A review of tonsillectomy for recurrent throat infection.
44
Citation
10
Reference
10
Related Paper
Citation Trend
Abstract:
Tonsillectomy is most frequently carried out for recurrent throat infection, but there is uncertainty about its effectiveness. This paper reviews the evidence of its effectiveness obtained from a search of the Cochrane database and MEDLINE for randomized controlled trials comparing tonsillectomy with non-surgical management of recurrent throat infection. The results show that the effectiveness of a procedure such as tonsillectomy, needs to be considered in the light of its adverse effects. Attempts should be made to inform patients about the uncertainty surrounding the procedure.Keywords:
Throat
Cite
Tonsil
Cite
Citations (0)
We describe three homosexual men presenting to the ear, nose and throat clinic with severe tonsillitis. All were subsequently diagnosed with secondary syphilis of the tonsil. Syphilis should be considered as a diagnosis in high risk patients presenting with tonsillar lesions, even in the absence of other classical features of the disease.
Throat
Tonsil
Acute Tonsillitis
Treponematosis
Syphilis Serodiagnosis
Cite
Citations (29)
The aim of this study was to evaluate the efficacy and safety of tranexamic acid (TXA) in elderly patients with intertrochanteric fracture undergoing intramedullary fixation surgery.We searched MEDLINE, the Cochrane Library and EMBASE for published randomized clinical trials relevant to use of TXA in elderly patients with intertrochanteric fracture treated with intramedullary fixation surgery. Meta-analysis was performed according to the guidelines of the Cochrane Reviewer's Hand book.Five trials assessing 540 patients were included for meta-analysis. The pooled results showed that the mean total blood loss in TXA group was significant lower than that in the control group (mean difference - 172.83, 95% CI -241.43 to -104.23; p<0.00001, fixed-effect model). The intra- and postoperative transfusion rate for the TXA group was 34.4% (91/264) and for the control group was 49.27% (136/276), and the relative risk was 0.71 (95% CI 0.52 to 0.97; p<0.03, random-effect model) with substantial heterogeneity (I2=63%, p=0.03). The overall incidence of thrombotic events was 6.43% (17/264) in the intravenous TXA group, 7.63% (21/275) in the control group, with no significant difference (relative risk 0.84, 95% CI 0.46 to 1.54; p=0.57, fixed-effect model).The present evidence shows that TXA can significantly reduce total and hidden blood loss, transfusion rate, and do not increase the risk of thrombotic events in elderly patients with intertrochanteric fracture undergoing intramedullary fixation surgery. However, the impact of TXA on thrombotic events needs to be researched in more high-quality, large-sample randomized clinical trials.Level I Therapeutic Study.
Cite
Citations (15)
The authors report 6 cases of life threatening hemorrhage which occurred in 1985-1995. The cases were characterized by massive recurrent bleeding resistant to standard conservative methods of stopping. In a posttonsillectomy patient bleeding from the tonsillar niche and in two patients nasal bleeding because of trauma or tumor were stopped only after ligation of the external carotid artery. Arrosive bleeding from the internal jugular vein in a patient after opening of a deep tonsillogenic neck flegmon was stopped by ligation of the jugular vein along the length of the wound. Bleeding after opening of a paratonsillar abscess was stopped after abscess tonsillectomy. Bleeding from tracheostoma was stopped only after suturing of the vessel in the wound. All the 6 patients were discharged in a satisfactory condition.
Internal jugular vein
Peritonsillar Abscess
External jugular vein
Jugular vein
Neck dissection
Cite
Citations (0)
Original Article from The New England Journal of Medicine — Efficacy of Tonsillectomy for Recurrent Throat Infection in Severely Affected Children — Results of Parallel Randomized and Nonrandomized Clinical Trials
Throat
Cite
Citations (507)
Sore throat
Endotracheal intubation
Cite
Citations (37)
Objective: To compare monopolar cautery with cold steel dissection for tonsillectomy in pediatric age group.Study Design: A randomized clinical trial.Place and Duration of Study: Ear, nose and throat (ENT) department Combined Military Hospital Gujranwala,from Jan 2013 to Jan 2015.Material and Methods: A total of 220 consecutive pediatric patients undergoing tonsillectomy for recurrent or chronic tonsillitis between Jan 2013 to Jan 2015. Both groups were compared with regards to surgery time, intraoperative bleeding, post operative pain and complications.Results: A total of 20 patients were excluded from the study for various reasons while the data of the rest of the patients has been presented. Mean age of the study group was 8.82 years. A total of 58% of the patients were male. Average time of surgery for monopolar cautery was 29.33 (SD 2.77) min as compared to 18.53 min (SD 2.94) for dissection method which was significant (p<0.005). Average blood loss for monopolar surgery was 11.66 ml and 29.04ml for dissection method (p<0.005). Average pain scores were less for dissection method at 2nd post op day 3.59 vs. 5.51. Rates of primary and secondary hemorrhage were less for monopolar method although they were not statistically significant.Conclusion: Monopolar cautery though causes decreased intraoperative blood loss however requires longeranesthesia and causes significant post operative pain to the patient.
Throat
Cite
Citations (0)
Tonsillectomy is most frequently carried out for recurrent throat infection, but there is uncertainty about its effectiveness. This paper reviews the evidence of its effectiveness obtained from a search of the Cochrane database and MEDLINE for randomized controlled trials comparing tonsillectomy with non-surgical management of recurrent throat infection. The results show that the effectiveness of a procedure such as tonsillectomy, needs to be considered in the light of its adverse effects. Attempts should be made to inform patients about the uncertainty surrounding the procedure.
Throat
Cite
Citations (44)
Objectives: There has been recent controversy with regard to optimal postoperative pain control for tonsillectomy. Codeine is no longer recommended for children under the age of 12 years because of the risk of respiratory depression. Hence, identifying alternative/adjunct analgesia for post‐tonsillectomy pain is a high clinical priority. This is a protocol for a randomized controlled trial. The primary objective is to determine whether GeloRevoice throat lozenges (contain sodium hyaluronate) are effective as adjunct therapy to standard analgesia (paracetamol, ibuprofen, difflam spray) in post‐tonsillectomy pain. Methods: A total of 72 patients were randomized to 2 groups. Parents with children aged 6 to 18 years undergoing tonsillectomy were approached to participate in the study. The intervention group received GeloRevoice throat lozenges and the control group received a placebo. The study was subject to trust research and audit and safety reporting procedures, and ethical approval was applied for. Results: The primary endpoint was a pain score using a visual analog scale for pediatric populations. Pain scores were recorded on a diary card daily for 1 week postoperatively. Visual analog scale data were compared between 2 groups using a 2‐tailed t test where P <. 05 was considered to be statistically significant. Conclusions: This double‐blinded randomized controlled trial provides evidence on the safety and efficacy of GeloRevoice throat lozenges when used as adjunctive analgesia for post‐tonsillectomy pain.
Throat
Pain scale
Cite
Citations (0)