Background: There is an increasing importance to increasing the day-case rate for children undergoing adenotonsillectomy. The primary aim of this study was to evaluate the immediate post-operative complication (IPOC) rate of children undergoing adenotonsillectomy for the treatment of paediatric obstructive sleep apnoea (OSA), with a view to increasing the day-case rate. IPOC was defined as any adverse clinical events experienced if admitted, or as a re-presentation to the emergency department/ward if done as a day-case, within 24 hours of the surgery. The secondary aim was to evaluate the risk factors predictive of IPOC. Methods: A retrospective analysis of children undergoing adenotonsillectomy for OSA between 01/11/2019–31/03/2022. Results: 464 children were included. Children done as a day-case experienced 0% IPOC (n=260; 220 were planned day-case). Children done as an inpatient experienced 16.7% IPOC (n=34/204). Every child who experienced IPOC had one or more of the following four clinical features: age <3 years, <15 kg, >98th weight centile, significant medical comorbidities. 269 children had none of these four clinical features, and experienced 0.371% IPOC (n=1/269; primary post-tonsillectomy bleed). Children with pre-operative oximetry scores of McGill 3-4 experienced 0% IPOC if they had none of the four clinical features (n=20). The overall readmission rate was 2.80% (n=13/464). Conclusion: Our experience suggests children with none of the four clinical risk factors identified can have adenotonsillectomy performed as a day-case procedure, irrespective of the pre-operative oximetry results. Pre-operative oximetry does not appear to add any additional value in predicting adverse post-operative events.

Objectives Dizziness has a lifetime prevalence of 17 – 30%. These symptoms have multiple aetiologies and can be difficult to diagnose in a routine ENT clinic. Several units have established multi-disciplinary ‘Dizzy Clinics’ to standardise the management of complex patients. We have developed a multi-disciplinary ‘Dizzy Clinic’ comprising clinicians and allied healthcare professionals, which incorporates a telephone triage service. Our service has been radically changed to triage patients to either a rapid access 30-minute BPPV clinic, or a 1-hour complex balance clinic and this study assesses the efficacy of our new model. Methods We conducted a retrospective audit of 124 patients referred to ‘generic’ ENT clinics for dizziness in 2019. This data was used to implement a new service where patients would receive a telephone triage before progressing to a multi-disciplinary clinic comprising audiologists, physiotherapists, and ENT surgeons. We prospectively re-audited 151 patients referred to this service in 2021. Results 40% of patients referred with dizziness in 2019 did not require a face-to-face appointment for an assessment of their dizziness. A telephone triage introduced to our ‘Dizzy Clinic’ streamed only 35.8% of referrals to a face-to-face appointment. 90% of face-to-face appointments from the ‘Dizzy Clinic’ were performed by a non-ENT surgeon. The ‘Dizzy Clinic’ showed more thorough and improved examinations compared to the previous cycle, and 60% were discharged from the ‘Dizzy Clinic’ after their first assessment, compared to 61% in the previous cycle. Conclusions Our ‘Dizzy Clinic’ effectively triages patients and enables a multi-disciplinary team to contribute to the management of dizzy patients.

Olfactory and Taste Disorders and COVID-19: Our experience in 77 adults in the North East of England.