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The Performer’s Voice – Second Edition

The editors of this 450-page book are amongst the most respected laryngologists in the world, with a vast amount of experience between them. It is therefore no surprise that they have put together a very comprehensive and well thought-out book....

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...

Long-term effectiveness of sleep surgery for obstructive sleep apnoea

n this study, 39 patients from Turkey with obstructive sleep apnoea (of varying severity) underwent an expansion sphincter pharyngoplasty. This operation was devised by Prof Kenny Pang in Singapore and involves using the palatopharyngeus muscle and partly relocating it laterally...

Role of maxillary sinus irrigation as an adjuvant to current management of chronic rhinusitis without polyposis

Several decades have passed since irrigation of maxillary sinuses generally became a treatment of the past. A more recent concept of biofilms may have evoked new interest in this past procedure, fraught with its own issues. In this study, the...

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...

Method of delivery: all topical nasal corticosteroids are not made equal

There is an increasing body of evidence that the role of surgery for chronic rhinosinusitis is to facilitate the delivery of topical medical treatment – most notably, topical corticosteroids. Two recent studies, one using flow dynamics and another one examining...

Beware the skinny patient…

The adverse health impacts of an excessive BMI are well known. This study highlights one laryngeal pathology for which a low BMI appears to be a significant risk factor. The records of 28 patients treated for arytenoid cartilage dislocation were...

What is the evidence for contralateral tonsillectomy in TORS for known unilateral tonsil malignancy?

The concept of field changes by carcinogens within the upper aerodigestive tract is well established with reported rates of synchronous tumours of 4% and second primaries of 36%. The tonsil in particular has the highest rate of synchronous tumours, postulated...

Rationales to explore the neck in penetrating injuries

Penetrating neck injuries in the UK are more commonly associated with low velocity objects such as knives and blades as opposed to gunshots. To explore the neck requires careful consideration of the need to do so in line with Burgess...

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...

Learning curve for sialendoscopy

Sialendoscopy represents a minimally invasive technique that permits direct salivary tree visualisation and treatment using endoscopic techniques. Previous studies have shown that it is an efficacious, safe and potentially gland preserving method to treat major salivary gland disease. However, it...

Addressing ear and hearing care through task sharing: the Malawian experience

How can ear and hearing care be addressed in a setting with limited resources? Wakisa Mulwafu, Chris Prescott and Johan Fagan present an innovative model for training ear surgery technicians to perform endoscopic myringoplasty under local anaesthesia on a large...