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How useful is AHI?

There is a growing unease in the sleep medicine world about the usefulness of the apnoea-hypopnoea index (AHI). Most of our objective evidence about obstructive sleep apnoea (OSA) is in some way related to the AHI, and the respiratory physicians...

Less pain more gain: impact of prophylactic gabapentin on swallowing outcomes in head and neck cancer patients undergoing radiation treatment

Patients planned for chemoradiation to the head and neck are usually advised to expect some pain and soreness during their treatment and that pain relief will be offered as and when it is required. Uncontrolled pain and mucositis affect oral...

Microsurgical trainees to avoid strenuous exercises?

It is commonly believed among microsurgeons that over-exertion can impair microsurgical performance. The authors aimed to investigate if they could prove this theory and compared the performance of medical students, postgraduate trainees and expert controls who were microsurgery tutors. A...

Associated findings in MRI used for detecting acoustic neuroma

Presently, gadolinium enhanced magnetic resonance imaging is the ‘gold standard’ for investigating acoustic neuroma. There are often ‘incidental’ findings that may or may not be significant. In this study of 109 scans, the authors noted an uptake of 0.9% for...

Is it possible to fix condylar neck fractures with one plate?

Fractures of the condylar neck are fairly common and account for over 25% of all mandible fractures. Over the years a number of modalities have been used to fix these fractures. Direct reduction is complicated by the overlying proximity of...

Is bone cement a cost-effective solution?

This study looks at the functional results of 52 patients who underwent bone cement ossiculoplasty. Patients were divided into four groups based on ossicular disruption. Group 1 (30 patients) had lenticular erosion only. Group 2 (13 patients) had absent incus....

Stenting and sinus surgery

Stents are used in sinus surgery with the aim of maintaining patency of sinus cavity avoiding restenosis from inflammation or scarring. The exact indication for stenting in sinus surgery however is still debated. The authors discussed the potential role of...

Allergen immunotherapy and allergic rhinitis – EAACI guideline 2017

Allergic rhinitis (AR) is a common chronic childhood disease with considerable social burden and impact on quality of life, frequently necessitating treatment with various combinations of antihistamines and corticosteroids. The allergen immunotherapy (AIT), sometimes known as desensitisation therapy, can modify...

Role of oral and intranasal steroids in the management of otitis media with effusion

Inflammation is considered an important factor in the pathogenesis and continuation of otitis media with effusion. Theoretically, this may support the use of steroids, oral or intranasal in the management of this condition. This study comprised three well matched groups...

Myringoplasty in a bottle?

Management of large traumatic TM perforations can involve observation and water precautions or surgical repair. Closure rates for larger perforations can be 8-12 weeks and occurs for between 38-79%. Animal and human studies have shown that exogenous application of epidermal...

Help or hinder: how and why do SLTs make clinical decisions around swallowing?

Dysphagia is a relatively common consequence of stroke, with estimates between 50% and 60% of people presenting with swallowing dysfunction following stroke. It is associated with pneumonia, malnutrition and dehydration which in turn lead to increased length of hospital admission,...

Facial reconstruction with polyethylene implants

Planning reconstructive surgery for complex craniofacial defects challenges even the most experienced of surgeons. In most cases surgery is undertaken to improve anatomical functioning. However the anatomical structure of these regions is also critical to facial aesthetics and patient satisfaction...