Radiophonosurgery of benign superficial vocal fold lesions

2005 ◽  
Vol 119 (12) ◽  
pp. 961-966 ◽  
Author(s):  
Sameh M Ragab ◽  
Mohamed N Elsheikh ◽  
Magdy E Saafan ◽  
Sayed G Elsherief
Keyword(s):  
Vocal Fold ◽  
Acoustic Analysis ◽  
Controlled Trial ◽  
Perceptual Evaluation ◽  
Prospective Randomized Controlled Trial ◽  
Significant Difference ◽  
Cold Knife ◽  
Vocal Nodules ◽  
Perceptual Assessment ◽  
Operative Recovery

Objective: To conduct a prospective randomized controlled trial describing and investigating the efficacy and safety of radiosurgical excision of benign superficial vocal fold lesions.Materials and methods: Fifty patients with benign superficial vocal fold lesions (20 vocal nodules, 27 vocal polyps and three Reinke’s oedema) who failed conservative therapy were included in the study. They were equally randomized into cold knife or radiosurgical excision. Clinical and voice assessments were done pre-operatively and after surgery. Voice analysis included a subjective visual analogue scale (VAS) and a perceptual assessment with a simplified version of the GRBAS scale (GRB) consisting of G (grade), R (roughness), and B (breathiness). Acoustic voice evaluation included jitter and shimmer. Post-operative voice therapy was provided for all patients. Complications, smoothness of post-operative recovery, and administration of analgesia were reported.Results: Both groups experienced significant improvement in VAS, perceptual evaluation and acoustic analysis after surgery, with no evidence of significant differences between the cold knife and radiofrequency groups. The radiofrequency group showed a decrease of 17 per cent in the mean operative time when compared with the cold knife group, but this was not statistically significant. No evidence of a significant difference was noticed in the smoothness of post-operative recovery, administration of analgesia and complication rate.Conclusion: Radiophonosurgery opens a new therapeutic approach for patients with benign superficial vocal fold lesions. It combines the advantages of both cold knife and laser phonosurgery, being easy, safe, precise and effective, and having excellent tactile and haemostatic properties.

scholarly journals Effect of Cooling Irrigating Saline in Tongue Base Ablation in Obstructive Sleep Apnea

OTO Open ◽  
2021 ◽  
Vol 5 (1) ◽  
pp. 2473974X2198959
Author(s):  
Ahmed Yassin Bahgat
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Controlled Trial ◽  
Tongue Base ◽  
Control Group ◽  
University Hospitals ◽  
Energy Field ◽  
Obstructive Sleep ◽  
Prospective Randomized Controlled Trial ◽  
Significant Difference

Objective Plasma is formed by creating a high-density energy field within an electrically conductive fluid such as saline. Sometimes ablated bits of tissue get stuck between the electrodes of the wand, obstructing the suction channel. The purpose of this study is to investigate the effect of cooling the irrigating saline during ablation of the hypertrophied tongue base in patients with obstructive sleep apnea. Study Design Prospective randomized controlled trial. Setting An otorhinolaryngology department in Main University hospitals. Methods Sixty adult patients with obstructive sleep apnea and tongue base hypertrophy underwent tongue base ablation surgery. Patients were randomly divided into 2 groups of 30 patients each: cooled saline and room temperature saline. The Coblation wand used was the EVac 70 Xtra HP (Smith & Nephew). Results In this study, a significant difference in operative time (mean ± SD) was seen between groups: 21.2 ± 5.5 minutes in the cold group and 47 ± 9.5 minutes in the control group ( P = .001). The wands in the cold group did not obstruct, while all the wands in the control group were obstructed by tissue clogs with variable degrees, hence wasting more time to clean the wands’ tips. Conclusion Cooling the irrigating saline overcame the problem of wand clogs, and the wand tip did not occlude at all during the procedures, thus saving time lost in wand cleaning and demonstrating a faster and safer surgical procedure. Further studies are needed to identify the hemostatic effect of the cooled saline over the regular one.

scholarly journals Open release versus radiofrequency microtenotomy in the treatment of lateral epicondylitis: a prospective randomized controlled trial

2017 ◽  
Vol 10 (1) ◽  
pp. 45-51 ◽  
Author(s):  
Katharine Hamlin ◽  
Christopher Munro ◽  
Scott L. Barker ◽  
Sean McKenna ◽  
Kapil Kumar
Keyword(s):  
Randomized Controlled Trial ◽  
Grip Strength ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Controlled Trial ◽  
Lateral Epicondylitis ◽  
Open Release ◽  
Randomized Controlled ◽  
Prospective Randomized Controlled Trial ◽  
Significant Difference

