A five-year follow-up observational study of the T-14 paediatric throat disorders outcome measure in tonsillectomy and adenotonsillectomy.

INTRODUCTION: The T-14 questionnaire is a validated outcome measurement tool to assess the value of paediatric tonsillectomy from a parent's perspective. There is a paucity of data regarding the long-term postoperative effects of tonsillectomy on quality of life in the paediatric population. Our previous study assessed T-14 scores up to year 2 postoperatively, with this study extending follow-up to 5 years. MATERIALS AND METHODS: We undertook a prospective uncontrolled observational study examining 54 paediatric patients undergoing tonsillectomy at Portsmouth Hospitals NHS Trust. Parents of children undergoing surgery were invited to complete a T-14 questionnaire preoperatively, as well as at 3 months, 6 months, 1 year, 2 years and now 5 years postoperatively. RESULTS: In total, 44 of 54 patients completed questionnaires preoperatively and at all postoperative time points, with 46 being completed at 5 years. There was a highly significant (P < 0.001) difference between the preoperative scores and all other measured T-14 scores postoperatively. The mean score preoperatively was 33.3 compared with 1.0 at 5 years. CONCLUSIONS: This is the first study to assess long-term quality of life following paediatric tonsillectomy using the T-14 questionnaire. The benefits of tonsillectomy on long-term quality of life further confirms its value within the paediatric population.

A two-year follow-up observational study of the T-14 paediatric throat disorders outcome measure in tonsillectomy and adenotonsillectomy.

INTRODUCTION: The T-14 questionnaire is a validated patient reported outcome measure used to assess the value of paediatric tonsillectomy from the patient's perspective. There are currently limited data revealing the long-term postoperative effects of tonsillectomy on quality of life in the paediatric population. A previously published study was therefore extended to provide additional data at 12 and 24 months following surgery. METHODS: A prospective uncontrolled observational study was undertaken examining 54 paediatric patients undergoing tonsillectomy at Portsmouth Hospitals NHS Trust. Parents of children having surgery were invited to complete a T-14 questionnaire preoperatively as well as at 3, 6 (previously published), 12 and 24 months postoperatively. RESULTS: The questionnaire was completed for 50 of the 54 patients preoperatively as well as at 3, 6 and 12 months postoperatively, with 44 being completed at 24 months. The mean difference between the preoperative T-14 scores and the scores at 3, 6, 12 and 24 months following surgery were highly statistically significant (p<0.001). CONCLUSIONS: This is the first study published in the literature to assess the T-14 questionnaire at 12 and 24 months following paediatric tonsillectomy, providing evidence of the ongoing benefit of patient reported outcome measures. This further confirms the value of tonsillectomy in the paediatric population and demonstrates its ongoing positive effects on quality of life.

Patient information leaflet on mastoid surgery risks: assessment of readability and patient understanding.

INTRODUCTION: It is important that patients have a good understanding of surgery-related risks, particularly for mastoid surgery, which exposes patients to the risk of very serious complications, despite addressing conditions which often have only minor symptoms. MATERIALS AND METHODS: A patient information leaflet describing the risks of mastoid surgery was prepared. However, the Hospital Patient Advice and Liaison Services team thought it was too long and complicated. It was introduced unchanged. Fifty-four consecutive mastoidectomy patients were given a questionnaire asking for their opinion of the leaflet. The leaflet was also assessed with readability formulae and the Ensuring Quality Information for Patients tool. RESULTS AND ANALYSIS: Ninety-eight per cent of respondents thought the leaflet's writing style was easy to understand. The majority (96 per cent) thought the length was 'just right'. The 7 readability formulae used established readability at a grade 9 level (i.e. appropriate for a reading age of 13-15 years). The Ensuring Quality Information for Patients score was 87.5 per cent. DISCUSSION: Despite the drive to simplify patient information leaflets, quite detailed information is sometimes required. A style which is too simple may be perceived as patronising and may encourage patients to underestimate potential risks. It is important to ask patients their opinion.

The sodium pertechnetate Tc 99m scan: an aid in the evaluation of gastrointestinal bleeding.

Twenty pediatric patients presenting primarily with unexplained gastrointestinal bleeding were evaluated with sodium pertechnetate Tc 99m imaging. Three patients had normal barium enemas and scans consistent with Meckel's diverticulum. These three patients and three additional patients with normal scans underwent surgical exploration. Meckel's diverticula containing gastric mucosa were found in all three patients with positive scans. No diverticula were found in the three patients with normal scans. Four other patients had scans that were considered abnormal but not felt to represent Meckel's diverticula. In one of these patients a radiographic gastrointestinent, a nonspecific terminal ilial ulcer without gastric mucosa was found at surgery. The two other patients had normal radiographic gastrointestinal studies and no further evaluation was carried out. The etiology of gastrointestinal bleeding in pediatric patients is frequently unexplained even after thorough evaluation including celiotomy. The sodium pertechnetate Tc 99m scan is a safe, simple, non-invasive procedure that can demonstrate Meckel's diverticula with greater certainty than the barium enema and can suggest suspicious areas that can then be evaluated by more definitive procedures.