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A medical student’s perspective on the future of obstructive sleep apnoea management

Obstructive sleep apnoea remains an immensely challenging condition to treat. Many treatments have been used over the years, but no single management strategy has proven significantly better than the others. We hear about some technological innovations in the field of...

The role of the respiratory physician in sleep medicine

ENT surgeons may feel that they are the first point of referral for the majority of patients with snoring and possible obstructive sleep apnoea, but in reality a significant number of patients with sleep-disordered breathing (of any cause) are seen...

Vocal cord dysfunction and dysfunctional breathing: an evolving clinical paradigm

Patients frequently present to the ENT department with breathing difficulties. The entity of ‘vocal cord dysfunction’ (also known as paradoxical vocal cord movement, inducible laryngeal obstruction, and many other names) is increasingly well recognised. Ravi Thevasagayam gives us an overview....

What has NAIROS taught us about septoplasty?

Septoplasty is a commonly performed procedure worldwide for nasal obstruction associated with a deviated nasal septum. In the UK, with long waiting lists for septoplasty, there is a large and unexplained variation in the incidence of this procedure between individual...

The Laryngectomee Guide

As a Macmillan Head and Neck Specialist Nurse, I was very pleased to be asked to review this book, The Laryngectomee Guide, by Itzhak Brook, MD. It is fair to say that for most laryngectomy patients, life does go on...

“It’s paediatric resus calling…”

This article is one of many within this issue that addresses a variety of ENT emergencies. The article outlined the stepwise process of assessing and managing a child with a suspected foreign body (FB) inhalation. Nuts, seeds and vegetable matter...

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...

Hypoglossal stimulation for OSA

Continuous positive airway pressure (CPAP) is a highly effective treatment for moderate-to-severe obstructive sleep apnoea (OSA), but suffers significantly from poor patient adherence. This paper reports the three-year outcomes of a prospective multicentre cohort study examining the effect of hypoglossal...

Suspect the unsuspecting in thyroid cancer

This article reminds readers of how often invasive thyroid disease can appear, as the symptomatology is minimal. Noticeable airway symptoms appear after 50% of the airway is involved and surgeons can often fall in the unsuspecting trap of discovering locally...

Clinical assessment in OSA

This paper divides the assessment up into anatomical (nasal and oropharyngeal), endoscopic and imaging. It points out the salient features to look out for in OSA patients with regards the nasal valve and also oropharyngeal anatomy, with tonsil hypertrophy grading...

Does CPAP help diabetes?

This meta-analysis and review of the literature examines the long-held belief that CPAP treatment improves glucose levels in patients with OSA. As usual in these cases, thousands of articles were initially flagged up in the search with only six RCTs...

DISE as a rationalising tool for sleep apnoea surgery

This retrospective study on 85 adult obstructive sleep apnoea (OSA) patients provides further interesting information for sleep surgeons. These patients were all investigated with polysomnography (PSG) and drug induced sleep endoscopy (DISE). They all then underwent a simple uvulopalatoplasty with...