Monopolar cautery versus cold steel dissection for tonsillectomy in children. a randomized clinical trial

Objective: To compare monopolar cautery with cold steel dissection for tonsillectomy in pediatric age group

Study Design: A randomized clinical trial

Place and Duration of Study: Ear, nose and throat [ENT] department Combined Military Hospital Gujranwala, from Jan 2013 to Jan 2015

Material and Methods: A total of 220 consecutive pediatric patients undergoing tonsillectomy for recurrent or chronic tonsillitis between Jan 2013 to Jan 2015. Both groups were compared with regards to surgery time, intraoperative bleeding, post operative pain and complications

Results: A total of 20 patients were excluded from the study for various reasons while the data of the rest of the patients has been presented. Mean age of the study group was 8.82 years. A total of 58% of the patients were male. Average time of surgery for monopolar cautery was 29.33 [SD 2.77] min as compared to 18.53 min [SD 2.94] for dissection method which was significant [p<0.005]. Average blood loss for monopolar surgery was 11.66 ml and 29.04ml for dissection method [p<0.005]. Average pain scores were less for dissection method at 2nd post op day 3.59 vs. 5.51. Rates of primary and secondary hemorrhage were less for monopolar method although they were not statistically significant

Conclusion: Monopolar cautery though causes decreased intraoperative blood loss however requires longer anesthesia and causes significant post operative pain to the patient

Management of suicidal cut throat-a case report

Suicide is one of the 10 leading causes of death in the world, accounting for more than 400,000 deaths annually1. Hanging, poisoning and fire arm are the most common methods of committing suicide in the world. Knives and razor blades are the common implements used in suicide2. Tentative marks were present in most fatalities3. Suicide by cutting one's own throat without hesitation cuts remains rare. Such life threatening injuries require emergency treatment3,4. Here we present a case of young individual presenting in ENT department Combined Military Hospital [CMH] Quetta with a suicidal cut throat injury, using a long bladed knife

Effects of single preoperative dose of steroid on postoperative morbidity in peritonsillar abscess

The objective of this study was to compare the effect of single preoperative intravenous dose of Dexamethasone on postoperative morbidity that is pain, fever, and hospital stay in patients with peritonsillar abscess undergoing incision and drainage with those who did not receive Dexamethasone [control group]. Comparative study. [Case control type] Joint Venture of Department of ENT and Head and Neck surgery Combined Military Hospital Rawalpindi and Department of ENT and Head and Neck surgery Combined Military Hospital Lahore from January 2007 to January 2009. Total of 60 patients were included and divided into two groups of 30 each. Group A received single dose of Dexamethasone preoperatively intravenously 10 minutes before start of procedure while group B [control group] did not receive any steroid. Pain control had significant difference in both groups with better control rates in group A. Similarly fever control was significantly better in Group A. Hospital stay was less in case of Group A. Single dose of Dexamethasone given preoperatively significantly reduced the postoperative morbidity that is pain; fever and hospital stay in patients undergoing incision and drainage for peritonsillar abscess

Surgical management of otosclerosis- stepedectomy versus stapedotomy

To compare post operative morbidity after stapedotomy with stapedectomy. Quasi-experimental study. Place and Duration of Study: ENT Departments of CMH Rawalpindi and CMH Lahore from Jan 2006 to Jan 2009. Forty eight patients were included in this study and were divided into two groups; 14 patients underwent stapedectomy and 34 patients underwent stapedotomy. Severity and duration of vertigo and hospital stay with stapedotomy were less as compared to stapedectomy. Conclusions: These results demonstrated that postoperative morbidity with stapedotomy was less as compared to stapedectomy

Evaluation of mastoid cavities after canal wall down mastoidectomy

To evaluate mastoid cavities after canal wall down procedures in terms of achieving a dry mastoid cavity, presence of residual or recurrent disease [Granulations and cholesteatoma]. Quasi-experimental study. The study was done in the ENT Department, CMH Rawalpindi Study was done in fourteen months from Nov 2006 to Jan 2008. Fifty patients undergoing canal wall down mastoidectomy were included. Their mastoid cavities were evaluated for persistence of discharge and recurrence of granulations and cholesteatoma after the surgery. After follow up period of 3 months, 8% patients had mild discharge, 12% had granulation and 2% patients had recurrence of cholesteatoma. Canal wall down mastoidectomies are very effective in controlling the recurrence of cholesteatoma, granulations formation and otorrhoea to a greater extent