Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery
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To determine whether an increase in the use of bipolar diathermy energy to perform a tonsillectomy is associated with an increase in postoperative pain and haemorrhage. ⋯ Increased use of bipolar diathermy during the performance of a tonsillectomy is associated with a statistically significant increased amount of postoperative pain. The dose-response relationship between diathermy energy and postoperative bleeding is less clear. This suggests that there could be other important factors such as surgical instrument characteristics and degree of tonsillar adherence that have an additional influence and are therefore possible areas for future research.
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Randomized Controlled Trial
A pilot randomized controlled trial of coblation tonsillectomy versus dissection tonsillectomy with bipolar diathermy haemostasis.
To compare postoperative recovery in children between 4 and 12 years undergoing tonsillectomy, using either coblation tonsillectomy or dissection tonsillectomy with bipolar diathermy haemostasis. ⋯ In our pilot study, patients undergoing coblation tonsillectomy reported less pain, quicker return to normal diet, quicker return to normal activity, and less use of analgetics over a 10-day period than patients undergoing dissection tonsillectomy. Our results indicate that the recovery period for coblation tonsillectomy was approximately 2 days shorter and demonstrated less morbidity.
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The petrous apex is a relatively inaccessible region, deeply situated within the skull base. Removal of lesions from this area, traditionally accomplished via lateral approaches, can cause significant morbidity. We undertook an anatomical study to investigate the surgical anatomy of the petrous apex through an endonasal endoscopic approach, which has been sporadically described in the literature, to investigate its feasibility and to characterise clear and consistent surgical landmarks for access. ⋯ Endoscopic approach to the petrous apex is anatomically feasible, and, aided by image navigation, could extend the scope of endonasal surgery to access highly-selected lesions in the middle cranial fossa.