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J Pediatr Surg 2019 Feb 28. Epub 2019 Feb 28.

Division of Pediatric Surgery, Department of General Surgery, Medical University of South Carolina, Charleston, SC, USA.

Background: Opioid misuse has reached epidemic proportions, and postoperative opioids have been linked to overdose, diversion, and dependency. We recently found our opioid prescribing practices following common pediatric operations to be inconsistent and excessive. In this study, we evaluate the efficacy of an educational intervention on opioid prescriptions following tonsillectomy and hernia repair. Read More

Dan Med J 2019 Mar;66(3)

Introduction: The National Clinical Guideline for Ton-sillectomy (Danish Health Authority, 2016) suggests inpatient admission after elective tonsil surgery in patients aged < 4 years at the time of surgery. We aimed to evaluate the safety of tonsil surgery as day surgery in children ≤ 4 years of age.

Methods: The charts of 414 patients aged 2-15 years who underwent elective tonsillectomy, adenotonsillectomy or tonsillotomy at Svendborg Hospital, Denmark, from February 2010 to April 2015 were reviewed in a retrospective cohort. Read More

Int J Pediatr Otorhinolaryngol 2019 Feb 20;121:20-25. Epub 2019 Feb 20.

Department of Paediatric ENT, The Children's Hospital at Westmead, Australia; Discipline of Child and Adolescent Health, University of Sydney, Australia. Electronic address:

Objectives: Tertiary hospitals see a wide array of complex paediatric patients requiring the procedure of tonsillectomy to alleviate airway symptoms. To investigate the implications of patient-specific factors on postoperative morbidities and hospital stay length, including the role of BMI and AH as predictors for airway complications following surgery.

Methods: A retrospective chart review was performed for all patients presenting at The Children's Hospital at Westmead for routine tonsillectomy between July 2010 and July 2014. Read More

Int J Pediatr Otorhinolaryngol 2019 Feb 23;121:15-19. Epub 2019 Feb 23.

Surgical Pathology Service, Triângulo Mineiro Federal University, Uberaba, Minas Gerais, Brazil. Electronic address:

Braz J Infect Dis 2019 Mar 5. Epub 2019 Mar 5.

Universidade Federal de Goiás (UFG), Instituto de Patologia Tropical e Saúde Pública, Departamento de Biociências e Tecnologia, Goiânia, GO, Brazil. Electronic address:

Introduction: Bacterial tonsillitis is an upper respiratory tract infection that occurs primarily in children and adolescents. Staphylococcus aureus is one of the most frequent pathogens in the etiology of tonsillitis and its relevance is due to its antimicrobial resistance and persistence in the internal tissues of the tonsils. Tonsillectomy is indicated in cases of recurrent tonsillitis after several failures of antibiotic therapy. Read More

Laryngoscope 2019 Mar 8. Epub 2019 Mar 8.

Department of Otorhinolaryngology, Kantonsspital Baselland, Liestal, Switzerland.

Objectives/hypothesis: To investigate the relationship of tonsil volume and grade on outcomes of uvulopalatopharyngoplasty (UPPP) with tonsillectomy in patients with obstructive sleep apnea (OSA).

Study Design: Retrospective cohort analysis.

Methods: Data of 70 consecutive patients undergoing UPPP with tonsillectomy between 2015 and 2018 were analyzed. Read More

Eur Arch Otorhinolaryngol 2019 Mar 7. Epub 2019 Mar 7.

Department of Otorhinolaryngology, The Affiliated Yiwu Hospital, 699 Jiangdong Road, 322000, Yiwu City, Zhejiang Province, China.

J Pediatr Psychol 2019 Mar 7. Epub 2019 Mar 7.

Department of Psychology, University of Calgary.

Objective: Parent-child reminiscing about past negative events has been linked to a host of developmental outcomes. Previous research has identified two distinct between-parent reminiscing styles, wherein parents who are more elaborative (vs. repetitive) have children with more optimal outcomes. Read More

JAMA Otolaryngol Head Neck Surg 2019 Mar 7. Epub 2019 Mar 7.

Department of Otorhinolaryngology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

Importance: The lateral pharyngeal wall is recognized as an important site of upper airway collapse during sleep in patients with obstructive sleep apnea (OSA), and expansion sphincter pharyngoplasty (ESP) may have promising clinical utility in patients with OSA and lateral pharyngeal wall collapse.

