Subject(s)
Neck Dissection , Neoplasm Recurrence, Local , Thyroid Neoplasms , Humans , Thyroid Neoplasms/surgery , Thyroid Neoplasms/diagnostic imaging , Thyroid Neoplasms/pathology , Female , Reoperation , Middle Aged , Male , Ultrasonography , Thyroidectomy/methods , Adult , Aged , Ultrasonography, InterventionalABSTRACT
OBJECTIVES: To assess current variation in the management of pinna haematoma (PH) and its effect on outcomes. DESIGN: Multicentre retrospective observational record-based study. SETTING: Eleven hospitals around the UK. PARTICIPANTS: Eighty-three patients above the age of 16 with PH. OUTCOME MEASURES: The primary outcome measure was recurrence rate of PH over a 6-month period post-treatment, assessed by treatment type (scalpel incision vs needle aspiration). Secondary outcome measures assessed the impact of other factors on recurrence, infection and cosmetic complications of PH over a period of 6 months. RESULTS: After adjusting for confounding factors, involvement of the whole ear, and management within an operating theatre were associated with a lower rate of recurrence of pinna haematoma. The drainage technique, suspected aetiology, choice of post-drainage management, grade and specialty of practitioner performing drainage, the use of antibiotic cover and hospital admission did not affect the rate of haematoma recurrence, infection or cosmetic complications. CONCLUSIONS: Where possible PH should be drained in an operating theatre. Multicentre randomized controlled trials are required to further investigate the impact of drainage technique and post-drainage management on outcome.
Subject(s)
Ear Auricle , Ear Diseases/therapy , Hematoma/therapy , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Ear Diseases/complications , Ear Diseases/epidemiology , Female , Hematoma/complications , Hematoma/epidemiology , Humans , Male , Middle Aged , Outcome and Process Assessment, Health Care , Recurrence , Retrospective Studies , United Kingdom , Young AdultABSTRACT
BACKGROUND: Inadvertent (or incidental) parathyroidectomy can occur during thyroidectomy. However, the factors associated with inadvertent parathyroidectomy remain unclear. This study aimed to report the rate of inadvertent parathyroidectomy during thyroidectomy and associated risk factors. METHODS: Variables including fine needle aspiration cytology findings, age, sex, thyroid weight, concurrent neck dissection, extent of thyroidectomy, and the presence of cancer and parathyroid tissue within the specimen were recorded for 266 patients. The incidence of post-operative hypocalcaemia was also recorded. Univariate and multivariate analysis were performed to identify factors associated with inadvertent parathyroidectomy. RESULTS: The inadvertent parathyroidectomy rate was 16 per cent. Univariate analysis revealed that cancer and concurrent neck dissection predicted inadvertent parathyroidectomy. On multivariate analysis, only concurrent neck dissection remained an independent predictor of inadvertent parathyroidectomy: it was associated with a fourfold increase in inadvertent parathyroidectomy. CONCLUSION: The inadvertent parathyroidectomy rate was 16 per cent and concurrent neck dissection was identified as an independent predictor of inadvertent parathyroidectomy.
Subject(s)
Hypocalcemia/epidemiology , Medical Errors/statistics & numerical data , Neck Dissection/statistics & numerical data , Parathyroidectomy/statistics & numerical data , Postoperative Complications/epidemiology , Thyroid Neoplasms/surgery , Thyroidectomy , Adolescent , Adult , Aged , Aged, 80 and over , Biopsy, Fine-Needle , Female , Humans , Incidence , Male , Middle Aged , Multivariate Analysis , Retrospective Studies , Risk Factors , Thyroid Diseases/pathology , Thyroid Diseases/surgery , Thyroid Neoplasms/pathology , Young AdultABSTRACT
Chemotherapy may cause oral ulceration but a thorough investigation of symptoms and signs is important to determine the underlying diagnosis accurately. We describe a case of a patient with a poorly differentiated urothelial carcinoma of the bladder developing a tongue metastasis. This is a challenging diagnosis to make given the rarity of the presentation but it illustrates the need to evaluate any new symptoms fully.
Subject(s)
Adenocarcinoma/pathology , Adenocarcinoma/secondary , Tongue Neoplasms/secondary , Urinary Bladder Neoplasms/pathology , Fatal Outcome , Humans , Male , Middle Aged , Tongue Neoplasms/diagnosisABSTRACT
OBJECTIVES: This study aims to assess the safety of daycase cochlear implant surgery. METHODS: A retrospective review was conducted on all patients who underwent cochlear implant surgery at a teaching hospital in Oxford, UK between September 2008 and February 2012. RESULTS: One hundred and sixteen patients underwent cochlear implant surgery. This included 73 adults and 43 children. Twenty-six patients underwent the procedure as a daycase procedure. There were no readmissions. DISCUSSION: The demand 'to do more with less' has led to increasing drives for efficiency and cost-effectiveness. Therefore, the role of daycase surgery is becoming increasingly widespread. Daycase surgery has been shown to be advantageous for both patients and hospitals. CONCLUSION: Daycase cochlear implant surgery is feasible and can be safely conducted in a select group of patients.
