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https://www.readbyqxmd.com/read/28806028/treatment-of-peritonsillar-abscess-in-immunosuppressed-patients
#1
Jed H Assam, William C Spanos
Peritonsillar abscess (PTA) is a common pathology in otolaryngology emergency. The treatment of PTA is usually bedside drainage or surgical removal of the tonsils (Quincy tonsillectomy) in combination with antibiotic treatment. However, patients with immune suppression might have a more difficult treatment course. Such difficulties may be further magnified within older patients. This case report will describe successful multi-modality treatment of two separate incidents of PTA developing in the context of immunosuppression...
July 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28804904/early-impact-on-outpatients-of-mandatory-adoption-of-the-diagnosis-related-group-based-reimbursement-system-in-korea-on-use-of-outpatient-care-differences-in-medical-utilization-and-presurgery-examination
#2
Seung Ju Kim, Kyu-Tae Han, Woorim Kim, Sun Jung Kim, Eun-Cheol Park
OBJECTIVE: To explore the impact of mandatory adoption of diagnosis-related groups (DRGs) on the use of outpatient care in Korea. DATA SOURCES: National Health Claim data from 2,022 hospitals and 1,029,101 admission cases during 2011-2014: tonsillectomy/adenoidectomy, inguinal/femoral hernia operation, and hemorrhoidectomy. STUDY DESIGN: Outcome variables included probability of outpatient visit, number of outpatient visits, and outpatient medical expenditures within 30 days...
August 14, 2017: Health Services Research
https://www.readbyqxmd.com/read/28802392/utilization-and-trends-in-surgical-instrument-use-in-pediatric-adenotonsillectomy
#3
David L Walner, Christopher Mularczyk, Auddie Sweis
OBJECTIVE: Examine trends in surgical instrument usage for pediatric adenotonsillectomy. METHODS: An online survey asking questions about current and previous surgical instrument use was created by the authors and distributed to 517 members of the American Society of Pediatric Otolaryngology in October 2015. The survey was designed to assess trends in the use of surgical instruments in pediatric adenotonsillectomy by comparing the results of our 2015 survey to data from a previously published 2005 study...
September 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28802375/post-tonsillectomy-hemorrhagic-outcomes-in-children-with-bleeding-disorders-at-a-single-institution
#4
Priyesh N Patel, Alexandra M Arambula, Allison P Wheeler, Edward B Penn
OBJECTIVE: To report on the post-tonsillectomy bleeding outcomes and factors associated with hemorrhage among children with pre- or post-operatively diagnosed bleeding disorders treated with an institutional protocol. METHODS: Retrospective cohort study of patients with hematologic disorders who underwent tonsillectomy between 2003 and 2016 and were treated with perioperative desmopressin or factor replacement and/or aminocaproic acid. Postoperative outcomes were compared to controls matched for age, sex, and indication for surgery...
September 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28802358/guillotine-vs-classic-dissection-adenotonsillectomy-what-s-the-ideal-technique-for-children-in-tanzania
#5
Desderius C Chussi, Sophie W Poelman, Niels Van Heerbeek
OBJECTIVES: Adenotonsillectomy (ATE) is one of the most performed surgeries in children. Extensive research on which operation technique is the best in terms of minimal pain and complications, operative time and duration of hospital stay is being done mostly in highly resourced developing countries. In developing countries a need for cost effective and time saving operation techniques is essential due to the low-resource setting. This study aims to investigate whether the Guillotine Sluder operation techniques is ideal in a limited resource developing country setting...
September 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28790543/haemorrhage-rates-after-two-commonly-used-tonsillectomy-methods-a-multicenter-study
#6
Faris Brkic, Majda Mujic, Sekib Umihanic, Nermin Hrncic, Amna Goga, Ermin Goretic
INTRODUCTION: Tonsillectomy is a frequently used, low-risk surgical procedure. The post-tonsillectomy haemorrhage occurs rarely, but is a life-threatening complication. Some studies show that the surgical technique affects the haemorrhage rate. AIMS: To analyse the post-tonsillectomy haemorrhage rate, and to determine whether the effect of the surgical technique on the haemorrhage rate exists. METHODS: We retrospectively reviewed data of all patients who underwent a tonsillectomy in three regional ENT departments in Bosnia and Herzegovina (Tuzla, Zenica and Bihac) between January 1(st) 2015 and October 31(st) 2016...
April 2017: Medical Archives
https://www.readbyqxmd.com/read/28782298/transoral-robotic-surgery-for-tonsillar-cancer-addressing-the-contralateral-tonsil
#7
Peter T Dziegielewski, Brian J Boyce, Matthew Old, Theodoros N Teknos, Amit Agrawal, Hafiz Patwa, Enver Ozer
BACKGROUND: The purpose of this study is to determine the incidence and risk factors for bilateral tonsillar cancers treated with transoral robotic surgery (TORS) and to determine the morbidity of the procedure. METHODS: Patients undergoing TORS for known tonsillar cancer were retrospectively reviewed. Perioperative variables and surgical outcomes were analyzed to determine predictive factors for bilateral disease and morbidity rates. RESULTS: Seventy-nine consecutive patients with tonsillar cancers underwent primary TORS radical tonsillectomy...