Background Optimal surgical treatment of lateral epicondylitis remains uncertain. Recently, radiofrequency microtenotomy (RFMT) has been proposed as a suitable treatment. We compared RFMT with standard open release (OR) in this prospective randomized controlled trial. Methods In total, 41 patients with symptoms for at least 6 months were randomized into two groups: 23 patients had RFMT and 18 had OR. Two patients from RFMT withdrew. Each patient underwent Numerical Rating Scale (NRS) pain score, grip strength and Disabilities of the Arm, Shoulder and Hand (DASH) scores pre-operatively and at 6 weeks. Pain and DASH scores were repeated at 6 months and 12 months. Results NRS pain scores improved by 4.8 points for RFMT and by 3.9 points for OR. There was a significant improvement in both groups from pre-operative scores, although there was no statistically significant difference between the groups at 1 year. Grip strength improved by 31% in the RFMT group compared to 38% in OR. There was no significant difference between the initial and 6 weeks scores or between treatments. At 1 year, DASH was 39.8 points for RFMT and 24.4 points for OR. There was a significant improvement in both groups from pre-operative scores, although there was no statistically significant difference between the groups at 1 year. Conclusions Both groups showed significant improvements and similar benefit to the patient. The results of the present study do not show any benefit of RFMT over the standard OR. As a result of the extra expense of RFMT, we therefore recommend that OR is offered as the standard surgical management.

scholarly journals Prospective randomized controlled trial comparing the functional outcome of olecranon osteotomy versus triceps tongue elevation for surgical exposure of distal humerus in adults

2018 ◽  
Vol 7 (4) ◽  
pp. 134-139
Author(s):  
Asish Rajak ◽  
Rajiv Maharjan ◽  
Bikram Prasad Shrestha ◽  
Pashupati Chaudhary ◽  
Rosan PS Kalawar
Keyword(s):  
Functional Outcome ◽  
Controlled Trial ◽  
Distal Humerus ◽  
Mature Adult ◽  
Demographic Profiles ◽  
Randomized Controlled ◽  
Prospective Randomized Controlled Trial ◽  
Significant Difference ◽  
Randomized Control

Background: Fractures of the distal end of the humerus are difficult to treat. The goal of treatment is to achieve a stable, painless elbow with early adequate range of motion. They are operated mainly by posterior approach among which olecranon osteotomy (bony component violation) and triceps tongue elevation (soft tissue component breach) were used in this study. Objectives: The aim of this study was to compare olecranon osteotomy and triceps tongue elevation in terms of functional outcome (Mayo elbow performance index), rates of complications and others. Methodology: A randomized control trial was conducted including 39 eligible adults (20 in triceps tongue elevation and 19 in olecranon osteotomy group) presenting to B.P. Koirala Institute of Health Sciences during the study period of 12 months duration. All skeletally mature adult patients with isolated traumatic closed intra-articular or distal end fracture of humerus without distal neurovascular deficit were included. Patients with polytrauma, refractures, compartment syndrome and patient not giving consent were excluded from the study. They were operated and followed up at 2, 6, 12 and 24 weeks. Results: The demographic profiles of the two groups were comparable. There was significant difference between the intraoperative time between the two groups (p=0.009). At final follow up, there were no significant differences in functional outcome and complications. Conclusion: The approaches are comparable in terms of union, post-operative function and complications. There was increased intraoperative time in the olecranon osteotomy approach suggesting that patients who cannot tolerate longer intraoperative time may benefit from triceps tongue elevation approach. 

Prospective, Randomized, Controlled Trial of a Hemostatic Sealant in Children Undergoing Adenotonsillectomy

2007 ◽  
Vol 137 (3) ◽  
pp. 454-458 ◽  
Author(s):  
Stephen H. Jo ◽  
Ronald A. Mathiasen ◽  
Deepak Gurushanthaiah
Keyword(s):  
Randomized Controlled Trial ◽  
Blood Loss ◽  
Postoperative Morbidity ◽  
Controlled Trial ◽  
Safety And Efficacy ◽  
Randomized Controlled ◽  
Pain Medications ◽  
Prospective Randomized Controlled Trial ◽  
Cold Knife ◽  
To Receive