Objectives: To evaluate the therapeutic outcomes of ESP in conjunction with other surgical procedures and to investigate indications for ESP in patients with OSA.

Design, Setting, And Participants: Cohort study of 63 patients with OSA diagnosed with lateral pharyngeal collapse under drug-induced sleep endoscopy who underwent ESP combined with tonsillectomy, uvuloplasty, or nasal surgery at Seoul National University Hospital in Seoul, Korea, between March 1, 2015, and December 1, 2016. Read More

Cochrane Database Syst Rev 2019 Mar 6;3:CD001976. Epub 2019 Mar 6.

Royal Blackburn Hospital, Haslingden Road, Blackburn, UK, BB2 3HH.

Background: Guttate psoriasis is a distinctive acute form of psoriasis which characteristically occurs in children and young adults. It is closely associated with preceding streptococcal sore throat or tonsillitis. Some authorities have claimed that ordinary (chronic plaque) psoriasis may also be made worse by infection at distant sites. Read More

Cochrane Database Syst Rev 2019 Mar 5;3:CD011571. Epub 2019 Mar 5.

Department of Immuno-Allergology, CHU Brugmann, Place A.Van Gehuchten 4, Brussels, Belgium, 1020.

Background: Psoriasis is a chronic skin disease that affects approximately two per cent of the general population. Plaque psoriasis is the most common form: it usually appears as raised, red patches of inflamed skin, covered with silvery white scales. The patches often occur in a symmetrical pattern. Read More

J Robot Surg 2019 Mar 5. Epub 2019 Mar 5.

Department of Otolaryngology-Head and Neck Surgery, Royal Adelaide Hospital, Adelaide, South Australia, 5001, Australia.

Transoral robotic surgery (TORS) has become an accepted treatment option for a variety of benign and malignant pathologies of the head and neck. The Medrobotics Flex system is a novel single port platform available as an alternative tool to current multiport robotic technology. We present the Adelaide experience with this system thus far. Read More

Clin Exp Otorhinolaryngol 2019 Mar 6. Epub 2019 Mar 6.

Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.

Objectives: Although adenotonsillar hypertrophy is the main cause of sleep-disordered breathing in children, surrounding anatomic factors, such as the width of the nasopharynx, can affect upper airway patency. However, there have been no reports of the association of nasopharyngeal width with sleep-disordered breathing in children. This study was undertaken to measure nasopharyngeal width in children undergoing adenotonsillectomy for sleep-disordered breathing and to investigate the clinical implications of this factor. Read More

Arkh Patol 2019 ;81(1):40-45

Pathoanatomical Department of Clinical Molecular Morphology, E.E. Eichwald Clinic, I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia, Saint Petersburg, Russia.

Objective: To assess the applicability of imported tissue-marking dyes and the samples of experimental dyes and decorative acrylic paints to mark the resection margins of a surgical specimen.

Material And Methods: Three sets of tissue-marking dyes: 2 imported sets and 1 experimental set, each containing red, orange, yellow, green, blue, purple, and black dyes, and a set of decorative acrylic paints containing black, blue, light blue, green, yellow, ocher, orange, magenta, and purple dyes. The experimental dyes and imported ones were used to mark tonsillar fragments obtained at tonsillectomy. Read More

Laryngoscope Investig Otolaryngol 2019 Feb 28;4(1):154-159. Epub 2018 Nov 28.

Department of Otolaryngology-Head and Neck Surgery Nationwide Children's Hospital and The Ohio State University Wexner Medical Center Columbus Ohio.

Objective: Based on previous studies in the pediatric population, it remains unclear whether there is a difference in postoperative pain between two widely used tonsillectomy techniques: coblation and bovie electrocautery. This large prospective study investigates whether postoperative pain scores differ between these two surgical techniques for tonsillectomy.

Methods: Prospective, non-randomized study of children aged 2-8 enrolled in a randomized controlled trial of single-dose intravenous acetaminophen for pain associated with adenotonsillectomy. Read More

Laryngoscope Investig Otolaryngol 2019 Feb 17;4(1):30-38. Epub 2019 Jan 17.

The Research Institute Nationwide Children's Hospital Columbus Ohio.

