Tonsillectomy performed by ultrasonic harmonic scalpel is associated with lower postoperative pain as compared with conventional blunt dissection method

Aims: To compare the mean intensity of post-operative pain in Harmonic scalpel tonsillectomy and conventional blunt dissection method in pediatric age group

Patients and Methods: It was randomized control trial with non-probability, consecutive sampling done in the ENT Department, Shaikh Zayed Hospital, Lahore. The study was conducted. from 01-03-2012 to 31-08-2013

Results: In 81 out of 162 patients, tonsillectomy was performed by Harmonic scalpel and they were labeled as Group-A. While in remaining 81 patients, labeled as Group-B, tonsillectomy was performed by conventional blunt dissection method. The post operative pain was significantly less in Group-A on day 1, 2, 3 and 5 with P-value <0.001. While on day seven although the pain is less in Group-A but it is not statistically significant

Conclusions: Tonsillectomy performed by ultrasonic harmonic scalpel is associated with lower postoperative pain as compared with conventional blunt dissection method. Thus, we believe that the use of this new technique for tonsillectomy may result in additional benefit to the patients

Nasal packing: is it necessary in septal surgery

Aim the study was carried out to evaluate the necessity of nasal packing following septoplasty

Methods: This observational study of 60 cases was carried out at the Department of ENT, Shaikh Zayed Federal Postgraduate Medical Institute and Hospital, Lahore from September 2008 to March 2009. Group A contained patients with nasal packing. Group B contained patients without nasal packing

Results: The incidence of headache in group A was very high as compared to group B. 90% patients in group A had headache as compared to 20% patients in group B [p<0.001] The incidence of sleep disturbance in group A was very high as compared to group B. 24 [80%] patients in group A had sleep disturbance as compared to 4 [13.3%] patients in group B [p<0.001] The incidence of hemorrhage following septoplasty was low in both groups. Only 2 [6.6%] patients developed hemorrhage in group B. It was not found in group A [0%]. The incidence of septal hematoma following septoplasty was low in both groups. Only 2 [6.6%] patients in group A developed septal hematoma and required incision and drainage, as compared to 0 [0%] patients in group B

Conclusion: Nasal packing is not necessary in each post operative patient of septoplasty

Prevalence of verrucous carcinoma in laryngeal cancers and their metastatic potential

To study the frequency of: [1] Verrucous carcinoma in malignant laryngeal tumours [2] Lymph node metastasis in patients with laryngeal verrucous carcinoma. Descriptive study. Purposive type. Department of ENT and head and neck surgery, Pakistan institute of medical sciences, Islamabad. Period of study extended from 1St January 2001 to 31st December 2003. Frequency of verrucous carcinoma was evaluated among One hundred and twenty, [120] cases of malignant laryngeal tumours presented and primarily diagnosed in our ENT department. Cases of verrucous carcinoma were also evaluated for presence or absence of lymph node metastasis. Frequency of verrucous carcinoma in malignant laryngeal tumours was 2.5%. None of these patients had palpable lymph nodes at the time of presentation. Verrucous carcinoma in our population is relatively uncommon disease. Lymph node involvement is rare even with advanced t umours

Tympanoplasty: overlay versus underlay technique

To determine the rates of success of two different techniques of Tympanoplasty. Prospective comparison study. Department of ENT and head and neck surgery, Pakistan institute of medical sciences, Islamabad. Period of study extended from January 1999 to December 2000. This study included 30 patients that underwent tympanoplasty in the department of otolaryngology, head and neck surgery, Pakistan Institute of Medical Sciences Islamabad. Out of these 30 patients, 20 were males and 10 females. 15 cases underwent underlay technique and 15 patients were operated on by overlay technique. Outcome was measured for healing, post operative hearing and incidence of complications. According to this study, the success rate of tympanoplasty in graft uptake by underlay technique was 86% and by overlay technique was 70%. Hearing results were significantly different between overlay and underlay groups. Closure of Air Bone Gap with in 0 - 20 d B in underlay group was 86% while in overlay group it was 69%. The most significant finding in this study was high success rate with underlay technique with low incidence of complications. It was an ideal technique to repair perforations that are small and easily visualized in all quadrants, blunting and lateralization of the grafts were avoided