ABSTRACT
BACKGROUND: The ultrasonic scalpel is a recently introduced device in head and neck surgery. Total thyroidectomy is the most common endocrine procedure performed by surgeons. METHODS: This was an open, phase IV, multicenter, randomized controlled trial (RCT) that compared the use of an ultrasonic scalpel with a conventional technique in patients who underwent total thyroidectomy. The outcomes were surgical complication rate, operative time, drainage volume, postoperative pain, and costs. RESULTS: In all, 261 patients were included in 11 centers. There was a mean difference of 17% of operative time in favor of the ultrasonic scalpel group. There were no differences in postoperative complications. There was a difference in costs of 14% in favor of the ultrasonic scalpel group, but it was not statistically significant. CONCLUSIONS: The use of an ultrasonic scalpel was as safe as that of the conventional technique and had the advantage of a shorter operative time and lower postoperative drainage. Costs were not different between groups.
Subject(s)
Thyroidectomy/instrumentation , Ultrasonic Surgical Procedures/instrumentation , Carcinoma/surgery , Drainage , Female , Goiter/surgery , Humans , Male , Middle Aged , Postoperative Complications , Thyroid Neoplasms/surgery , Thyroidectomy/economics , Time FactorsABSTRACT
O carcinoma epidermóide das vias aerodigestivas superiores está entre as 10 neoplasias mais freqüentes do mundo. Os pacientes portadores deste tipo de neoplasia apresentam na maioria das vezes o consumo crônico de tabaco e álcool. O consumo crônico destas substâncias e a presença de comorbidades podem interferir no processo de escolha e execução do tratamento cirúrgico. A utilização de índices ou de informações no pré-operatório pode ajudar no melhor planejamento terapêutico. O objetivo principal foi estudar as comorbidades, através do ACE-27 e o estado nutricional pelo SGA/ANS, no pré-operatório e correlacionar com a presença de complicações locais e sistêmicas. O número de comorbidades, duas ou mais, esteve relacionado com as complicações sistêmicas com um p = 0,005. A severidade das comorbidades (medido pelo ACE-27) não mostrou a mesma associação. O estado nutricional esteve significativamente associado com a presença de complicações locais, especificamente considerando-se: a capacidade funcional, perda de peso ponderal e a demanda metabólica. A avaliação pré-operatória das comorbidades e do estado nutricional.
Subject(s)
Humans , Nutrition Assessment , Mouth , Carcinoma, Squamous Cell , Comorbidity , Postoperative Complications , Pharyngeal Neoplasms , Laryngeal Neoplasms , Head and Neck Neoplasms/complicationsABSTRACT
Com a evolucão e o desenvolvimento tecnológico, houve mudancas nos métodos de avaliacão da voz, tanto na prática médica como fonoaudiológica. OBJETIVO: Relacionar os resultados da avaliacão perceptivo-auditiva vocal, análise acústica e avaliacões médicas no diagnóstico de alteracões vocais e/ou laríngeas em indivíduos com queixa vocal. FORMA DE ESTUDO: Clínico prospectivo. MATERIAL E MÉTODO: Foram avaliados 29 indivíduos que participaram de uma acão de protecão de saúde. Os sujeitos foram submetidos à avaliacão fonoaudiológica peceptivo-auditiva (AFPA), análise acústica (AA), laringoscopia indireta (LI) e telelaringoscopia (TL). RESULTADOS: Foram estabelecidas as relacões entre os métodos de avaliacão médica e fonoaudiológica, verificando possíveis significâncias estatísticas a partir da aplicacão do Teste Exato de Fischer. Houve significância estatística na relacão entre AFPA e LI, AFPA e TL, LI e TL. CONCLUSAO: Esta pesquisa realizada numa acão de protecão de saúde vocal mostrou concordância entre a avaliacão fonoaudiológica perceptivo-auditiva e as avaliacões médicas, bem como os exames médicos entre si no diagnóstico de alteracões vocais e/ou laríngeas.
Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Laryngoscopy/methods , Speech Acoustics , Speech Perception/physiology , Voice Disorders/physiopathology , Voice Quality/physiology , Voice Disorders/diagnosisABSTRACT
UNLABELLED: As a result of technology evolution and development, methods of voice evaluation have changed both in medical and speech and language pathology practice. AIM: To relate the results of perceptual evaluation, acoustic analysis and medical evaluation in the diagnosis of vocal and/or laryngeal affections of the population with vocal complaint. STUDY DESIGN: Clinical prospective. MATERIAL AND METHOD: 29 people that attended vocal health protection campaign were evaluated. They were submitted to perceptual evaluation (AFPA), acoustic analysis (AA), indirect laryngoscopy (LI) and telelaryngoscopy (TL). RESULTS: Correlations between medical and speech language pathology evaluation methods were established, verifying possible statistical signification with the application of Fischer Exact Test. There were statistically significant results in the correlation between AFPA and LI, AFPA and TL, LI and TL. CONCLUSION: This research study conducted in a vocal health protection campaign presented correlations between speech language pathology evaluation and perceptual evaluation and clinical evaluation, as well as between vocal affection and/or laryngeal medical exams.