August 7, 2017: Head & Neck
https://www.readbyqxmd.com/read/28782104/emergency-department-visits-hospitalizations-and-readmissions-of-patients-with-a-peritonsillar-abscess
#8
Romaine F Johnson
OBJECTIVES: To determine the demographics and treatment outcomes of patients with a peritonsillar abscess (PTA) and to provide guidance for treatment options. METHODS: The 2012 National Emergency Department Database, 2012 National Inpatient Sample, and 2013 Nationwide Readmissions Database were used to analyze patients with a PTA who presented to emergency departments (ED), were admitted and/or readmitted to hospitals in the United States. Outcomes were used to create a decision model to compare initial medical versus surgical management...
August 7, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28764608/rare-post-tonsillectomy-internal-carotid-artery-pseudoaneurysm-management-by-parent-artery-occlusion-using-detachable-balloons
#9
Arun Sharma, Sanjeev Kumar, S Leve Joseph Devarajan, Himanshu Agarwal
Iatrogenic cervical internal carotid artery pseudoaneurysm is a rare and potentially lethal complication following tonsillectomy. It can be complicated by thromboembolism, mass effect and eventually may rupture leading to death. Various endovascular treatment options are available for the management of these pseudoaneurysms, including coil embolization, detachable balloon occlusion, or stent graft placement. Parent artery occlusion using detachable balloons can be a therapeutic option in a subset of patients...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28762292/tonsillectomy-in-children-with-down-syndrome-a-national-cohort-of-inpatients
#10
Andrew B Baker, Zachary Farhood, Kathleen A Brandstetter, Ronald J Teufel, Angela LaRosa, David R White
Objective To describe the cost, length of stay, and incidence of postoperative hemorrhage associated with Down syndrome (DS) patients undergoing tonsillectomy in a national sample of inpatient children. Study Design This study uses a national cross-sectional cohort to analyze children with and without DS undergoing tonsillectomy with or without adenoidectomy. Setting 2012 Healthcare Cost and Utilization Project Kids' Inpatient Database. Subjects and Methods The database was analyzed for postoperative hemorrhage and respiratory compromise, length of stay, and total charges of hospital stay...
June 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28756097/impact-of-the-korean-diagnosis-related-groups-payment-system-on-the-outcomes-of-adenotonsillectomy-a-single-center-experience
#11
Sang Hyun Kwak, Ji Hoon Kim, Da Hee Kim, Jung Min Kim, Hyung Kwon Byeon, Won Shik Kim, Yoon Woo Koh, Se-Heon Kim, Eun Chang Choi
OBJECTIVES: To report outcomes with regard to clinical aspects and medical costs of adenotonsillectomy and tonsillectomy at a single institution before and after implementation of the Diagnosis-Related Groups (DRG) payment system in Korea. METHODS: We retrospectively reviewed the records of patients treated with adenotonsillectomy or tonsillectomy between July 2012 and June 2014. The Korean DRG payment system was applied to seven groups of specific diseases and surgeries including adenotonsillectomy and tonsillectomy from July 2013 at all hospitals in Korea...
July 26, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/28754260/learning-curve-of-tonsillectomy
#12
Pei-Yin Wei, Chia-Huei Chu, Mao-Che Wang
OBJECTIVE: To determine the time required to sufficiently educate a well-trained surgeon to perform tonsillectomy. MATERIAL AND METHODS: From July 1, 2000 to June 30, 2008, we analyzed 110 patients who underwent bilateral tonsillectomy. All the procedures were performed by 16 ENT surgeons trained in the same tertiary referral medical center during their residency. This training included a 4-year training program before 2002, and a 5-year training program thereafter...
July 25, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/28748971/follicular-dendritic-cell-sarcoma-of-the-head-and-neck-literature-review-and-report-of-the-tonsil-occurrence-in-a-ugandan-patient
#13
I Pecorella, T R Okello, G Ciardi, E Ochola, M D Ogwang
We report a case of follicular dendritic cell sarcoma (FDCS) in a 60-year-old Ugandan female who presented with a 6-year history of a progressive left sided tonsillary mass. General systemic examination was unrevealing and the patient underwent left tonsillectomy. She was subsequently lost to follow-up. Grossly, the mass measured 6 cm in diameter and had a mottled appearance due to tissue microhaemorrhages. Markers specific for follicular dendritic cell differentiation (CD21, CD35 and CD23), p53 and EGFR were expressed on immunohistochemical analysis...
