Microscopic Partial Tonsillectomy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Conventional tonsillectomy with the naked eye has posed problems in obtaining a good surgical field and in minimizing damage to the adjacent tissue. Tonsillectomy using an operating microscope offers outstanding illumination and visualization of the surgical field, thereby reducing the incidence of complications associated with tonsillectomy. The objective of this study was to compare the surgical methods of the conventional and the microscopic tonsillectomies, and to evaluate the usefulness and effectiveness of the microscopic tonsillectomy. MATERIALS AND METHODS: Two hundred children between the ages of five and ten who received tonsillectomy between June 1995 and August 1998 at Korea University Hospital were divided into two groups,' one group underwent tonsillectomy using an operating microscope (Group 1, n=100) and the other group underwent tonsillectomy using the conventional dissection and snare technique (Group 2, n = 100). Duration of surgery, post-operative healing period, amount of intra and post-operative hemorrhage, post- operative pain score, and the incidence of post-operative cicatrical pharyngeal stenosis were compared between the two groups. RESULTS: There was no statistically significant diference in operating time and post-operative healing period between the two groups, but cicatrical pharyngeal stenosis due to post-operative scarring was more common in the group that underwent conventional tonsillectomy. The amount of hemorrhage both intra and post-operatively, and post-operative pain was significantly decreased in the microscopic tonsillectomy group. CONCLUSION: The widespread use of operating microscope in otolaryngological surgeries allows this technique to be applied to tonsillectomy with few problems. This technique affords decreased intra-operative bleeding, less post-operative complications, and decreased post-operative pain compared with conventional techniques. We believe that microscopic tonsillectomy is a safe, elegant and effective procedure that represents a new concept in tonsil surgery.

Laser Assisted Partial Adenotonsillectomy in Children / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: In children, adenotonsillectomy is performed for treating recurrent tonsillitis, mouth breathing and sleep disorder. However, there are some complications associated with the complete removal of the tonsil and adenoid. The conventional method involving dissection and snare techniques used for adenotonsillectomy has been the subject of debate over its indications and appropriate time for surgery, since it removes most of the tonsil tissues and may have destructive effect on the local defense mechanism. The aim of this study was to analyze the results of laser assisted partial adenotonsillectomy by using KTP-532 laser to preserve minimal amount of tonsil tissue needed for the local defense mechanism. MATERIALS AND METHODS: Sixty cases of laser assisted partial adenotonsillectomy, and sixty cases of conventional adenotonsillectomy with dissection and snare techniques were examined. RESULTS: There were no differences regarding the recurrence rate, improvement of symptoms, and degree of postoperative pain between the laser partial adenotonsillectomy group and the conventional groups. There were less incidence of preoperative bleeding and postoperative scar formation in the laser partial adenotonsillectomy. CONCLUSION: Compared to the conventional method, the laser assisted partial adenotonsillectomy has a similar incidence of postoperative result but a low incidence of preoperative complications such as bleeding. It also preserves minimal tonsil tissues responsible for local defense mechanism. We suggest that the laser assisted partial adenotonsillectomy is an attractive surgical method in children.

Management of Congenital Choanal Atresia with the KTP/532 Laser / 대한이비인후과학회지

Congenital choanal atresia is an uncommon anomaly. In most reported series it has an incidence of 1 in 7,000 or 80,000 births with female preponderance. Approximately 90% of cases are reported as having unilateral bony type congenital atresia. Bilateral congenital choanal atresia cause acute life-threatening respiratory obstruction in newborns, whereas unilateral atresia alone does not cause significant airway obstruction. Rarely an infant may compensate by rapidly learning mouth breathing and the diagnosis may escape detection for months or even years. A variety of techniques are available to correct this problem, but none is entirely satisfactory. The authors recently experienced a case of unilateral membranous type congenital choanal atresia which was treated by KTP/532 laser and report the case with review of literatures.