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Davidson et al present a case of uvula angio-oedema associated with the recreational drug ecstasy.1 Referrals of patients to our ENT unit in Scotland with isolated uvula angio-oedema are not uncommon. However, on occasion the aetiology seems to differ from the causative factors which the authors discuss.
Many of these patients give a history of alcohol ingestion and heavy snoring thereafter (often corroborated by their partner). Most quickly settle with no intervention and do not receive steroids or antihistamines. It has been postulated that the snoring itself is responsible, worsened by the sedative and desensitising effects of the alcohol, and relative dehydration. The anaesthesia literature includes reports of uvula oedema after deep sedation and heavy snoring.
Clearly it is important to consider the other aetiologies that the authors discuss, and in severe cases follow the management plan that their case necessitated. Quincke's oedema is an important differential diagnosis.
However, we write to highlight a subgroup of patients who may simply be manifesting a relatively innocuous ENT equivalent of the “Saturday night palsy” and will settle with reassurance, oral rehydration, and no further intervention.
Competing interests: None declared.