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Comparison of Cob.ation Tonsillectomy vs Dissection Tonsillectomy

International Journal of Otolaryngology and Head & Neck Surgery 2019年第1期8卷 49-60页

作者： Vivek Sasindran Nidhi Mathew A. K. Shab.a b. harikrishan Pushpagiri Institute of Medical Science and Research Centre Thiruvalla India

b.ckground: Tonsillectomy is one of the most commonly performed surgical operations in the recent years. It is mainly done for chronic tonsillitis and ob.tructive symptoms. Aims & Ob.ectives: To compare the operating time, intraoperative b.ood loss, postoperative pain, time needed to return to normal diet and activity in cob.ation and dissection tonsillectomy. Methods: This is a prospective study done at Pushpagiri Medical College for a period of one and a half years from March 2015 to Septemb.r 2016. Out of the 50 patients, 25 underwent cob.ation tonsillectomy and 25 underwent conventional dissection tonsillectomy. Method of surgery depended on patients’ or parents’ choice. Intra operative measures like operating time, b.ood loss and post-operative morb.dity were measured and compared. Results: In this study, there was significant difference in intraoperative time in cob.ation tonsillectomy compared to cold dissection tonsillectomy (mean operative time—13.4 minutes for cob.ation and 20.4 minutes for cold dissection with p value less than 0.05). Intraoperative b.ood loss was significantly less for cob.ation (18.9 ml) compared to traditional (43.0 ml) with p value 0.002. Average postoperative pain score 6 hours after operation was 7.6 for cob.ation and 8.5 for cold dissection with a significant p value of 0.002. Average time taken to return to normal diet among cob.ation was 6.4 days and dissection was 7.0 days with p value of 0.078 which is not statistically significant. However, average time taken to return to normal activity among cob.ation was 6.3 days and dissection was 7.1 days with a significant p value of 0.024. Conclusion: Cob.ation tonsillectomy significantly reduces the operation time, intraoperative b.ood loss, immediate postoperative pain, and patient returns early to regular routine, b.t with a higher cost.

关键词： Tonsillectomy Cold Dissection Cob.ation Operation Time Postoperative Pain

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Hearing Outcome in Stapes Surgery Using Various b.omaterial Prostheses

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International Journal of Otolaryngology and Head & Neck Surgery 2018年第6期7卷 330-343页

作者： Sasindran Vivek N. K. Feb.n Mathew Nidhi b. harikrishan Department of Otorhinolaryngology and Head & Neck Surgery Pushpagiri Medical College Tiruvalla India

Aims: To assess the hearing outcome in patients who have undergone stapes surgery using polytetrafluoroethylene (PTFE) and Titanium prosthesis at 1 and 3 months post operatively. Material & Methods: Research design: Prospective study. Setting: ENT department, Pushpagiri Medical College. Study population: All age groups with clinical diagnosis of otosclerosis and air-b.ne gap more than 15 db.irrespective of sex difference. Patients with Meniere’s disease are excluded. Method: A prospective study was conducted for a period of one and a half years from January 2014 to July 2015 to find out the hearing outcome of stapes surgery in patients with otosclerosis using polytetrafluoroethylene (PTFE) and Titanium prostheses, attending our outpatient department. Results: In this study, 84.21% of ears with polytetrafluoroethylene (PTFE) and 81.81% of ears with titanium were ab.e to achieve good results in terms of Air-b.ne gap (Ab.) closure (Ab. Conclusion: Stapes surgery is the surgical procedure of choice for otosclerosis. In our study, a significant hearing improvement was seen in majority of cases. None of the factors considered relevant for the success of stapes surgery like age, sex, type of prosthesis appeared to affect the post-operative hearing significantly. Hence stapes surgery can b. effectively used to improve hearing in otosclerosis.

关键词： Otosclerosis PTFE and Titanium AC Threshold Gain Ab Gap

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