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Surgical management of permanent facial paralysis

This article explores the management of flaccid facial palsy focusing on weakness less than one to two years’ duration. As a general rule, primary nerve repair produces the best outcome and should be performed where possible. For long-standing paralysis of...

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...

An alternative device for obstructive sleep apnoea

Continuous positive airway pressure (CPAP) is the first-line treatment for obstructive sleep apnoea (OSA), primarily due to the vast amount of short-term evidence in the medical literature it has accrued. The enduring obstacle to CPAP from becoming a treatment option...

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...

Dysphagia in people with HPV-related oropharyngeal cancer

Human papilloma virus (HPV) associated oropharyngeal cancers are becoming much more prevalent and, in some geographic areas, have overtaken tobacco as the leading cause of oropharyngeal cancer. HPV-associated cancers are also reported to have better prognosis in general, and research...

Foretelling: post-stroke recovery of dysphagia is predicted by cognition

Around two thirds of people in the acute phase of stroke recovery will experience dysphagia. Up to six months following a stroke this may be present in 13-18% of cases. The degree of cognitive impairment seems to be associated with...

Does the appearance, texture, and flavour of food affect how we swallow?

Texture modification and the use of thickened fluids are well-known strategies used to facilitate swallowing in people with dysphagia. However, some controversy exists around thickeners and their possible negative impact on hydration and medication absorption. This paper considers other properties...

Does vocal tremor lead to changes in swallowing function?

Vocal tremor (VT) is a debilitating problem, but remains challenging to treat. Its pathophysiology remains indeterminate and there is a lack of consensus on phenotypes. Clinically, VT is often noted to be present in muscles outside of the larynx, including...