Intraoperative bleeding and postoperative pain in tonsillectomy using monopolar diathermy versus harmonic scalpel

This study aimed at comparing tonsillectomy procedure using the monopolar diathermy to the ultrasonic harmonic scalpel as regards duration of the procedure, amount of intraoperative bleeding and postoperative pain scores. The study included 48 patients divided into two equal groups. Monopolar diathermy was used in one group and the ultrasonic harmonic scalpel in the other group. No post-tonsillectomy bleeding and good healing was seen in both groups. Time factor was nearly the same for both procedures, intraoperative bleeding and postoperative pain results were collectively in favor of the harmonic scalpel. The study recommends the use ultrasonic harmonic scalpel in tonsillectomy to reduce intraoperative bleeding and postoperative pain

Prevalence and resistance patterns of oropharyngeal flora in acne patients treated with long term antibiotics

This is a cross sectional study aimed at the estimation of the prevalence and resistance patterns of Streptococcus pyogenes and Staphylococcus aureus in the oropharynx of antibiotic user and non-user individuals with acne. The main outcome measure was the presence or absence of S pyogenes and S aureus in the oropharynx as determined by culture and their resistance patterns to tetracyclines as determined by agar disk diffusion. Of 105 participants, 42 were using oral or topical antibiotics and 63 were not using antibiotics. Six [10%] of non-users had positive S pyogenes cultures compared with 13 [33%] of those successfully evaluated using antibiotics [n=39]. A total of 85% of S pyogenes cultures [11/13] from antibiotic users were resistant to at least tetracycline antibiotic compared with 20% from those non-antibiotic users [p=0.1]. Of non-antibiotic users 29% had positive S awe us cultures compared with 22% of antibiotic users. No significant differences in resistance patterns of S aureus were found. It was clear that S pyogenes colonization and resistance in the oropharynx are associated with antibiotic therapy in patients with acne. The clinical and long-term effects of this finding need further studies

Minimally invasive techniques in the management of benign surgical salivary problems

Sialolithiasis is considered as the commonest underlying pathology for sialadenitis, commonly affecting submandibular salivary glands, to lesser extent parotid glands and rarely sublingual or minor salivary glands. Stenosis of secondary and tertiary ducts of the salivary ductal system can also precipitate suppuration of the salivary glands. Patients with history of sialadenitis were best investigated by ultrasound and/or sialography. Patient should be informed by a written consent that if the endoscopic trial failed, the procedure should be shifted to external sialoadenectomy. Interventional sialoendoscopy is a new procedure to visualize the salivary ductal system followed by stone extraction, fragmentation of big stones then extraction or dilatation of stenosed duct by metallic dilator or balloon catheter. The surgical duration ranged between 10-20 minutes, with limited complications as duct perforation requiring sialoadenectomy or duct stenosis with fibrosis that was detected in the routine postoperative ultrasound and/or sialograms. Being a simple outpatient ambulant procedure, sialoendoscopy avoids the risk of general anesthesia and the need to do maximum neck extension in patients suffering of neck problems