Objective: Accurate assessment of risk factors such as congenital heart disease (CHD) can aid in risk stratification of children presenting for surgery. Risk stratification is especially important in tonsillectomy ± adenoidectomy (T/A), a common pediatric procedure that is usually performed electively, but that has a high rate of adverse events. In this study, we examined the association of CHD with revisits after T/A. Read More

Croat Med J 2019 Feb;60(1):12-19

Antun Bačić, Clinical Department of ENT, Head and Neck Surgery, Merkur University Hospital, Zajčeva 19, HR-10000 Zagreb, Croatia,

Aim: To assess the immunomodulatory effect of tonsil-derived mesenchymal stem cells (MSCs) on T-lymphocyte proliferation and cytokine production.

Methods: Tonsils were obtained from children aged 3 to 12 years (n=15) who underwent tonsillectomy for obstructive sleep apnea from April 2012-October 2014 at the Merkur University Hospital, Zagreb. Tonsil-derived MSCs were co-cultured with peripheral blood mononuclear cells (PBMCs) and phytohemagglutinin as a mitogen. Read More

J Robot Surg 2019 Mar 1. Epub 2019 Mar 1.

Department of Otolaryngology - Head and Neck Surgery, Boston University School of Medicine, Boston, MA, USA.

Transoral robotic surgery (TORS) is a common modality for treatment of oropharyngeal and laryngeal cancer. Current FDA approval extends to the da Vinci S and Si platforms. Many hospitals are adopting the da Vinci Xi platform. Read More

Clin Exp Immunol 2019 Feb 27. Epub 2019 Feb 27.

Department of Medicine, Imperial College London, London, UK.

Streptococcal pyrogenic exotoxin (Spe) A expression is epidemiologically linked to streptococcal tonsillo-pharyngitis and outbreaks of scarlet fever, although the mechanisms by which superantigens confer advantage to Streptococcus pyogenes are unclear. S. pyogenes is an exclusively human pathogen. Read More

Am J Otolaryngol 2019 Feb 18. Epub 2019 Feb 18.

Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University Health System, Richmond, VA, United States of America. Electronic address:

Importance: Pediatric tonsillectomy is a common procedure now being performed most often for patients with obstructive sleep apnea, which has been associated with increased sensitivity to the respiratory side effects of opioid medications. This study investigates a strategy to decrease the use of opiate medications in a particularly vulnerable population.

Objective: Describe an interdisciplinary approach between Otolaryngologists and Anesthesiologists to decrease opiate use in tonsillectomy patients. Read More

Otolaryngol Head Neck Surg 2019 Feb;160(1_suppl):S1-S42

15 Department of Research and Quality, American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA.

Objective: This update of a 2011 guideline developed by the American Academy of Otolaryngology-Head and Neck Surgery Foundation provides evidence-based recommendations on the pre-, intra-, and postoperative care and management of children 1 to 18 years of age under consideration for tonsillectomy. Tonsillectomy is defined as a surgical procedure performed with or without adenoidectomy that completely removes the tonsil, including its capsule, by dissecting the peritonsillar space between the tonsil capsule and the muscular wall. Tonsillectomy is one of the most common surgical procedures in the United States, with 289,000 ambulatory procedures performed annually in children <15 years of age based on the most recent published data. Read More

Rheumatol Int 2019 Feb 23. Epub 2019 Feb 23.

Division of Rheumatology, Department of Pediatrics, Ankara Training and Research Hospital, University of Health Sciences, 06100, Ankara, Turkey.

Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome is a recurrent fever syndrome of early childhood with increasing number of adult-onset cases. Although it is a self-limited disease, it may negatively affect the quality of life. The aim of this review is to present a detailed analysis of PFAPA syndrome and an algorithm for diagnosis, therapeutic options, and evaluation of outcome. Read More

PLoS One 2019 22;14(2):e0212317. Epub 2019 Feb 22.

Department of Otolaryngology, Shanghai Children's Medical Center Affiliated with Shanghai Jiaotong University School of Medicine, Shanghai, China.

The study aims to examine drug-induced sleep endoscopy (DISE) in the decision-making process of pediatric obstructive sleep apnea (OSA) patients with small tonsils. This was a retrospective study of children who underwent awake flexible endoscopy, DISE, and adenoidectomy with/without tonsillectomy at the Shanghai Children's Medical Center between 03/2015 and 12/2016. Tonsillectomy was performed for tonsillar obstruction found by DISE. Read More

J Surg Case Rep 2019 Feb 8;2019(2):rjy348. Epub 2019 Feb 8.

