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Liu H, Zhao JJ, Yang H. A case report of otoendoscopic radiofrequency resection of squamous cell carcinoma of the external auditory canal. EAR, NOSE & THROAT JOURNAL 2024; 103:NP259-NP264. [PMID: 35815669 DOI: 10.1177/01455613221112357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Squamous cell carcinoma is the most common pathological type of external and middle ear malignancy. Squamous cell carcinoma of the external auditory canal and middle ear is closely associated with long-term chronic inflammatory irritation. The patient was admitted with a major complaint of a "stuffy feeling in the left ear for more than three months." The results of the otoendoscopic examination were as follows: The left external auditory canal was filled with a granuloma-shaped mass with an unsmooth surface that showed obvious oozing of blood. The tympanic membrane was not visible. After the completion of the relevant examinations, radiofrequency resection of the external auditory canal mass was performed under otoendoscopy and the wound healed well with postoperative dressing changes. Pathological results revealed a well-differentiated keratinizing cutaneous squamous cell carcinoma and there was no recurrence throughout the next 5 years after the operation. Proper preoperative evaluation and the correct selection of surgical approaches can be of great importance. The primary complication of ear squamous cell carcinoma was local recurrence with a low incidence of metastasis. Early and complete resection was determined to be the optimal course of treatment.
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Affiliation(s)
- Hong Liu
- Department of Otolaryngology, The Fifth People's Hospital of Ningxia Autonomous Region, Shizuishan, China
| | - Jing-Jing Zhao
- Department of Otolaryngology, The Fifth People's Hospital of Ningxia Autonomous Region, Shizuishan, China
| | - Hua Yang
- Department of Otolaryngology, The Fifth People's Hospital of Ningxia Autonomous Region, Shizuishan, China
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Wang J, Dang PH, Chang HH, Wang ZH. Subtotal intracapsular tonsillectomy may be the first choice for tonsillectomy in children. J Int Med Res 2021; 49:3000605211011930. [PMID: 33947259 PMCID: PMC8113930 DOI: 10.1177/03000605211011930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective To investigate the effect and prognosis of subtotal intracapsular
tonsillectomy. Methods All children (n=162) with tonsillar hypertrophy and chronic tonsillitis were
randomly divided into two groups: tonsillectomy (n=75) and subtotal
intracapsular tonsillectomy (n=87). Tonsillectomy: the tonsillar tissue was
completely removed along with the tonsillar capsule. Subtotal intracapsular
tonsillectomy: 80% to 90% of the tonsils and the complete epithelium of the
tonsillar crypts were removed without damaging the tonsillar capsule. The
Face, Legs, Activity, Cry, and Consolability (FLACC) and parents’
postoperative pain measure (PPPM) scales were used to evaluate postoperative
pain, and the obstructive sleep apnea (OSA)-18 questionnaire was used to
assess the children’s postoperative quality of life. The patients were
followed-up for 2 years. Results 1. The FLACC and PPPM scales indicated that the children’s postoperative pain
after subtotal intracapsular tonsillectomy was significantly less than that
of children undergoing tonsillectomy. 2. The OSA-18 scale scores indicated
that subtotal intracapsular tonsillectomy significantly improved the
children’s quality of life. 3. Two years after subtotal intracapsular
tonsillectomy, no patients required reoperation. Conclusion Subtotal intracapsular tonsillectomy may be the first choice for tonsillar
hypertrophy and chronic tonsillitis patients.
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Affiliation(s)
- Jie Wang
- Department of Otolaryngology-Head and Neck Surgery, The Affiliated Children's Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710003, China
| | - Pan-Hong Dang
- Department of Otolaryngology-Head and Neck Surgery, The Affiliated Children's Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710003, China
| | - Huan-Huan Chang
- Department of Otolaryngology-Head and Neck Surgery, The Affiliated Children's Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710003, China
| | - Zi-Han Wang
- Department of Otolaryngology-Head and Neck Surgery, The Affiliated Children's Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, 710003, China
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Coblation tonsillectomy versus cold steel dissection tonsillectomy: a morphological study. The Journal of Laryngology & Otology 2019; 133:770-774. [DOI: 10.1017/s0022215119001762] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
AbstractObjectiveTo compare the extent of tissue damage produced by conventional cold steel and coblation tonsillectomy.MethodsTwenty patients underwent conventional and 18 underwent coblation tonsillectomy. The removed tonsils were histopathologically evaluated.ResultsAnalgesic use was lower in the coblation group during the early post-operative period. Histological investigation of tonsils removed by the conventional method showed intensive haemorrhage and hyperaemia in the tonsillar capsules, which was not seen in the coblation group. Furthermore, in the coblation group, there was less mast cell degranulation (p = 0.0081) and a smaller amount of skeletal muscle tissue (p = 0.0043) in the tonsillar capsules, indicating less tissue damage.ConclusionCompared to the cold steel technique, coblation tonsillectomy is superior in terms of less early post-operative pain and less damage to surrounding tissues. Significantly lower mast cell degranulation in coblation tonsillectomy may contribute to the reduction of post-operative pain.
