ABSTRACT
Tonsillectomy as a surgical procedure has been practiced by ENT surgeons for a very long time. A common indication for Tonsillectomy is Chronic Tonsillitis, among others. The surgery is largely safe irrespective of the method used. Haemorrhage can be a life-threatening complication post Tonsillectomy if it is not identified and treated immediately. Various techniques are used to achieve haemostasis and prevent haemorrhage including surgical tie, cautery, local application of adrenaline or hydrogen peroxide among others. To understand the vasoconstrictive and haemostatic properties of Hydrogen Peroxide in Tonsillectomy bleed. One hundred and thirty-three (133) patients undergoing Tonsillectomy for Chronic Tonsillitis were part of the study. Dissection and Snare technique was performed. 23 patients needed the use of cautery/knot for haemostasis and were then excluded from the study. To avoid bias, dissection of the right tonsil was taken as Group 1 and left tonsil as Group 2. Normal Saline soaked cotton ball was used to give local pressure in the tonsillar fossa in Group 1 and 3% Hydrogen Peroxide soaked cotton ball was used in Group 2. Blood loss and time taken to dissect were taken as parameters of study. In Group 1, it took 14.29 min on an average from first incision to completion. In Group 2, it took 12.15 min on an average from first incision to completion. The time in Group 2 was 14.97% lesser than Group 1. The average blood loss in Group 1 was 56.47 ml and in Group 2 the same value stood at 47.41 ml. The blood loss in Group 2 was 16.04% lesser than in Group 1. There were no complications encountered. Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation 3% Hydrogen Peroxide is a potent agent for antimicrobial activity and haemostasis when introduced in the tonsillar fossa post tonsillectomy. When used in moderation, it is very effective in preventing blood loss. Also, there are no serious complications associated with the use of Hydrogen Peroxide as a haemostatic agent.
ABSTRACT
The nasal airways and their close association to paranasal sinuses are an integral part of the respiratory tract. Mucociliary clearance is the predominant clearance mechanism for both upper and lower airways. The two components of mucociliary clearance are cilia and the secretions above them. It is known that CRS coexists in as many as 40-75% of patients with BA. CRS can present with polyposis or without polyposis. Treatment options for CRS include medical therapy, surgical intervention or both. According to recent guidelines, ESS is the most favourable surgical approach in patients who fail to respond adequately to medical therapy. To assess the extent of improvement in CRS following ESS (either microdebrider or conventional) and if it brings an improvement in the pulmonary function tests. This also assesses symptom scores, endoscopic appearances and CT findings pre-operatively and post-operatively. This study was carried out at the outpatient Department of Otorhinolaryngology and Head and Neck Surgery in Meenakshi Medical College, Hospital and Research Institute, Tamil Nadu. Patients were consented and started on medical treatment with systemic steroids for 2 weeks and topical nasal steroids for 1 month. If the disease persisted after medical therapy, patients were equally randomized into two groups of 30 each-microdebrider and conventional technique. Subjective symptoms of CRS were based on the CRS criteria. Symptoms score were given with Lund-Mckay symptoms scoring, pre-operatively 1 week before and post-operatively 2 months after surgery. Lund-Mckay CT scoring system separately assessed the extent of opacification of sinuses. PFT was assessed using Spirometer (KOKO Legend). There was a statistically considerable difference in the FEV1 values in microdebrider ESS than conventional ESS. Microdebrider ESS is considered superior when we have to address the coexistence of lower airway diseases along with CRS.
ABSTRACT
Septal Correction is an age-old procedure being practiced for the major part of a century now. The aim of this study was to assess the quality of life after Septal Correction. Fifty patients with complaints of nasal obstruction, trouble breathing via the nose, headache and facial pain were selected for the study. Initial pre-operative assessment was done based on a symptomatic score [Nasal Obstruction Symptom Evaluation Scale (NOSE Scale)]. The presence of a septal deviation was confirmed with an X-ray and computed tomography of the paranasal sinuses along with a diagnostic nasal endoscopy. Based on the extent and location of deviation, the malformed part was corrected. Post-operative assessment was done after a period of 8 weeks based on the NOSE Scale. The results were co-related and documented. It was found that the scores were better post-surgery. Thus, it can be concluded that Septal Correction as a surgical procedure is still relevant in today's World for symptomatic betterment and for a healthier lifestyle.
ABSTRACT
Inflammatory and infectious diseases of tonsils are common in paediatric and adult otolaryngological practice and ensue in tonsillectomy which is a common surgical procedure. Dissection and snare method is being performed for ages and has evolved over a period of time while coblation is a newer technique started in 1997. It combines radiofrequency energy and normal saline, resulting in a plasma field of highly ionized particles which dissociates intercellular bonds and thus melts tissue at low temperatures (40-70 °C) thereby reducing tissue damage. To compare the intraoperative time, intraoperative blood loss, post operative pain and post operative blood loss between dissection tonsillectomy and coblation tonsillectomy. This study was carried out at the outpatient Department of Otorhinolaryngology and Head and Neck Surgery in Meenakshi Medical College, Hospital and Research Institute, Tamil Nadu. Patients with chronic and recurrent tonsillitis who were planned electively for tonsillectomy were included in this study. Study was based on the analysis of 60 patients aged between 5 and 40 years. All these 60 patients were thoroughly investigated by doing a complete surgical workup. They all were subjected to 2 different tonsillectomy procedures-dissection and snare method and coblation technique. Patients were assigned into two groups of 30 each by simple random sampling. Among these 60 patients, blood loss and post operative pain was less in Group 2 (coblation) and the duration of surgery was less in Group 1 (dissection and snare). In this study, patients who underwent surgery in Group 2 (coblation) showed better outcome when compared to Group 1 (dissection and snare method).