June 2017: Pathologica
https://www.readbyqxmd.com/read/28748511/unique-histologic-features-of-tonsils-from-patients-with-periodic-fever-aphthous-stomatitis-pharyngitis-and-cervical-adenitis-pfapa-syndrome
#14
Kalpana Manthiram, Hernan Correa, Kelli Boyd, Joseph Roland, Kathryn Edwards
The objective of this study is to compare the histology and immune cell composition of tonsils from patients with periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome to those from patients with obstructive sleep apnea (OSA). Patients with PFAPA and age-matched controls with OSA who had undergone tonsillectomy at Vanderbilt Children's Hospital were recruited. After informed consent, archival paraffin-embedded, formalin-fixed tonsil tissues were obtained. Sizes of major histologic regions were measured...
July 26, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28741425/gabapentin-in-the-management-of-pain-following-tonsillectomy-a-randomized-double-blind-placebo-controlled-trial
#15
James G Sanders, Claire Cameron, Patrick J D Dawes
Objective To determine if a single dose of oral gabapentin given prior to tonsillectomy decreases postoperative morbidity. Study Design Prospective randomized double-blind placebo-controlled trial. Setting Southern District Health Board University Hospitals, New Zealand, over a 10-month period. Subjects and Methods Seventy-three adults undergoing tonsillectomy were randomized to receive either a single preoperative dose of oral gabapentin (600 mg) or placebo. A standard analgesic protocol was prescribed for 14 postoperative days...
July 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28728615/success-of-tonsillectomy-for-obstructive-sleep-apnea-in-children-with-down-syndrome
#16
David G Ingram, Amanda G Ruiz, Dexiang Gao, Norman R Friedman
STUDY OBJECTIVES: Obstructive sleep apnea (OSA) is common in children with Down syndrome (DS) and associated with significant morbidity. In the current study we examined polysomnographic outcomes of children with DS who underwent tonsillectomy. METHODS: A retrospective chart review of children with DS who underwent a tonsillectomy between 2009-2015 was performed. All children had either a concurrent adenoidectomy or had previously underwent an adenoidectomy. Children with preoperative and postoperative polysomnograms within 6 months of surgery were included in the analysis...
July 14, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28722102/expression-of-cd34-and-cd146-vascular-markers-contributes-to-the-immunological-function-of-the-human-palatine-tonsil
#17
Marko Jović, Verica Avramović, Predrag Vlahović, Aleksandra Veličkov, Vladimir Petrović
The fundamental function of the palatine tonsil is the immune response to airborne and foodborne pathogenic agents. Small blood vessels have an important role in the provision of a special microenvironment in which the immune response occurs. In this study, we investigated the expression of vascular markers CD34 and CD146 and basal lamina marker - type IV collagen - in the small blood vessels of the human palatine tonsil in the context of their role in the immunological function of the tonsil. The tonsils were collected after tonsillectomy from ten patients with chronic tonsillitis, aged 18-28 years...
July 19, 2017: Histology and Histopathology
https://www.readbyqxmd.com/read/28719712/post-tonsillectomy-hemorrhage-rates-in-children-compared-by-surgical-technique
#18
Nicole M Reusser, Robert W Bender, Nikhil A Agrawal, James T Albright, Newton O Duncan, Joseph L Edmonds
Despite the sheer number of pediatric tonsillectomies performed in the United States annually, there is no clear consensus as to which surgical technique is superior. One way to compare surgical techniques is to study the morbidity associated with each. We report postoperative hemorrhage rates, one of the frequently encountered major adverse events, as part of a retrospective chart review across four different surgical techniques. These surgeries involved either (1) Coblation, (2) Co-blation with partial suture closure of the tonsillar fossa, (3) diathermy, or (4) partial intracapsular tonsillectomy (PIT)...
July 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28719708/plasmablade-vs-cold-dissection-tonsillectomy-a-prospective-randomized-double-blind-controlled-study-in-adults
#19
Rasim Yilmazer, Zahide Mine Yazici, Meliksah Balta, Ibrahim Erdim, Omer Erdur, Fatma Tulin Kayhan
We conducted a prospective, randomized, double-blind, controlled clinical study to compare the efficacy and safety of the PlasmaBlade device and cold dissection for adult tonsillectomy. Our study group was made up of 20 patients-12 men and 8 women, aged 18 to 50 years (mean: 27.1)-who were undergoing a bilateral tonsillectomy. Each patient had one randomly chosen tonsil removed by the PlasmaBlade and the other by cold instrumentation. We compared the duration of surgery, the amount of intraoperative blood loss, the number of sutures required, the status of tonsillar fossa wound healing at 7 and 14 days postoperatively, the amount of postoperative pain, and postoperative complications...
July 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28719036/a-novel-method-for-achieving-optimal-neck-extension
#20
David Black, Thomas Snooks, Matthew Clark
From tonsillectomies to major neck dissections, a large proportion of ENT operations require the neck to be extended. This is normally achieved by a gel pad or sand bag shoulder bolster, or in more frugal hospitals - a bag of normal saline. In our theatres two sizes of shoulder bolster are generally available. This article is protected by copyright. All rights reserved.
July 18, 2017: Clinical Otolaryngology
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