Peter Tassone

Randomised-controlled study comparing post-operative pain between coblation palatoplasty and laser palatoplasty

Objectives: This study aimed to evaluate differences inpost-operative pain comparing KTP laser-assisted uvulo-palatoplasty without tonsillectomy (LAUP) with a newdescribed surgical method: coblation uvulopalatoplastywith tonsillectomy (CP). We also evaluate the impact ofeach surgical technique in reduction of snoring loudness.Material and methods: Single blind randomized-controlled trial. From a population of 41 consecutivepatients on the waiting list for uvulopalatoplasty for sim-ple snoring, the study group was reduced to 17 CP and13 LAUP. Post-operative pain and reduction of snoringloudness were recorded using visual analogue scales(VAS) during the first 15 post-operative days. Post-opera-tive snoring loudness was documented for 1-year period.Results: Both groups had similar post-operative pain dur-ing the first seven post-operative days. A statistically sig-nificant reduction in post-operative pain was observed inthe CP group after day 8, and maintained until the endof the study. Reduction of snoring loudness was signifi-cant in both groups, but no differences were observedbetween them.Discussion: Coblation uvulopalatoplasty compared withLAUP demonstrates a reduction in post-operative pain,significant after the first post-operative week. The collat-eral thermal injury caused by laser is responsible for theslow-healing rate and maintained post-operative pain.Coblation dissociates tissue at lower temperatures withminimal collateral thermal injury and consequently fasterand less painful recovery. Both surgical procedures havesignificant and similar reduction in snoring loudness.Conclusions: Both methods are adequate treatmentoptions for snoring. The less painful recovery in CPpromotes this surgical technique as our preferred choicefor palate surgery.Ikematsu in 1952 described the principles of uvulo-palatopharyngoplasty (UPPP or U3P),

Timing of tracheostomy in adult patients: Potential ramifications are alarming

EDITOR—In their systematic review and meta-analysis Griffiths et al conclude that tracheostomies should be performed earlier in critically ill patients.1 As ear, nose, and throat surgeons we find the potential ramifications quite alarming, primarily as undertaking this major operation is not without potential morbidity in patients who are already systemically unwell.2 3 These patients are often …

Bullet Points in ENT: Postgraduate and Exit Exam Preparation

Concise and to-the-point, this book provides a highly effective review and study aid for postgraduate and exit exam candidates in otolaryngology-head and neck surgery. It covers the full breadth of the field in manageable nuggets of information that are easily learned and retained, and ensures that trainees are prepared for all frequently asked exam questions. Special Features: * Distills key facts into bullet points for rapid access to essential information, without the need to wade through lengthy, extraneous material * Covers the full range of topics in the modern ENT syllabus, as well as other important areas (e.g., imaging techniques, pharmacology, medical statistics) that are encountered in todays exams * Organized by subspecialty for quick, convenient review of selected topics* Serves equally well as a compact reference and refresher in the clinic, hospital or operating theatre* Offers a valuable overview of otolaryngology for trainees in allied specialties, such as maxillofacial and plastic surgery, audiology and speech-language pathology Primarily geared to the Diploma of Otolaryngology-Head Neck Surgery (DOHNS) and Fellowship Intercollegiate (FRCS-ORL HNS) exams in the UK, Key Revision for Otolaryngology is also an excellent learning resource for similar tests in Europe, India, Canada, Australia, New Zealand, South Africa and other countries. It is ideal as a current, comprehensive, study and revision aid in this rapidly expanding specialty. Thieme eOtolaryngology is the premier online resource for otolaryngology-head and neck surgery. For a free trial, go to: thieme.com/eototrial