Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
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Otolaryngol Head Neck Surg · Nov 2008
Review Practice GuidelineClinical practice guideline: benign paroxysmal positional vertigo.
This guideline provides evidence-based recommendations on managing benign paroxysmal positional vertigo (BPPV), which is the most common vestibular disorder in adults, with a lifetime prevalence of 2.4 percent. The guideline targets patients aged 18 years or older with a potential diagnosis of BPPV, evaluated in any setting in which an adult with BPPV would be identified, monitored, or managed. This guideline is intended for all clinicians who are likely to diagnose and manage adults with BPPV. ⋯ This clinical practice guideline is not intended as a sole source of guidance in managing benign paroxysmal positional vertigo. Rather, it is designed to assist clinicians by providing an evidence-based framework for decision-making strategies. The guideline is not intended to replace clinical judgement or establish a protocol for all individuals with this condition, and may not provide the only appropriate approach to diagnosing and managing this problem.
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Otolaryngol Head Neck Surg · Nov 2008
Controlled Clinical TrialRapid risk stratification for obstructive sleep apnea, based on snoring severity and body mass index.
It is unclear whether all snoring patients require polysomnography, and there are no highly sensitive clinical predictors of sleep apnea. Our objective was to develop a simple clinical screening test for OSA in snoring patients. ⋯ The statistic most predictive of OSA was snoring severity. Combining this with BMI yielded a highly sensitive screening test for moderate/severe OSA. This clinical assessment may be useful in risk-stratifying patients for polysomnography and therapy, facilitating deferred work-up in low-risk patients and expedited therapy in high-risk patients.
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Sinonasal disease is a common diagnosis that is encountered by nearly all specialties. This study examines medical malpractice trends in sinonasal disease. ⋯ Physicians must be diligent in forming differential diagnoses, and surgeons must ensure informed consent is obtained and documented. Future studies should continue to identify risk management strategies and areas for malpractice reform.