Postoperative outcome of palatine tonsillectomy by tonsil pillar suture with knot-free suture

Acta Oto-Laryngologica, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 5

Published: March 13, 2025

Postoperative haemorrhage following palatine tonsillectomy occurs in 5-14% of cases. Since 2021, our department has used knot suturing with 3-0 Vicryl, and from 2023, continuous the V-Loc™ closure device to reduce suture time. While is reported postoperative bleeding pain, no studies have compared outcomes between different methods. This study retrospectively analysed bleeding, complications 125 patients undergoing tonsillectomy, or without sutures. Patients aged ≥15 years who underwent bilateral October 2019 March 2024 were grouped into no-suture, knot-suture, knot-free-suture categories. Data on operative time, dissection, using Mann-Whitney U test for variables chi-square nominal variables. Knot-free sutures had shortest time (53 ± 16 min) (62 19 (94 22 min). Pain decreased over across all groups. Bleeding rates similar, though knot-free required frequent removal (76%). Knot a significantly lower dissection rate (<0.001). improve surgical efficiency but may require additional interventions, representing cost-effective alternative high-energy devices.

Language: Английский

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COMPARATIVE STUDY OF VARIOUS TECHNIQUES TONSILLECTOMY

BULLETIN OF STOMATOLOGY AND MAXILLOFACIAL SURGERY, Journal Year: 2024, Volume and Issue: unknown, P. 92 - 100

Published: March 20, 2024

Objective: The purpose of the study was to compare intraoperative factors and postoperative outcomes between image-guided acute dissection technique endoscopic technique. Material methods: conducted in 153 patients (81 men 72 women, average age 26.4 years) who underwent tonsillectomy (2018-2023). Patients were randomly assigned 2 group 52% percent patients(group1) with under visual control, 48% (group 2) visualization using a 4.0 mm 0° endoscope (Karl Storz, Tuttlingen, Germany). Indications for hypertrophy tonsils 82 patients, recurrent tonsillitis 23 focal infection 48 patients. Tonsillectomy performed general anesthesia an oral speculum specifically designed tonsillectomy. All assessed compared pain, bleeding, recurrence, or tonsil tissue growth immediate late period. removed adenoid is sent histology. Clinical diagnosis: Chronic decompensated tonsillitis. Pathohistological Within limits examined material, histological picture corresponds chronic tonsillitis, nasopharyngeal tissue. Results: There no serious intra- complications. Bleeding points identified 47 (31 group1 16 2). source bleeding observed central deep part adenoids - 18 lateral parts on both sides 13. Remnants found (17 1 6 bipolar diathermy image guidance. operation time shorter than traditional procedures. Conclusions: visibility provided by techniques improves ease precision surgery. significance determines need further testing already proposed means methods.

Language: Английский

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Endoscopic Powered Intracapsular Tonsillectomy and Adenoidectomy in Pediatric Obstructive Sleep Apnea With High-Risk Comorbid Disease Conditions: A Case Series

Cureus, Journal Year: 2024, Volume and Issue: unknown

Published: June 3, 2024

Objective: Pediatric obstructive sleep apnea (OSA) caused by adenoids or an enlarged palatine tonsil has a negative impact on physical and mental growth. Surgical removal of the tissue is effective but entails life-threatening risk postoperative bleeding, which up to 30 times higher in chronic pediatric disease cases. However, endoscopes resection devices provide safe, reliable surgical methods. Here, we report efficacy safety endoscopic powered intracapsular tonsillectomy adenoidectomy (PITA) for OSA patients with high-risk comorbidities. Methods: This retrospective case series included who underwent PITA at single tertiary medical center between April 2017 May 2023. Ten (three males seven females; mean age 6.4 years, range 2-12 years) were included; all met Japanese criteria complex conditions. Results: The average operative time was 61 min; microdebrider used eight cases coblator two Although there no one experienced regrowth. Conclusions: Our data show that approach could reduce severe bleeding relieve sleeping conditions OSA.

Language: Английский

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Modification of McGill Oximetry Score in Improving the Diagnostic Capability of Paediatric OSA

Clinical Otolaryngology, Journal Year: 2024, Volume and Issue: 49(6), P. 801 - 809

Published: Aug. 22, 2024

This study aimed to devise a modified oximetry scoring system and calculate its diagnostic accuracy in detecting paediatric obstructive sleep apnoea syndrome (OSAS).

