ABSTRACT
BACKGROUND: Hypocalcaemia is a common and serious complication after thyroidectomy. The purpose of this study is to assess the effectiveness of first postoperative day parathyroid hormone (PTH) measurement in order to predict the presence and severity of postthyroidectomy hypocalcaemia. METHODS: One hundred consecutive cases undergoing total thyroidectomy in a tertiary referral center were prospectively assessed. Preoperative measurements of PTH were compared with postoperative levels in the first morning after surgery. All cases of hypocalcaemia were recorded and evaluated with regard to preoperative and postoperative levels of PTH. RESULTS: A decrease of 56% of PTH levels on the first postoperative day could accurately predict postoperative hypocalcaemia with a sensitivity and specificity of 80%. CONCLUSION: Serum PTH levels on the first postoperative day may be used as a reliable predictive marker for calcium supplementation need and even prolonged hospitalization in cases undergoing total thyroidectomy.
Subject(s)
Hypocalcemia/blood , Hypocalcemia/etiology , Parathyroid Hormone/blood , Postoperative Complications/blood , Postoperative Complications/etiology , Thyroidectomy/adverse effects , Adult , Cohort Studies , Female , Humans , Hypocalcemia/diagnosis , Male , Middle Aged , Postoperative Complications/diagnosis , Predictive Value of Tests , ROC Curve , Severity of Illness Index , Time FactorsABSTRACT
OBJECTIVE: To present the experience of our department on microscopic surgery of the nose and sinuses and compare our results with those of other standard approaches. Furthermore we attempt to specify the main indications for the use of the method. METHODS: During the period between January 1990 and December 2002, the prementioned technique was performed in a total of 250 patients. The preoperative evaluation, surgical technique and postoperative management of all patients are described in detail. RESULTS: Most common diagnoses included nasal polyps and chronic rhinosinusitis. The average age of patients was 42 years. Males accounted for 48%. No major postoperative complications were noted. Minor complications such as epistaxis and midfacial pain were observed in 24% of cases. While the majority of patients reported severe symptomatology preoperatively, 91% reported substantial improvement of their clinical condition within 3 months after surgery. CONCLUSION: Microscopic surgery is a technique which can be used alternatively to traditional procedures. It provides an excellent, clear, stereoscopic vision and allows the surgeon to work bimanually. Complications are rare and easily controlled. Our experience favors the use of microscopic technique compared to common endoscopic approaches, especially in cases of nasal polyps and chronic rhinosinusitis.
Subject(s)
Endoscopy/methods , Microsurgery/methods , Paranasal Sinus Diseases/surgery , Adolescent , Adult , Aged , Aged, 80 and over , Anesthesia, General , Anesthesia, Local , Child , Chronic Disease , Female , Humans , Male , Middle Aged , Nasal Polyps/diagnosis , Nasal Polyps/surgery , Sinusitis/diagnosis , Sinusitis/surgeryABSTRACT
The aim of this prospective study was to evaluate the efficacy of cocaine flakes compared to tetracaine with adrenaline solution, as a local anaesthetic for patients undergoing septoplasty. From January 2001 to December 2002, 220 patients underwent septoplasty under local anaesthesia. Patients were randomly classified in group A and group B, where cocaine and the solution of tetracaine/adrenaline were used respectively. A visual analogue scale was used to evaluate the severity of the patients'pain during the procedure. The patients of group B showed a statistically significant lower pain score than patients of group A. We believe that the solution of tetracaine/adrenaline is an effective and safe anaesthetic for patients undergoing septoplasty under local anaesthesia.