ABSTRACT
Tonsillectomy is a commonly performed surgery in otolaryngological practice. Owing to the possibility of postoperative bleeding, it is considered as one of the major surgical procedures. Various techniques have been advocated, however dissection and electrocautery are the most commonly used techniques in tonsillectomy. The objective was to study and compare the relative efficacy using two methods of tonsillectomy- bipolar electrocautery versus silk ligation. This prospective study included 50 patients who underwent tonsillectomy. Patients were randomly divided into two groups. In Group A, left tonsillar fossa haemorrhage was controlled by ligation, while in Group B, bipolar diathermy was used to control bleeding of right tonsillar fossa. Comparison was done in terms of time taken for hemostasis, amount of intra-operative blood loss and post-operative pain. 130 (72.22%) male and 50 (27.77%) females were included. Group A included 20 cases while Group B included 30 cases. The mean time taken for hemostasis in Group A patients was 40.5 ± 4.4 min as compared to 25.3 ± 6.2 min in Group B patients. The mean blood loss on cautery side was 49.5 ± 4.5 ml and that on the ligation side was 68.6 ± 5.3 ml. Post-operative pain was significantly more in Group B patients as compared to Group A patients. Bipolar diathermy is a quicker and faster method to achieve hemostasis with little intraoperative blood loss as compated to silk ligation.
ABSTRACT
The present study was aimed to compare percutaneous dilatational tracheostomy (PDT) with that of conventional surgical tracheostomy (ST) in critically ill adult patients requiring tracheostomy for respiratory management. For this purpose 32 critically ill patients, admitted to the ICU between July 2016 and June 2018, were subjected to tracheostomy and randomly divided into two groups (PDT and ST) of 16 patients each. Mean duration of intubation was similar between the two procedures while the mean size of the tracheostomy tube was smaller in percutaneous technique. In comparison, post-operative infection after 7 days seem to be statistically lowered and the length of scar tend to be smaller in PDT patients. Although early and late post-operative complication rates are not statistically significant in the PDT groups, yet investigations of the long-term outcome following PDT are, therefore, necessary. Generally, PDT has lower acute complications than ST, although this may vary by the specific PDT technique. Patient factor may also influence complications. In view of the benefit versus risks in tracheostomy, PDT may be considered the "procedure of choice" for performing elective tracheostomies in critically ill adult patients.
ABSTRACT
Castleman's disease (giant or angio follicular lymph node hyperplasia) was first described by Benjamin Castleman in the year 1957 and was named after him. It is an uncommon lympho proliferative disorder which is localised to single lymphnode (unicentric) or multiple lymph node level systemically (multicentric).It is a very rare disorder characterised by non-cancerous growths. The most common sites of this are mainly thorax (mediastinum or lung hilum) and abdomen. It rarely occurs in cervical area. We report a case of unicentric cervical castleman's disease of neck in an 18-year-old female, who came to ENT OPD with history of right sided neck mass since 6-8 months. After thorough clinical examination and investigations, complete excision of the mass was done. Histopathological examination confirmed the diagnosis of Castleman's disease. On follow-up for one year no recurrence has been seen.
