Surgeons' preferences and anxiety levels in paediatric adenotonsillectomy: European perspective.

OBJECTIVE: This study assessed the preferences of surgeons regarding surgical modalities used for adenotonsillectomy, and determined anxiety levels related to the adenotonsillectomy procedure. METHODS: A 10-question survey created by the authors was administered to 413 ENT specialists attending the 4th Congress of Otorhinolaryngology Head and Neck Surgery, held in October 2017 in Barcelona, Spain. RESULTS: Cold knife dissection was the preferred surgical modality for both adenoidectomy and tonsillectomy. Most participants reported encountering one to five patients with post-tonsillectomy bleeding throughout their entire career. The mean anxiety levels during surgery and the 10-day post-operative period were 3.39 ± 2.14 and 4.18 ± 2.63, respectively (p < 0.05). There was a significant negative correlation between anxiety level and surgeon's experience (p < 0.05). CONCLUSION: Cold dissection is still the preferred surgical modality for adenotonsillectomy, while both suture ligation and electrocautery are used for haemostasis. Paediatric adenotonsillectomy is likely to generate anxiety in ENT surgeons, and the possibility of secondary post-tonsillectomy bleeding increases the anxiety levels of surgeons in the post-operative period.

Radiofrequency dissection versus 'knot tying' in conventional total thyroidectomy.

OBJECTIVE: To evaluate the safety and effectiveness of radiofrequency dissection in conventional 'open' total thyroidectomy. METHODS: Thirty-nine patients scheduled for conventional total thyroidectomy were included in a prospective randomised study. Patients were randomly assigned to one of two groups: a radiofrequency dissection method was used in one group, and a knot tying technique was used in the other. RESULTS: Significantly fewer surgical instruments and materials were required for the radiofrequency dissection group than the knot tying group (p < 0.01). There were no significant differences between the two groups in mean operative time, blood loss, post-operative drainage and pain, recurrent palsy, and hypocalcaemia (p > 0.05). CONCLUSION: Radiofrequency dissection is a safe alternative to the knot tying technique, and enables a significant reduction in the number of surgical instruments required for the operation.

Impedance-controlled radiofrequency vs. cold dissection tonsillectomy.

OBJECTIVE: To compare the efficacy and safety of radiofrequency (RF) and cold dissection (CD) tonsillectomy. STUDY DESIGN: Prospective, double-blind, controlled clinical study. PATIENTS AND METHODS: One hundred and fourteen patients underwent tonsillectomy. The RF and CD techniques were used for the right and left tonsils, respectively; the patients and examining physicians were blinded to this information to avoid bias. We compared operation times, intraoperative bleeding, and postoperative pain associated with the respective techniques. RESULTS: The RF and CD techniques required similar operation times. Intraoperative bleeding was lower after RF dissection than after CD. The severity of pain did not differ between the two techniques on postoperative day 1, but was significantly lower for the CD technique than the RF technique on postoperative days 5 and 10. CONCLUSION: The RF technique is superior to CD regarding intraoperative bleeding, but not regarding operation time or time to return to a painless dietary regimen.