Carcinoma of the external auditory canal.

Carcinoma of the external auditory canal is one of the most inaccessible areas of the body. It is a rare malignant neoplasm with an aggressive nature and an overall poor prognosis. In a ten year period, 16 patients were treated in King Chulalongkorn Memorial Hospital. From TNM staging proposed by the University of Pittsburgh, the authors found T1 = 1, T2 = 6, T3 = 5, T4 = 4 cases. In 14 patients who were operated on (radical mastoidectomy in 8, lateral temporal bone resection in 5, sleeve resection in 1), 7 had cured (50%), 7 were recurrence. 6 cases of recurrence developed in patients with radical mastoidectomy, 1 case with lateral temporal bone resection. The overall cure rate in stage I-II = 85.71% (6/7) but only 11.11% (1/9) in the advanced stages (III-IV). The present data suggest that in early cancer (stage I-II) the lateral temporal bone resection with postoperative radiation is better than radical mastoidectomy with postoperative radiation.

Comparison of pain after radiofrequency tonsillectomy compared with conventional tonsillectomy: a pilot study.

Tonsillectomy results in a severe sore throat, especially in the first few days, until the exposed and inflamed muscle becomes covered with regenerated mucosa. There are a variety of techniques of tonsillectomy including monopolar and bipolar diathermy, blunt dissection, and most recently radiofrequency tonsil ablation and coblation. The objective of the present study was to assess the postoperative pharyngeal or ear pain of radiofrequency tonsillectomy and compared with traditional blunt dissection tonsillectomy with loop ligation hemostasis.

KTP laser inferior turbinoplasty: an alternative procedure to treat the nasal obstruction.

OBJECTIVE: Nasal obstruction resulting from inferior turbinate hypertrophy (ITH) was treated with KTP laser inferior turbinoplasty (KIT). The effectiveness of the procedure was assessed. METHODS: A prospective clinical trial was carried out in King Chulalongkorn Memorial Hospital from October 1, 1998 to September 30, 2000. Forty-eight patients with chronic nasal obstruction underwent KIT. Nasal obstruction was pre- and postoperatively assessed, based on 4-point scale, by the patient and investigator. The scores were compared by paired t-test. The correlation of assessment by the patient and investigator was also demonstrated by weighted kappa test. Pre- and postoperative rhinomanometric evaluations were performed in 29 patients and were compared with paired t-test. RESULTS: Significant reduction of nasal obstruction was obtained from assessment by the patient (P<0.000) and by the investigator (P<0.000). The symptoms of sneezing, itching and rhinorrhea were significantly reduced postoperatively (P<0.000). The cure and improvement rate of nasal obstruction were at 70.8 and 100% (assessed by the patient) and at 77.1 and 100% (assessed by the investigator) respectively, and they showed a moderate correlation (Kw=0.65). Rhinomanometrically, the total airway resistance decreased but of not statistic significance (P=0.219), however, the inspired nasal airflow at 150 Pa and the volume of nasal cavities were significantly increased (P<0.00 and P<0.001, respectively). CONCLUSION: KIP was shown to effectively reduce the symptom and sign of nasal obstruction as well as other nasal symptoms without any significant complications. It should be an alternative method in treating the patients with nasal obstruction resulting from hyperplastic inferior turbinate.