OBJECTIVES: To evaluate the efficacy of Floseal as a hemostatic sealant compared to traditional electrocautery hemostasis after cold knife adenotonsillectomy. STUDY DESIGN: Prospective, randomized, controlled trial of 68 consecutive patients undergoing cold steel adenotonsillectomy. Patients were randomized to receive either Floseal (FS) or electrocautery (EC) for hemostasis. RESULTS: FS patients had shorter operative times than EC patients (16 min vs 31.2 min, P < 0.0001) and less blood loss (49.2 mL vs 70.8 mL, P < 0.05). Four EC patients were crossed over to Floseal when adequate hemostasis could not be achieved in the adenoid bed. No Floseal patients were crossed over. FS patients had significantly less pain on postoperative days two through 11 ( P < 0.05) and less use of narcotic pain medications over the first 10 postoperative days ( P < 0.05). FS patients also had a faster return to regular diet (5.5 days vs 7.9 days, P < 0.01) and activity (5.3 days vs 7.8 days, P < 0.01) as compared to the EC patients. There were no significant complications in either group. CONCLUSIONS: Floseal is safe and efficacious, and decreases postoperative morbidity as compared to electrocautery hemostasis after cold steel adenotonsillectomy. SIGNIFICANCE: This study demonstrates the safety and efficacy of Floseal as a hemostatic method in children undergoing adenotonsillectomy.

scholarly journals One day versus three days’ antibiotic prophylaxis in joint arthroplasty. A prospective randomized controlled trial

2021 ◽  
Vol 0 ◽  
pp. 1-5
Author(s):  
Mahmoud Elsaqa ◽  
Mahmoud A. Karim ◽  
Walid Ebeid ◽  
Mohamed Youness
Keyword(s):  
Randomized Controlled Trial ◽  
Antibiotic Prophylaxis ◽  
Antimicrobial Prophylaxis ◽  
Controlled Trial ◽  
Joint Arthroplasty ◽  
University Hospitals ◽  
Randomized Controlled ◽  
Prospective Randomized Controlled Trial ◽  
Significant Difference

Objectives: The objectives of the study was to compare the effectiveness of 1 day versus 3 days post-operative antibiotic prophylaxis in decreasing surgical site infection (SSI) rate after arthroplasty surgery. Methods: A prospective, randomized controlled trial was conducted over 1 year, in Cairo University Hospitals. The study included adult patients, who were scheduled for arthroplasty. Sixty patients were divided into two groups, 30 patients in each. The first group of patients received cefazolin for 1 day postoperatively (1-day group) and the other group for 3 days postoperatively (3-days group). Patients were randomized using the sealed opaque envelope method. Results: There were 32 females and 28 males. The mean patient age was 52 years (range 20–85 years). Wound infection developed in four cases (one case from the 1-day group and three cases from the 3-days group). All infections occurred within the early post-operative period, and completely resolved after proper management. Correlating the SSI to the type of surgery, operative time, the associated medical co-morbidities, and the duration of antimicrobial prophylaxis was not statistically significant. Conclusion: This study suggests that there is no significant difference in the prevalence of SSI between 1 day and 3 days of antimicrobial prophylaxis after primary joint arthroplasty within the average post-operative follow-up period of 3 months.

scholarly journals Ultrasound navigation during retrobulbar blockade in children with retinoblastoma and enucleation of the eyeball

2021 ◽  
Vol 15 (2) ◽  
pp. 127-136
Author(s):  
Ekaterina I. Belousova ◽  
Nune V. Matinyan ◽  
Anastasia A. Tsintsadze ◽  
Leonid A. Martynov ◽  
Dmitry A. Kuznetsov ◽  
...  
Keyword(s):  
Postoperative Period ◽  
Ultrasound Guidance ◽  
Controlled Trial ◽  
Postoperative Nausea And Vomiting ◽  
Average Dose ◽  
Randomized Controlled ◽  
Retrobulbar Block ◽  
Prospective Randomized Controlled Trial ◽  
Significant Difference ◽  
Ultrasound Group

BACKGROUND: The retrobulbar block in children is used to enucleate analgesia in the intra- and postoperative period and prevent oculocardiac reflex (OCD), postoperative nausea, and vomiting. However, when the block is performed blindly, it results in serious complications. AIM: This study aimed to evaluate the efficacy and safety of a retrobulbar block performed under ultrasound guidance compared with a retrobulbar block performed blindly during enucleation of the eyeball in children with retinoblastoma. MATERIALS AND METHODS: A prospective randomized controlled trial was performed. The study included 40 patients who met the inclusion criteria. The patients were divided into two groups: 20 patients who underwent ultrasound-guided retrobulbar blockade (RBВ + ultrasound) and 20 patients who underwent blindly retrobulbar blockade (RBВ). RESULTS: There was an insignificant decrease in intraoperative opioid requirements in the RBB + ultrasound group, where the average dose of fentanyl was 41.4 g/kg, and in the RBB group, 4.70.8 g/kg (p 0.05). The time before the administration of the first dose of analgesic in the postoperative period was 4.70.8 h in the RBB group and 11.73.3 h in the RBB + ultrasound group (p 0.05). VAS and CHIPPS scores obtained 6 h after the end of surgery in the RBB + ultrasound and RBB groups were 1.8 (1.2; 2) and 2.5 (3.8; 4.5) points (p 0.05), respectively. CONCLUSION: There was no statistically significant difference between the time of the retrobulbar blockade under ultrasound guidance and the retrobulbar regional block performed blindly. Retrobulbar blockade performed under ultrasound guidance provides a decrease in intraoperative opioid requirements, stable intraoperative hemodynamics, and longer postoperative analgesia.

