ENT / Head & Neck Surgery Evidence Evolution

5 evidence evolution narratives tracing how landmark trials and guideline updates reshaped ent / head & neck surgery practice.

Sleep Apnea Surgical Treatment

Nerve stimulation changes the game

UPPP (1981) → multi-level → Inspire (STAR 2014) → ADHERE registry → patient selection

Most don't need antibiotics

Antibiotics-always → Young 2008 → Garbutt 2012 → mostly viral → watchful waiting

Salvage with intratympanic steroids

No standard → systemic steroids → intratympanic rescue → combination → timing urgency

Less is enough

Total thyroidectomy → ESES/ATA evolution → hemithyroidectomy <4cm → lobectomy equivalent

Shared decision-making

Liberal → Paradise criteria (1984) → watchful waiting → NZATT → shared decision