Department of Otorhinolaryngology, University Hospital Coventry & Warwickshire NHS Trust, Coventry CV2 2DX, UK.

We report a rare complication following a routine elective tonsillectomy. A 32-year-old woman woke up from general anaesthesia with left sided hemiparesis. She underwent extensive investigations, which were normal. Read More

Hum Vaccin Immunother 2019 Feb 19. Epub 2019 Feb 19.

Introduction: Recurrent tonsillitis in adults is a common ENT disease. The current standard treatment is tonsillectomy. However, continuous prophylaxis with antibiotics has been prescribed in order to avoid tonsillectomy. Read More

Otolaryngol Head Neck Surg 2019 Feb 19:194599819829415. Epub 2019 Feb 19.

1 Department of Otolaryngology-Head and Neck Surgery, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.

Objectives: Surgical intervention for obstructive sleep apnea (OSA) in overweight and obese children may not be as effective as it is in normal-weight children. The purpose of this study was to systematically review the effects of various surgical interventions for OSA in obese children and to meta-analyze the current data.

Data Sources: PubMed, OVID, and Cochrane databases. Read More

Otolaryngol Head Neck Surg 2019 Feb 19:194599819827820. Epub 2019 Feb 19.

2 Department of Otology & Laryngology, Harvard Medical School, Boston, Massachusetts, USA.

This brief communication regards the indications and complications for and rates of readmission following lingual tonsillectomy. The National Readmissions Database (NRD) 2013-2014 was queried for all cases of lingual tonsillectomy occurring from 2013 to 2014. Among 602 lingual tonsillectomies (mean age 36. Read More

World J Otorhinolaryngol Head Neck Surg 2019 Mar 25;5(1):49-56. Epub 2018 Sep 25.

Tripler Army Medical Center, Division of Otolaryngology, Sleep Surgery and Sleep Medicine, Tripler AMC, 1 Jarrett White Rd, HI 96859, USA.

Objective: To systematically review outcomes for cautery-assisted palatal stiffening operation (CAPSO) as a treatment for adult obstructive sleep apnea (OSA).

Methods: Five databases (including PubMed/MEDLINE) were searched through July 12, 2017.

Results: Eight studies (307 patients) met criteria. Read More

Iran J Pathol 2018 25;13(4):471-473. Epub 2018 Sep 25.

Dept. of Pathology, SHKM, GMC, Nalhar, Mewat, Haryana, India.

A choriostoma is an aggregate of microscopically normal cells or tissues which occurs in an aberrant location. It follows a benign course, rarely seen in head and neck region. A choriostoma of the palatine tonsil is very rare; less than 10 cases were reported till date. Read More

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2019 Feb 12. Epub 2019 Feb 12.

Department of Biology, Kirikkale University, Faculty of Arts and Sciences, Kirikkale, Turkey.

Objectives: The palatine tonsil is a significant part of the secondary immune system. Tonsillitis and idiopathic tonsillar hypertrophy (ITH) are the most common pathologies of this component. Although there are studies on their pathogenesis, there is insufficient study of the role of antioxidant agents. Read More

Eur Arch Otorhinolaryngol 2019 Feb 12. Epub 2019 Feb 12.

Department of Otorhinolaryngology-Head and Neck Surgery, Bozyaka Training and Research Hospital, University of Medical Sciences, Ministry of Health, Izmir, Turkey.

Purpose: To investigate the safety of outpatient admission and the effects of surgical technique in tonsillectomy operations of adult patients.

Methods: The digital database was scanned for patients aged ≥ 15 years that underwent tonsillectomy in our institution between years 2014 and 2018. Demographic and clinical characteristics, the surgical technique, length of stay (LOS) in hospital, re-admissions after discharge, complications and interventions performed were recorded. Read More

Int J Pediatr Otorhinolaryngol 2019 Feb 3;120:36-39. Epub 2019 Feb 3.

Department of Vascular Surgery, Turku University Hospital and University of Turku, Turku, Finland.