scholarly journals New improvements in increasing trends of caesarean section: to compare the effectiveness of two techniques Misgav Ladach with Joel Cohen incision versus Munro Kerr with pfannenstiel incision for caesarean section

2019 ◽  
Vol 8 (7) ◽  
pp. 2799 ◽  
Author(s):  
Kanchan Sharma ◽  
Ankita Mani
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Controlled Trial ◽  
P Value ◽  
Postoperative Fever ◽  
Pfannenstiel Incision ◽  
Global Rate ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Operative Recovery

Background: Caesarean section (C-section) is the most common surgery among women worldwide, and the global rate of this surgical procedure has been continuously rising. Hence, it is significantly crucial to develop and apply highly effective and safe caesarean section techniques. In this study, we aimed at assessing the safety and effectiveness of the Joel-Cohen-based Misgav Ladach technique and comparing the results with the transverse Pfannenstiel incision (Munro Kerr) for C-section.Methods: It was a prospective randomised controlled trial conducted on 100 women undergoing caesarean section at Patna Medical College and hospital in 2017. Patients were randomly allocated in 2 groups  and intra operative  and postoperative findings (blood loss, duration of surgery, post op fever, wound complication, APGAR scores etc. were calculated.Results: The duration of surgery was significantly low in Misgav Ladach technique (19.9 minutes vs. 29.54 minutes p value <0.001) Misgav technique was found economically better method as only 1 suture was used in 43 patients (p value<0.001). Post operative recovery (ambulation and bowel transit time) was found much early in Misgav Ladach vs. Munro Kerr (p value <0.001).Post operative use of analgesics was significantly less in Misgav technique (p value <0.0001). However no significant difference was observed in incidence of postoperative fever, blood loss and mean APGAR scoring of neonates.Conclusions: From this study it can be concluded that Misgav ladach method of caesarean section is associated with better short time post operative outcomes, especially resulting in reduction of pain and postoperative hospital stay.

scholarly journals Voice Quality After Radiotherapy and Cordectomy in Early-Stage Glottic Carcinomas

2019 ◽  
pp. 014556131987690 ◽  
Author(s):  
Dursun Mehmet Mehel ◽  
Abdulkadir Özgür ◽  
Nilgün Şahin ◽  
Aslı Aybüke Vural ◽  
Tuğba Yemiş ◽  
...  
Keyword(s):  
Early Stage ◽  
Voice Quality ◽  
Assessment Scale ◽  
Glottic Carcinoma ◽  
Upper Respiratory Tract ◽  
Perceptual Evaluation ◽  
Significant Difference ◽  
Functional Scores ◽  
Choice Of Treatment ◽  
Perceptual Assessment

Laryngeal carcinomas are the most common upper respiratory tract cancers and most commonly involve the glottic region. The aim of this study is to evaluate the voice quality after radiotherapy (RT) and microsurgical cordectomy (MC) treatments using Voice Handicap Index (VHI) and Grade, Roughness, Breathiness, Astenicity, and Strain (GRBAS) perceptual evaluation scale in patients with early-stage glottic carcinoma. A total of 37 patients with early-stage glottic carcinomas, 19 patients had RT and 18 patients with MC, were included in our study. The patients were evaluated in terms of their sound quality by using VHI-10 and GRBAS perceptual assessment scale 3 months after the treatment was completed. Although the findings were better in favor of RT according to GRBAS perceptual assessment scale of patients who received RT (n = 19) and MC (n = 18), no statistically significant difference was found between the 2 groups ( P = .613). Patients in both groups were evaluated with VHI-10, emotional ( P = .036) and physiological ( P = .038) scores were significantly higher in MC group and no significant difference was found in functional scores ( P = .192). However, there was no statistically significant difference between the 2 groups in terms of voice quality ( P = .185). In early-stage (Tis, T1a, T1b) glottic carcinoma, there was no significant difference between RT and MC in terms of voice quality. Therefore, the choice of treatment modality in patients with early-stage glottic carcinoma should be taken into account in terms of the patient’s occupation, comorbid diseases, cost of treatment, hospital stay, and, most importantly, patient preference.

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