Subject(s)
Humans , Male , Female , Postoperative Complications/prevention & control , Child , Surgical Procedures, Operative/psychology , Surgical Procedures, Operative/adverse effects , Anxiety , Stress Disorders, Post-Traumatic , Prospective Studies , Otorhinolaryngologic Surgical Procedures/adverse effects , AnesthesiaABSTRACT
Postoperative nausea and vomiting [PONV] is a most distressing adverse event for surgical patients with a considerable economic impact .The aim of the present study was to evaluate the effect of clonidine given orally for PONV in patients undergoing anesthesia for outpatient ear surgery. Sixty patients 30.2 +/- 9.9 years, scheduled for ear surgery, were randomly assigned to one of two groups [clonidine or placebo] in a double-blinded manner. Anesthesia was standardized laryngeal mask airway, fentanyl, propofol, halothane, nitrous oxide. A complete response, defined as no PONV and no need for rescue antiemetic medication, during the first 24h after anesthesia was 33% with placebo and 67% with clonidine, respectively [P. 0.01]. No clinically adverse event was observed in any of the groups. Oral premedication with clonidine reduced the rate of PONV in patients undergoing outpatient ear surgery
Subject(s)
Humans , Male , Female , Otorhinolaryngologic Surgical Procedures/adverse effects , Double-Blind Method , Postoperative Nausea and Vomiting/prevention & control , Premedication , Random Allocation , Treatment Outcome , Placebos , Ear/surgeryABSTRACT
BACKGROUND: The consequences of a diagnosis of head and neck cancer and the impact of treatment have a clear and direct influence on well-being and associated quality of life (QOL) in these patients. AIMS: To determine the QOL in head and neck cancer patients following a partial glossectomy operation. DESIGN AND SETTING: Cross-sectional cohort study; Head and Neck Oncology Unit, tertiary referral center. Materials and METHODS: 38 patients with partial glossectomy were assessed with the University of Washington head and neck quality of life (UW-QOL) scale, version 4. STATISTICAL ANALYSIS: Statistical analysis was performed using the Statistical Package for Social Sciences 10.0 (SPSS Inc, Chicago version III). Information from the scale was correlated using the Mann Whitney test. A P value less than/equal to 0.05 was considered as significant. RESULTS: The mean (sd) composite score of the QOL in our series was 73.6 (16.1). The majority (71.8%) quoted their QOL as good or very good. Swallowing (n = 16, 47.1%), speech (n = 15, 44.1%) and saliva (n = 15, 44.1%) were most commonly cited issues over the last 7 days. On the other hand, the groups with reconstruction, neck dissection, complications and radiotherapy demonstrated a significant reduction of quality of life scores (Mann Whitney test, P < 0.005). CONCLUSION: The composite score and overall QOL as assessed using the UW-QOL scale (version 4) were modestly high in our series of partial glossectomy patients. Swallowing, speech, and saliva are regarded as the most important issues. Stage of the disease, neck dissection, reconstruction, complications, radiotherapy and time since operation were seen to significantly affect domain scores.
Subject(s)
Age Factors , Glossectomy/adverse effects , Head and Neck Neoplasms/complications , Humans , Oral Surgical Procedures/adverse effects , Otorhinolaryngologic Surgical Procedures/adverse effects , Postoperative Complications/psychology , Quality of Life , Surveys and QuestionnairesABSTRACT
OBJETIVOS: Avaliar a segurança da ressecção bilateral das glândulas submandibulares e ligadura dos ductos parotídeos em crianças para reduzir a saliva, a eficácia e as complicações em médio e longo prazo no tratamento da sialorréia. FORMA DE ESTUDO: Coorte longitudinal. MATERIAL E MÉTODO: Trinta e uma crianças, com idades entre 6 e 13 anos (média de 7,6 anos), com múltiplas deficiências de etiologia neurológica foram submetidas à ressecção bilateral das glândulas submandibulares e ligadura dos ductos parotídeos, para controle da sialorréia, entre dezembro de 1999 a dezembro de 2005, e seguimento médio de 36 meses. RESULTADOS: O critério de sucesso foi o estabelecido por Wilkie, e 87 por cento das crianças tiveram resultados excelentes e bons, sendo a morbidade insignificante e a principal complicação foi o edema temporário na região parotídea. CONCLUSÃO: A ressecção bilateral das glândulas submandibulares e a ligadura dos ductos parotídeos constituem técnica segura e eficaz para ser realizada em crianças, com 87 por cento de sucesso no controle da sialorréia.
