The Journal of laryngology and otology
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Obstructive sleep apnoea syndrome can lead to unhealthy open-mouth breathing. We investigated the possible relationship between obstructive sleep apnoea syndrome and dental health. We also evaluated other clinical factors that may affect oral health. ⋯ Obstructive sleep apnoea syndrome does not negatively affect oral and dental health.
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To explore the significance of the tumour necrosis factor-α/interleukin-10 ratio and the effect of continuous positive airway pressure in patients with different degrees of obstructive sleep apnoea hypopnoea syndrome severity. ⋯ The results suggest that inflammation is activated and anti-inflammatory cytokines are decreased in obstructive sleep apnoea hypopnoea syndrome patients. Tumour necrosis factor-α/interleukin-10 ratio may prove useful for severity monitoring and management of obstructive sleep apnoea hypopnoea syndrome patients, and may reduce the need for polysomnography.
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The identification and treatment of adult obstructive sleep apnoea and other sleep-related breathing issues demands nuanced clinical judgement to determine if surgery is appropriate and which surgery should be performed. No study to date has evaluated the sleep medicine curriculum from the perspective of the Australian ENT surgical trainee, or addressed potential strategies for improving levels of surgical skill and knowledge in this field. ⋯ Low confidence and lack of exposure to sleep surgery cases for ENT trainees supports a broadening of the Australian Society of Otolaryngology Head and Neck Surgery curriculum. This paper outlines possible ways to improve this situation.
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To assess the clinical utility of elective neck dissection in node-negative recurrent laryngeal carcinoma after curative radiotherapy for initial early glottic cancer. ⋯ Owing to the low occult neck disease rate and high post-operative fistula rate, elective neck dissection is not recommended for recurrent node-negative laryngeal tumours after radiation therapy if the initial tumour was an early glottic cancer.
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Patients with laryngectomy tracheostomas are at risk of developing acute airway obstruction due to mucous crusting. Current management relies on saline nebulisers, followed by suction and manual evacuation to remove the obstruction. This paper describes the first reported case of using N-acetylcysteine nebulisers in addition to saline to adequately soften the mucous plugs in order to facilitate removal. ⋯ N-acetylcysteine nebulisers can be used to assist in the removal of mucous plugs in saline-resistant cases.