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Blake KV, Hossain J, Chafin B, Black A, Schrum S, Josephson G. Postoperative Pain and 14-Day Recovery in Children Undergoing Adenotonsillectomy: Low Thermal Damage Device Versus Electrosurgery. EAR, NOSE & THROAT JOURNAL 2019; 98:E1-E7. [PMID: 30939911 DOI: 10.1177/0145561319838941] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
This was a randomized controlled trial of low thermal damage device versus traditional electrosurgery in children 3 to 17 years old with a clinical diagnosis of sleep disordered breathing, obstructive sleep apnea with adenotonsillar hypertrophy, or recurrent adenotonsillitis. Pain score (Wong-Baker FACES pain scale) was recorded each morning before eating, drinking, or administering pain medication for 14 days postoperatively. Seventy-five children were enrolled. There was no difference in the rate of decrease in pain scores. A significant interaction between rate of pain decrease and number of pain medication doses was present ( P < .0001). Median number of pain medication doses was greater with electrosurgery (36, range: 7-49) versus low thermal device (21, range: 2-124; P = .001). Pain scores reached 0 after a median of 7 days (95% confidence interval [CI], 5.2-8.6) for low thermal device and 9 days (95% CI, 8.0-10.0) for electrosurgery ( P = .67). One child randomized to electrosurgery was withdrawn due to hospitalization for postoperative bleed. In children, low thermal device results in significantly less pain medication used during the postoperative period than electrosurgery.
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Affiliation(s)
- Kathryn V Blake
- 1 Center for Pharmacogenomics and Translational Research, Nemours Children's Specialty Care, Jacksonville, FL, USA.,2 Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - Jobayer Hossain
- 3 Bioinformatics Core Facility, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA
| | - Brett Chafin
- 4 Division of Otolaryngology, Department of Surgery, Nemours Children's Specialty Care, Jacksonville, FL, USA.,5 Department of Otorhinolaryngology, Mayo Medical School, Rochester, MN, USA.,6 Department of Otolaryngology-Head and Neck Surgery, University of South Florida, Tampa, FL, USA
| | - Angela Black
- 4 Division of Otolaryngology, Department of Surgery, Nemours Children's Specialty Care, Jacksonville, FL, USA.,5 Department of Otorhinolaryngology, Mayo Medical School, Rochester, MN, USA
| | - Stefanie Schrum
- 5 Department of Otorhinolaryngology, Mayo Medical School, Rochester, MN, USA.,7 Division of Anesthesiology, Department of Surgery, Nemours Children's Specialty Care, Jacksonville, FL, USA
| | - Gary Josephson
- 4 Division of Otolaryngology, Department of Surgery, Nemours Children's Specialty Care, Jacksonville, FL, USA.,5 Department of Otorhinolaryngology, Mayo Medical School, Rochester, MN, USA.,6 Department of Otolaryngology-Head and Neck Surgery, University of South Florida, Tampa, FL, USA
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Wound healing after tonsillectomy - a review of the literature. The Journal of Laryngology & Otology 2018; 132:764-770. [PMID: 30289104 DOI: 10.1017/s002221511800155x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To summarise the available literature related to wound healing post tonsillectomy, including the stages of healing, experimental models for assessing healing (in animals and humans) and the various factors that affect wound healing. METHODS A search of the English literature was conducted using the Ovid Medline database, with the search terms 'tonsillectomy' or 'tonsil' and 'wound healing'. Thirty-one articles that objectively assessed tonsillectomy wound healing were included for analysis. RESULTS The majority of assessments in humans investigating tonsillectomy wound healing involve serial direct clinical examinations of the oral cavity. Many patient and surgical factors have been shown to affect wound healing after tonsillectomy. There is some research to suggest that the administration of adjunctive treatment in the post-operative period may be beneficial to tonsillectomy wound healing. CONCLUSION Wound healing post tonsillectomy has been poorly researched. Having a better understanding of the process of wound healing would allow surgeons to potentially prevent, anticipate and manage complications from the surgery that arise as part of the healing process.