Language: Английский

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Tonsillectomy Versus Tonsillotomy in Pediatric Sleep‐Disordered Breathing: A Systematic Review and Multi‐subgroup Meta‐analysis

The Laryngoscope, Journal Year: 2024, Volume and Issue: 135(2), P. 529 - 539

Published: Sept. 19, 2024

Objectives To evaluate the potential of tonsillotomy (TT) as an alternative to tonsillectomy (TE) for treating children with obstructive sleep‐disordered breathing (oSDB). Data Sources Two independent reviewers searched PubMed, Cochrane Library, Embase, and additional sources identify controlled studies comparing TT versus TE in pediatric patients oSDB. Review Methods We evaluated post‐surgery symptom relief, short‐ long‐term postoperative benefits children. Fixed‐effect meta‐analysis, sensitivity analysis, subgroup analysis were conducted. Results In our 32 9,430 children, revealed group had a similar therapeutic effect on improvement OSA‐18 (MD = 5.20, 95% CI: −32.67 43.07, p 0.96). terms short‐term outcome, days return normal diet shorter than that −2.49, 95%CI: −3.57 −1.28; < 0.001), less analgesics use −3.19, CI −3.44 −2.93, lower secondary bleeding (RR 0.33; 0.23 0.47; 0.001). But risk reoperation (OR 8.28; 2.66 12.64; oSDB recurrence 2.16; 1.20–3.86; 0.01), infection 1.82; 1.34 2.47; 0.001) was significantly higher group. Conclusions Tonsillotomy reduces pain bleeding, speeding up recovery oSDB, improving their quality life. Yet, recurrent infections from residual tonsil tissue, which may require reoperation, calls careful evaluation procedure's gains against its risks. Level Evidence NA Laryngoscope , 135:529–539, 2025

Language: Английский

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Dose‐Related Effects and Bleeding Risk of Ketorolac in Pediatric Tonsillectomy

Otolaryngology, Journal Year: 2024, Volume and Issue: unknown

Published: Nov. 16, 2024

Abstract Objective To investigate the safety and effectiveness of dose‐related ketorolac administration in children who underwent tonsillectomy. Data Sources sourced from PubMed, SCOPUS, Embase, Web Science, Cochrane databases, encompassing literature their inception until June 2024. Review Methods The perioperative comparison with a control group was included this analysis. outcomes assessed were postoperative pain levels; utilization patterns analgesic medication terms quantity frequency; incidence rates nausea, vomiting, bleeding. Results Eighteen studies 11,729 patients that investigated. treatment bleeding had higher primary (significant operative control) compared to group. However, did not affect risk secondary Subgroup analysis showed 0.9 1 mg/kg significantly increases (odds ratio [OR] = 4.0700 [1.6352; 10.1302]; I 2 0.0%) significant (OR 2.3200 [1.1322; 4.7538]; 0.0%). On other hand, 0.5 show any influence on control. (both 0.9‐1 mg/kg) led decrease (2‐24 hours), vomiting Conclusion Low‐dose (0.5 could reduce surgical hemostasis high‐dose (0.9‐1.0 mg/kg). In addition, low‐dose provide sufficient nausea vomiting.

Language: Английский

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Improvement of Surgical View and Working Space at the Lower Pole by Three-Dimensional Exoscope-Assisted Coblation Tonsillectomy: A Case Series

Medicina, Journal Year: 2023, Volume and Issue: 59(2), P. 259 - 259

Published: Jan. 29, 2023

Advantages of hot devices for tonsillectomy, represented by coblation, have been highlighted in recent years. During technique tonsillectomy it is important to identify and coagulate the vessels tonsillar capsule, especially at lower pole tonsil. Hot under microscope or endoscope has therefore recommended achieve accurate identification microstructure surgical field. We applied ORBEYE, a three-dimensional exoscope system, coblation tonsillectomy. using ORBEYE include high definition magnification images, flexibility camera position angle. This means there an improved view working space, particularly during performance Here, we demonstrate that can be effective instrument

Language: Английский

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Intracapsular tonsillectomy: setting a new standard

Current Opinion in Otolaryngology & Head & Neck Surgery, Journal Year: 2023, Volume and Issue: 31(6), P. 403 - 406

Published: Oct. 9, 2023

Purpose of review Tonsillectomy is one the most common surgical procedures performed on children in United States. Since 2002, intracapsular technique has been studied as a safer and less painful alternative to total tonsillectomy. Concerns have raised, however, potential for regrowth long-term outcomes regarding this technique. Recent findings Studies support use tonsillectomy management sleep disordered breathing, including syndromic populations, well tonsillitis. In addition, safety profiles continue be improved over that extracapsular dissection. While incidence ranges depending study duration follow up, it remains acceptably low. The consistent independent risk factor revision surgery includes young age. Summary more thoroughly historically, an important absence literature definitive superiority With continued high-level studies, additional examination outcomes, we should see greater acceptance standard practice vulnerable population.

Language: Английский

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Adenotonsillectomy in Arnold Chiari Malformation: Navigating Surgical Complexities

Indian Journal of Otolaryngology and Head & Neck Surgery, Journal Year: 2023, Volume and Issue: 75(3), P. 2621 - 2625

Published: May 10, 2023

Language: Английский

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