Objectives: Patient injuries in children can have lifelong effects on the patient and a marked impact on the whole family. The aim of this study was to identify the errors and incidents leading to patient injuries in pediatric otorhinolaryngology (ORL) by evaluating accepted patient injury claims.

Methods: The records of all accepted patient injury claims in ORL between 2001 and 2011 were searched from the nationwide Patient Insurance Centre registry. Read More

Acta Otorhinolaryngol Ital 2019 Jan 31. Epub 2019 Jan 31.

Faculty of Medicine, Department of Pathology, Cairo University, Egypt.

Tonsillotomy (tonsillar ablation) using diode laser and radiofrequency has been introduced for management of tonsillar hypertrophy as it is associated with fewer hazards to deep structures. We compared tissue volume and histological changes in the tonsils following radiofrequency tonsillotomy versus diode laser tonsillotomy in tonsillar hypertrophy. 40 tonsils excised from 20 patients were included in this study. Read More

Patient Educ Couns 2019 Feb 3. Epub 2019 Feb 3.

Johns Hopkins School of Medicine, Department of Otolaryngology-Head and Neck Surgery, Baltimore, MD, United States. Electronic address:

Objective: Unexplained medical terminology impedes clinician/parent communication. We describe jargon use in a pediatric surgical setting.

Methods: We evaluated encounters between parents of children with sleep-disordered breathing (SDB; n = 64) and otolaryngologists (n = 8). Read More

J Clin Sleep Med 2019 Feb 15;15(2):363-365. Epub 2019 Feb 15.

Division of Pulmonary and Critical Care Medicine, Center for Sleep Medicine, Mayo Clinic, Rochester, Minnesota.

Chest 2019 Feb;155(2):e37-e42

Department of Radiology, Lenox Hill Hospital, New York, NY.

Case Presentation: A 58-year-old postmenopausal woman presented to her primary care physician with lower back pain. She denied respiratory symptoms. Her medical history is significant for hypertension, hyperlipidemia, and prediabetes. Read More

JAMA Otolaryngol Head Neck Surg 2019 Feb 7. Epub 2019 Feb 7.

Department of Otolaryngology-Head & Neck Surgery, Michigan Medicine, Ann Arbor, Michigan.

Sci Transl Med 2019 Feb;11(478)

Division of Vaccine Discovery, La Jolla Institute for Immunology (LJI), La Jolla, CA 92037, USA.

"Strep throat" is highly prevalent among children, yet it is unknown why only some children develop recurrent tonsillitis (RT), a common indication for tonsillectomy. To gain insights into this classic childhood disease, we performed phenotypic, genotypic, and functional studies on pediatric group A (GAS) RT and non-RT tonsils from two independent cohorts. GAS RT tonsils had smaller germinal centers, with an underrepresentation of GAS-specific CD4 germinal center T follicular helper (GC-T) cells. Read More

Atlas Oral Maxillofac Surg Clin North Am 2019 Mar;27(1):77-81

Department of Pediatrics, Division of Pulmonary and Sleep Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, USA; Department of Pediatrics, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA. Electronic address:

Atlas Oral Maxillofac Surg Clin North Am 2019 Mar 27;27(1):17-22. Epub 2018 Dec 27.

Division of Sleep Surgery, Department of Otolaryngology, Stanford Sleep Surgery Fellowship, Stanford University School of Medicine, 801 Welch Road, Stanford, CA 94304, USA.

Salud Publica Mex 2018 Nov-Dic;60(6):653-657

Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas. México.

Objective: To determine the prevalence and risk factors for oral high-risk human papillomavirus (HR-HPV) infec- tion in human immunodeficiency virus(HIV)-infected men.

Materials And Methods: Consecutive male outpatients with HIV-infection were enrolled. Demographic and behav- ioral risk data were obtained. Read More

Curr Opin Otolaryngol Head Neck Surg 2019 Apr;27(2):73-79

Department of Otorhinolaryngology, Maxillofacial, and Thyroid Surgery, Fondazione IRCCS National Cancer Institute of Milan.

Purpose Of Review: To summarize the most recent nuances in diagnosis, management, and prognostic stratification of carcinoma of unknown primary of the head and neck (CUPHN), in light of its recent re-assessment in the eighth edition of the TNM Classification Manual.