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Yilmazer R, Yazici ZM, Balta M, Erdim I, Erdur O, Kayhan FT. PlasmaBlade vs. cold dissection tonsillectomy: A prospective, randomized, double-blind, controlled study in adults. EAR, NOSE & THROAT JOURNAL 2018; 96:250-256. [PMID: 28719708 DOI: 10.1177/014556131709600718] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We conducted a prospective, randomized, double-blind, controlled clinical study to compare the efficacy and safety of the PlasmaBlade device and cold dissection for adult tonsillectomy. Our study group was made up of 20 patients-12 men and 8 women, aged 18 to 50 years (mean: 27.1)-who were undergoing a bilateral tonsillectomy. Each patient had one randomly chosen tonsil removed by the PlasmaBlade and the other by cold instrumentation. We compared the duration of surgery, the amount of intraoperative blood loss, the number of sutures required, the status of tonsillar fossa wound healing at 7 and 14 days postoperatively, the amount of postoperative pain, and postoperative complications. We found statistically significant differences in the amount of blood loss and the number of sutures in favor of the PlasmaBlade technique. No significant differences were observed in any of the other outcomes.
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Affiliation(s)
- Rasim Yilmazer
- Department of Otolaryngology, Yeditepe University Hospital, Kulak Burun Bogaz Hastaliklari Anabilim Dali, Icerenkoy Mah. Hastane Sok. No:4 D:1 Atasehir, Istanbul, Turkiye.
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Thottam PJ, Christenson JR, Cohen DS, Metz CM, Saraiya SS, Haupert MS. The utility of common surgical instruments for pediatric adenotonsillectomy. Laryngoscope 2014; 125:475-9. [DOI: 10.1002/lary.24830] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/17/2014] [Accepted: 06/16/2014] [Indexed: 12/31/2022]
Affiliation(s)
- Prasad John Thottam
- Department of Pediatric Otolaryngology; Children's Hospital of Michigan; Detroit Michigan U.S.A
- Department of Otolaryngology; Detroit Medical Center; Detroit Michigan U.S.A
- Michigan State University; East Lansing Michigan U.S.A
| | - Jennifer R. Christenson
- Department of Pediatric Otolaryngology; Children's Hospital of Michigan; Detroit Michigan U.S.A
- Department of Otolaryngology; Detroit Medical Center; Detroit Michigan U.S.A
- Michigan State University; East Lansing Michigan U.S.A
| | | | | | - Sonal S. Saraiya
- Department of Pediatric Otolaryngology; Children's Hospital of Michigan; Detroit Michigan U.S.A
| | - Michael S. Haupert
- Department of Pediatric Otolaryngology; Children's Hospital of Michigan; Detroit Michigan U.S.A
- Department of Otolaryngology; Detroit Medical Center; Detroit Michigan U.S.A
- Michigan State University; East Lansing Michigan U.S.A
- Wayne State University; Detroit Michigan U.S.A
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Abstract
OBJECTIVE To describe the tonsillectomy techniques and management used by practicing otolaryngologists in the United States. STUDY DESIGN Anonymous 18-question postal survey of pediatric and general otolaryngologists on their current tonsillectomy practices. SETTING Tertiary academic medical center. SUBJECTS AND METHODS Current preoperative, perioperative, and postoperative practices in tonsillectomy were queried with multiple-choice and open-ended questions. Pediatric otolaryngologists and general otolaryngologists were compared. RESULTS Eighty percent of respondents perform subcapsular (total tonsillectomy) dissection. Most otolaryngologists trained with either monopolar cautery (52%) or cold steel (42%). The Coblator (ArthroCare ENT, Austin, Texas) is the most common single instrument used for tonsillectomy (27.5%), followed by monopolar cautery (26%), but in combination with other instruments, monopolar cautery was still more common (33.5%) than coblation (28.9%). Coblation was more common among private practice and general otolaryngologists. The majority of those surveyed do not use intraoperative local anesthesia, but most do use intraoperative steroids (67%). Compared with generalists, pediatric otolaryngologists were less likely to use coblation, were less likely to use local anesthetic, managed postoperative pain slightly differently, and were more likely to recommend diet ad libitum after surgery. Otolaryngologists were more likely to admit medically compromised patients postoperatively. CONCLUSIONS Coblation is becoming a more commonly used instrument for tonsillectomy. Pediatric otolaryngologists perform more tonsillectomies than do general otolaryngologists and manage their patients differently.
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Affiliation(s)
- Dhave Setabutr
- Division of Otolaryngology–Head and Neck Surgery, Penn State College of Medicine, Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA.
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