AIM: To evaluate the safety of bilateral submandibular gland excision and parotid duct ligation in order to control drooling in children; to assess its long-term efficacy and complications. STUDY DESIGN: longitudinal cohort. MATERIALS AND METHODS: Thirty-one children aged 6 to 13 years (7.6 years old in average), with multiple neurological disabilities were submitted to a bilateral submandibular gland excision with parotid duct ligation in order to control ptyalism between December 1999 and December 2005, mean follow up of 36 months. RESULTS: According to WilkieÆs success criteria, 87 percent of children had excellent or good results and insignificant morbidity was insignificant; with temporary parotid edema as the major complication. CONCLUSION: Bilateral submandibular gland excision with parotid duct ligation were safe to be performed in children, with 87 percent of success in drooling control.
Subject(s)
Humans , Male , Female , Child , Adolescent , Otorhinolaryngologic Surgical Procedures/methods , Parotid Gland/surgery , Sialorrhea/surgery , Submandibular Gland/surgery , Cohort Studies , Follow-Up Studies , Longitudinal Studies , Ligation/adverse effects , Ligation/methods , Otorhinolaryngologic Surgical Procedures/adverse effects , Treatment OutcomeABSTRACT
Abordagens cirúrgicas comuns para maxilectomia medial incluem a rinotomia lateral e a via de acesso degloving médio-facial. A rinotomia lateral fornece um excelente campo cirúrgico, mas deixa proeminentes cicatrizes na face. Já o degloving médio-facial tem sido superior à rinotomia lateral, pois não deixa nenhuma cicatriz externa, embora saibamos que este procedimento tem suas limitações¹. Este estudo tem o objetivo de descrever os resultados estéticos e de melhor acesso transoperatório de cirurgias nasossinusais via degloving, com avaliação da morbidade pós-operatória através das seguintes variáveis: hemoglobina pré e pós-operatória, necessidade de transfusão sangüínea, presença de complicações, uso de tampão nasal, uso de antibiótico, fio cirúrgico utilizado, tempo de internamento pós-operatório e presença de recidiva. Foi realizado um estudo retrospectivo a partir de 16 pacientes internados no Hospital Geral de Fortaleza SESA/SUS durante o período de dezembro de 1999 a novembro de 2003. Pelos dados obtidos, conclui-se que a via de acesso degloving é eficaz no tratamento de lesões nasossinusais extensas, com bons resultados estéticos e com reduzida morbidade pós-operatória.
Subject(s)
Humans , Child , Adolescent , Adult , Middle Aged , Nose Neoplasms/surgery , Otorhinolaryngologic Surgical Procedures/methods , Blood Transfusion , Hemoglobins/analysis , Length of Stay , Neoplasm Recurrence, Local , Paranasal Sinus Neoplasms/surgery , Otorhinolaryngologic Surgical Procedures/adverse effects , Retrospective Studies , Tampons, Surgical , Treatment OutcomeABSTRACT
Una de las secuelas potenciales de la paratidectomía es el síndrome de Frey. La incidencia de éste varía de un 6-96 por ciento según la metodología de estudio del problema. Se analizan los resultados del tratamiento preventivo del síndrome mediante la interposición de un colgajo de músculo estemocleidomastoideo. Entre agosto de 1994 y julio de 1998 se operaron 25 pacientes con tumores benignos de la parótida cubriendo el lecho quirúrgico con un colgajo de músculo estemocleidomastoideo de pedículo superior. La evaluación de los pacientes se realizó mediante encuesta, interrogatorio dirigido y utilizando el test de tinción yodada y almidón. Se presentó el síndrome de Frey como expresión voluntaria en 3 pacientes (12 por ciento), mediante interrogatorio dirigido 20 por ciento y utilizando el test de yodo-almidón 20 por ciento
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Parotid Neoplasms , Sweating, Gustatory/prevention & control , Otorhinolaryngologic Surgical Procedures/adverse effectsABSTRACT
Os autores apresentam uma atualizaçäo sobre as complicaçöes da cirurgia microendoscópica naso-sinusal