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Nasal decongestants don’t improve Eustachian tube function

Prescribing nasal steroids and decongestants. It’s something most of us do routinely, in an effort to reduce chronic middle ear effusion in an adult by trying to improve eustachian tube (ET) patency. This study used clever devices (tube manometry and...

European position paper on drug induced sedation endoscopy (DISE)

DISE is a controversial topic but a practice that is largely accepted in the UK. There has been much variation about the technique, and how to interpret the results. For this reason, a collection of European DISE bigwigs aimed for...

The effect of adenotonsillectomy on the immune system

Parents often ask about the effect of adenotonsillectomy on the immune system, with concerns that the child may be prone to more infections postoperatively due to the absence of immune tissue. This Belgian literature review looked at the local and...

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...

Military otolaryngology and its impact on civilian trauma care

Over the centuries, military conflicts and wars have caused both death and injuries and led to improvements in the care of the combat wounded. Military otolaryngologist-head and neck surgeons have been at the forefront of these developments and advances. War...

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....

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...

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...

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...