many surgical specialities as a means of reducing postoperative complications and length of stay in hospital. Whilst many head and neck teams have interventions used to aid postoperative recovery,...

Performing ethnic aesthetic rhinoplasty

This article reviews principles of performing rhinoplasty in non-Caucasian patients, exploring patient expectations based on differences in race, ethnicity and culture. One of the main challenges is a lack of well-established ideal facial measurements for different non-Caucasian groups. The authors...

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...