• Snoring
• Trouble breathing at night
• Sleep apnoea
• Effects
• Daytime somnolence
• Morning headache
• Seasonality
• Triggers
  
• Occupation
• Able to eat with mouth closed?
• Drooling?
  
• Able to breathe with mouth closed?
  
• Hearing change
• Number of infections/ Abx in last year

Indications for tonsilectomy

• Absolute
• Obstructive sleep apnoea
• Suspected malignancy
• Relative: Episodes of tonsilitis:
  
• 7 or more in last year
• 5 or more per year for last 2 years
• 3 or more per year for last 3 years
• 2 or more episodes of quinsy in the last year
  
• Tonsilitis is defined as sore throat plus one of:
• Temp >38.5
• Cervical adenopathy
• Tonsillar exudate
• Evidence of group B haemolytic Strep.
  

• Betnesol drops
• Betamethasone
• Can't use for too long (2 months)
• Mometasone furoate spray
  
• Glucocorticosteroid
• Mupirocin ointment
  
• Monoxycarbolic acid antibiotic
• Good vs Gram +ves incl. MRSA
  

• Low salt diet
• Diuretics
• Hydrochlorothiazide/triamterene or acetazolamide
• Vestibular suppressants, anti-emetics, or corticosteroids
• Used for symptomatic treatment of vertigo and its associated nausea or vomiting during acute attacks
• Act centrally on the vestibular nucleus
• Meclozine, dimenhydrinate, promethazine, diazepam, prochlorperazine, prednisolone, betahistine
• Intratympanic corticosteroids
• Meniett device
  
• Handheld device that delivers intermittent pressure pulses through the ear canal and is self-administered 3 times per day
• Vestibular and balance rehabilitation therapy
• Tinnitus maskers (white noise generators)
• Neuromonics
  
• Uses a customised neural stimulus combined with specific music, delivered through a coordinated program to interact with, interrupt, and desensitise tinnitus disturbance for long-term benefit
• Antidepressants or benzodiazepines
• Endolymphatic sac surgery
• Vestibular nerve section
• Prevents the vestibular afferent stimuli from reaching the brain
• Labyrinthectomy
• Hearing loss inevitable
  

• Destructive and expanding growth consisting of keratinizing squamous epithelium in the middle ear and/or mastoid process

• Presence of cognitive impairment, and a suspected dementia syndrome, confirmed by neuropsychological testing for a clinical diagnosis of possible or probable AD
• Memory
• Language
• Perceptual skills
• Attention
• Constructive abilities
• Orientation
• Problem solving
  
• Functional abilities
• Histopathologic confirmation including a microscopic examination of brain tissue is required for a definitive diagnosis