Relieving symptoms of chronic sinusitis in children by adenoidectomy

To determine the efficacy of adenoidectomy in relieving symptoms of chronic sinusitis in children. A prospective study carried out on 35 patients who underwent adenoidectomy or Adeno-tonsillectomy between May 2004 and October 2005. The patient ages ranged from 3 to 12 years. Five patients were unavailable for follow-up and did not complete the study so they were excluded. The pre-operative symptoms were rhinorhea, nasal congestion, headache, postnasal drainage, cough, halitosis and irritability. Also recorded was mouth breathing, fever and frequent antibiotic use. Telephone interviews with the patient's caregivers were conducted to collect information following the surgery regarding the presence of the same symptoms as well as an estimate of overall improvement. Follow-up ranged from 5 months to 1 year. The most frequently reported symptoms before surgery were rhinorrhoea, nasal congestion, mouth breathing, and frequent antibiotic use. [26, 28, 24, 30 patients respectively]. These numbers decreased following surgery to [11, 12, 6, 24 patients respectively]. Complete or near complete symptom resolution was reported in 18 [60%] patients. Some improvement was reported in 6 [20%] patients. Minimal or no improvement was reported in another 6 [20%] patients. In the majority of cases, symptoms of chronic sinusitis in children are relieved by adenoidectomy

use of foly catheters in epistaxis a question of informed consent

The Medicines and Health care products Regulatory Agency stated in 2003 that doctors should endeavor to avoid using products in treatments not covered by their product license. Foley catheters are commonly used in the management of epistaxis although their product license does not cover this. To study the extent of the use of these catheters and the knowledge that otolaryngologists had of their legal status. By undertaking a questionnaire survey of some Otolaryngologists in Baghdad Most members appear to use Foley catheters in the management of epistaxis; however most of them are not aware that the product is not licensed for this purpose. Because of this lack of knowledge, only few obtain verbal consent for treatment with this device and none of the surveyed members obtain written consent from patients. In the era of increasing litigation, documentation of informed consent could be considered mandatory to protect us from possible legal action, and this needs to be known by all practicing Otolaryngologists

use of for tonsillectomy

The aim was to ascertain the current practice of adjuvant therapy for tonsillectomy and to determine whether it is evidence based. A questionnaire answers were obtained from sixty otolaiyngologists in Baghdad. There was no any enthusiasm for routine intra-operative local anaesthesia. Paracetamol [Acetaminophen] is prescribed by nearly all surgeons for postoperative analgesia, and the current literature supports its efficacy and safety. Further, some practitioners combine paracetamol with NSAIDs, and/or Trarnadol-Opioids. Evidence to support the additional use of these agents is, however non existent or limited. For the use of antibiotics, we found some of the otolarymgologists do use a course of few days of pre-operative antibiotics and almost all of them do give postoperative antibiotics for seven-ten days. Some aspects of tonsillectomy care are uniform and evidence based. Others are heterogenoits and suffer from lack of adequate data in the literature

Bacteriology of the core of adenoids in a group of Iraqi patients undergoing adenoidectomy

Upper air way obstruction secondary to chronically inflamed adenoid and or tonsil is a common problem, in the presence of recurrent infection; tonsillectomy and or adenoldectomy are the most common surgery applied among pediatric population. The aim of this study was to assess the type of bacteria encountered with- In the core of the adenoid tissue at time of operation. During a period from Feb. 2005 to May 2005, twenty two adenoid samples were removed by surgery, and cross sectioned and sent for culture and sensitivity, at the department of ENT in Al-jerahat hospital for surgical specialties, most of the patients were under 10 year's old. This study showed that the bacteria isolated from the core of adenoid tissue were mostly part of bacterial flora of the upper respiratory tract, only 7 patients showed a growth of pathogenic bacteria: to which special sensitivity tests were performed to detect antibiotic sensitivity. The bacteria of the core of the adenoid were mostly composed of normal flora, and few of them were pathogenic and resistant to most ordinary antibiotics