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Tonsillectomy is a common, low-risk procedure. Post-tonsillectomy haemorrhage remains the most serious complication. Recent nationwide studies in the UK have identified an increased morbidity and mortality for both high-risk and low-risk elective general surgery performed at the weekend.
Data for tonsillectomies performed at a district general hospital over a three-year period were retrospectively reviewed. The same group of surgeons performed elective tonsillectomies on both weekends and weekdays. All patients who developed a post-tonsillectomy haemorrhage were identified and the day of original operation was noted.
Between 2010 and 2013, 2208 (94.00 per cent) elective tonsillectomies were performed on a weekday and 141 (6.00 per cent) were performed on the weekend. Post-tonsillectomy haemorrhages occurred in 104 patients (4.71 per cent) who underwent their procedure on a weekday and in 10 patients (7.09 per cent) who had their surgery at the weekend (p = 0.20).
There is no difference in the rate of post-tonsillectomy haemorrhage for procedures performed on a weekday or weekend.
To investigate the effects of adenotonsillectomy on the quality of life of children under three years of age with obstructive sleep apnoea. To our knowledge, there have been no previously published studies on this topic.
Thirty-nine children under three years of age and treated with adenotonsillectomy for obstructive sleep apnoea met the inclusion criteria. A quality of life questionnaire was adapted from the validated, six-item instrument developed by de Serres et al. (2000). The questionnaire assessed improvement in specific domains following adenotonsillectomy. Carers scored each domain on a point scale ranging from ‘none’ (0) to ‘couldn't be more’ (6).
The quality of life of all children improved after surgery. The greatest mean improvement scores were in the domains of care-giver concern, physical suffering and sleep disturbance. The modal questionnaire score was 4 and the overall mean questionnaire score was 4.2.
Adenotonsillectomy provides measurable improvements in quality of life for children under three years of age with obstructive sleep apnoea.
To demonstrate the successful treatment of laryngeal papillomatosis in a 32-month-old girl, using coblation (radio-frequency ablation) resection.
A 32-month-old girl was referred to the ENT out-patients clinic due to a hoarse cry and a very croaky voice since birth. Under general anaesthesia, fibre-optic airway endoscopy revealed a large papillomatous lesion involving the anterior glottis, which was reported as a laryngeal papilloma on histological analysis. This was later excised using an Evac 70Xtra wand. The patient made an uneventful post-operative recovery, and there were no signs of recurrence on repeated airway endoscopies at three and 18 months.
Coblation (radio-frequency ablation) is a promising surgical technique for the treatment of paediatric laryngeal papillomatosis. The main advantages of this technique include limited damage to underlying tissues and a bloodless field.
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