Recent Findings: At least in Western Countries, most CUPHN are expected to be Human Papilloma Virus (HPV)-positive with an oropharyngeal origin. Their appropriate diagnosis starts with fine needle aspiration cytology and/or core biopsy of pathologic lymph node(s) with staining for p16 by immunohistochemistry and subsequent HPV detection by PCR. Read More

Presse Med 2019 Feb 22;48(1 Pt 2):e77-e87. Epub 2019 Jan 22.

Department of Pediatrics, NU-Hospital Group, 45180 Uddevalla, Sweden; Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. Electronic address:

Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome is a complex autoinflammatory disease with a clinical phenotype characterised by recurrent episodes of fever, systemic inflammation and symptoms and signs depicted in disease acronym. Although PFAPA is the most common autoinflammatory disease among children in many parts of the world, the condition is still an enigma, which include the regular episodes, the prompt responses to corticosteroids, the genetic bases for the familial clustering and therapeutic effects of tonsillectomy. This review explores PFAPA syndrome with the aim of describing the current clinical and scientific understanding of the condition. Read More

Acta Otolaryngol 2018 Dec 25;138(12):1099-1104. Epub 2019 Jan 25.

a Department of Otolaryngology, Head and Neck Surgery , Kagoshima University Graduate School of Medical and Dental Sciences , Kagoshima , Japan.

Background: Tonsillectomy combined with steroid pulse therapy was reported to be effective for patients with IgA nephropathy. However, the mechanisms of the effect of tonsillectomy on IgA nephropathy are unknown.

Aim: The aim of this study was to investigate the involvement of the phosphorylcholine (PC)-specific immune response in the tonsils and peripheral blood of patients with IgA nephropathy. Read More

Mol Clin Oncol 2019 Feb 27;10(2):231-234. Epub 2018 Nov 27.

Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Mannheim, Medical Faculty Mannheim, University Heidelberg, D-68167 Mannheim, Germany.

Lung cancer rarely metastasizes to the palatine tonsil. There have only been a few cases that have reported on palatine tonsillar metastases of pulmonary adenocarcinoma. In the majority of these cases the primary diagnosis is a small cell lung cancer. Read More

Int J Pediatr Otorhinolaryngol 2019 Apr 16;119:59-62. Epub 2019 Jan 16.

Department of Otolaryngology, Faculty of Medicine, Beni-Suef University, Egypt.

Objective: Tonsillar hypertrophy may affect velopharyngeal closure and speech resonance. The aim of this study was to assess the impact of hypertrophied tonsils on velopharyngeal function in children with normal palate and to measure the effect of tonsillectomy on velopharyngeal closure and speech resonance.

Methods: Eighty seven children with hypertrophied tonsils and normal palate were subjected to tonsillectomy for indications other than speech problems. Read More

J Laryngol Otol 2018 Dec;132(12):1119-1127

ENT Department,Guy's and St Thomas' NHS Foundation Trust,London,UK.

Objective: This study aimed to estimate the cost-effectiveness of Coblation compared with cold steel tonsillectomy in adult and paediatric patients in the UK.

Method: Decision analysis was undertaken by combining published clinical outcomes with resource utilisation estimates derived from a panel of clinicians.

Results: Using a cold steel procedure instead of Coblation is expected to generate an incremental cost of more than £2000 for each additional avoided haemorrhage, and the probability of cold steel being cost-effective was approximately 0. Read More

Otolaryngol Head Neck Surg 2019 Jan 22:194599818825462. Epub 2019 Jan 22.

1 Department of Otolaryngology, National Taiwan University Hospital and Children's Hospital, Taipei, Taiwan.

Objective: To investigate 24-hour ambulatory blood pressure changes 6 months after surgery among children with obstructive sleep apnea.

Study Design: Prospective interventional study.

Setting: Tertiary medical hospital. Read More

BMJ Case Rep 2019 Jan 20;12(1). Epub 2019 Jan 20.

Otolaryngology Department, NHS Lothian, Livingston, UK.

A 30-year-old woman presented to the accident and emergency department 3 days post-tonsillectomy with bleeding from the tonsillar fossa and left-sided facial swelling. The patient denied any dysphagia or breathing difficulties but experienced pain on neck movement. On examination, although the bleeding had stopped on reaching the emergency department, a small clot was noted in her left tonsillar fossa. Read More