Tonsillectomy cured fewer than half of children with very severe sleep apnoea

The edition in brief

A retrospective cohort at a quaternary children's centre studied 174 children with polysomnography before and after tonsillectomy for obstructive sleep apnoea, using inverse probability weighting to correct for which children were retested. Overall, 70.1% reached a postoperative AHI under 5. Each additional event per hour before surgery lowered the odds of success (OR 0.96), and children with AHI over 30 were cured in only 41.7%. The effect of obesity was not statistically clear. Families of children with very severe apnoea should be told that surgery alone is unlikely to be curative and that postoperative sleep studies matter. A Brazilian otology and neurotology task force describes Ménière's disease as heterogeneous and multifactorial, with diagnosis remaining clinical and serial audiometry central. A randomised trial of 102 patients with uncomplicated BPPV found a mechanical rotational chair no better than manual repositioning manoeuvres, both producing large improvements in dizziness handicap. A randomised study of 66 caregivers of tracheostomy patients found simulation training produced the best suction knowledge and skills, followed by a mobile app, then routine bedside teaching. The pearl covers the Dix-Hallpike and Epley manoeuvres.