A new method for evaluating and reporting the severity of snoring.

We propose a new questionnaire-based method for evaluating and reporting the severity of snoring, the snoring scale score (SSS), which provides an assessment of the loudness, frequency and periodicity of snoring sound. Ninety-nine patients with snoring problems were assessed and the results of 19 patients who underwent surgery to reduce snoring were reported using the SSS and the linear analogue score (LAS) at six weeks and six months after surgery. All patients reported reduction of snoring on both the SSS and LAS after surgery although minor discrepancies of reporting were found in six patients when comparisons were made between reporting of outcome using the SSS and LAS. Our study suggested that the SSS offers a uniform, comprehensive and simple to understand method for the evaluation, grading and reporting of snoring which is not currently available.

Hypersensitive allergic reactions to bismuth-iodoform-paraffin paste following ear surgery.

The case notes of 185 patients who had bismuth-iodoform-paraffin paste (BIPP) impregnated ribbon gauze used for packing following ear surgery were analysed retrospectively. The incidence of hypersensitive allergic reactions to BIPP was 5.9 per cent and a five-fold increase risk of developing allergic reactions was found in those with previous exposure to BIPP. Where temporalis fascia was used to repair tympanic membrane defects, the incidence of tympanic membrane graft perforations was higher when allergic reactions to BIPP developed post-operatively, compared to non-allergic cases.

Epistaxis, von Willebrand's type bleeding diathesis and Wilms' tumour: a case report.

We report a case of persistent epistaxis in a seven-month-old child with Wilms' tumour who had an associated von Willebrand's type bleeding diathesis. Correction of the bleeding diathesis to control the epistaxis required treatment of the tumour with chemotherapy.

An alternative method for securing surgical drains in the neck.

A method for securing closed suction drains in the neck is described where it serves to prevent leakage, slippage and accidental removal. This method involves passing a stay suture through the most proximal holes of the drain and suturing it to the skin and an overlying short length of the tube externally. Drains secured in this manner can be left in the wound for up to fourteen days with no associated complications from our experience in sixty-two patients following head and neck surgery.

The role of history, Epworth Sleepiness Scale Score and body mass index in identifying non-apnoeic snorers.

Seventy-one adults referred with snoring over a 9-month period were assessed and their apnoeic-status determined by clinical assessment using symptoms suggestive of the obstructive sleep apnoea-hypopnoea syndrome, the Epworth Sleepiness Scale score (ESS) and body mass index (BMI). The results of clinical assessment were compared to that of overnight six-channel polysomnography where snoring noise level, pulse rate, capillary oxygen saturation, breathing effort, oronasal airflow and body position were monitored. Polysomnography detected an apnoea-hypopnoea index (AHI) of < 15 episodes/h in 61(86%) patients and an AHI of > or = 15 episodes/h in 10 (14%) patients. Clinical assessment alone identified 57 patients with AHI of < 15 episodes/h as 'non-apnoeic snorers' and six patients with AHI of > or = 15 episodes/h as 'apnoeic snorers'. The sensitivity of this method of clinical assessment in identifying the 'non-apnoeic snorers' from amongst patients referred with snoring was 93.4% and its specificity was 60% (P < 0.001).