Using low level laser therapy to reduce early postoperative airway obstruction following modified Hogan’s flap / El uso de la terapia con láser de baja intensidad para reducir la obstrucción de la vía aérea postoperatoria temprana después del colgajo de Hogan modificado

Introduction and objective: The most common postoperative complications of velopharyngeal insufficiency surgery are postoperative bleeding and airway obstruction or obstructive sleep apnoea. Consequently, the aim of this study was to evaluate the effect of low level laser therapy (LLLT) during the first postoperative days in children undergoing superiorly based pharyngeal flap (SBF) surgery. Materials and methods: A randomized double blind clinical study on 30 children divided on two groups 15 patients each, who underwent SBF. LLLT was used in a group and the other was a control group. The study was conducted in academic tertiary care medical centres between 2013 and 2015. The degree of edema, oxygen saturation, occurrence of obstructive sleep apnoea (OSA) and steroid administration were recorded. Results: The mean of the average oxygen saturation was significantly less in the control group in the 1st and 2nd day as compared to the laser group. The need for oxygen and the incidence of OSA in the first 3 days were significantly higher in the control group as compared to the laser group. The degree of edema showed no significant difference in the first day but was significantly higher in the control group in the 2nd and 3rd days. Hence, the need of steroids was significantly higher in the control group in the first 3 days. Conclusions: Preliminary results showed that low level laser therapy is effective in reducing the incidence of early postoperative airway obstruction after SBF operations (AU)

Introducción y objetivo: La más común de las complicaciones postoperatorias tras la cirugía de la insuficiencia velofaríngea son el sangrado y la obstrucción postoperatoria de las vías respiratorias, o la apnea obstructiva del sueño. Por lo tanto, el objetivo de este estudio fue evaluar el efecto de la terapia láser de baja intensidad durante los primeros días del postoperatorio en niños sometidos a colgajo faríngeo de base superior (SBF). Métodos: Estudio clínico aleatorizado doble ciego en 30 niños, entre el grupo de láser y el grupo control, que fueron sometidos a SBF. El estudio se llevó a cabo en dos centros médicos académicos de atención terciaria, entre 2013 y 2015. Se registró grado de edema, la saturación de oxígeno, la aparición de apnea obstructiva del sueño y la necesidad de esteroides. Resultados: Durante los 3 primeros días, la media de la saturación de oxígeno muestra cambios significativos entre los dos grupos. Por otra parte, la necesidad de oxígeno en los primeros 3 días muestra también cambios significativos entre los dos grupos. Así como la incidencia de apnea obstructiva del sueño. El grado de edema no muestra ningún cambio significativo en el primer día, pero sí en los 2 días siguientes. Por lo tanto, la necesidad de esteroides en los primeros 3 días también muestra cambios significativos entre los dos grupos. Conclusiones: Los resultados preliminares mostraron que la terapia con láser de baja intensidad es eficaz en la reducción de la incidencia de obstrucción de vía aérea en el postoperatorio temprano después de las operaciones SBF (AU)

The value of using loupe magnification and methylene blue dye in intra-operative identification of thyroglossal duct tract.

BACKGROUND: This was a comparative randomised study to find out the value of using loupe magnification and methylene blue dye in identification of the thyroglossal duct and to compare between them. PATIENTS AND METHODS: Twenty-two patients who presented with infrahyoid thyroglossal duct cyst were subjected to excision of the cyst with two methods for identification of thyroglossal duct track during the operation. Data were anlysed for identification of multiple tracts, the tract relation to the hyoid bone, incidence of complications and operative time. RESULTS: We found that multiple tracts were present in 9.1% of the patients in Group I and 36.3% in Group II, with no statistically significant difference between the two groups. The incidence of complications was 27.2% in Group I and 9.1% in Group II, with no statistically significant difference between both groups. However, the incidence of identification of the tract, and its relation to the hyoid bone was higher in Group II (90.9%) than in Group I (45.5%) , with a statistically significant difference between both groups. Also the incidence of identification of the extension level of the tract above the hyoid bone and up to the tongue base was significantly higher in Group II (72.8%) as compared to Group I (9.1%). The operative time was significantly shorter in Group II (54.35 min) and was 76.55 min in Group I, (P = 0.0001). CONCLUSION: Intra-operative identification of the thyroglossal tract is an essential step in the removal of the thyroglossal duct cyst. Both loupe magnification and methylene blue dye help in the tract identification, however, the usage of surgical loupes enhances better and safe results.

The effectiveness of low-level laser on postoperative pain and edema in secondary palatal operation.

OBJECTIVE: The postoperative period after palatal surgery is usually very painful, requiring the use of pain-relieving drugs. Hence, the aim of this study was to evaluate the efficacy of Low-level laser therapy (LLLT) in post-operative pain control and edema after secondary palatal operations. METHODS: A randomized double blinded clinical study on 20 children undergoing secondary palatal operations between 2013 and 2015 was done. Patients were randomly divided on two groups 10 patients each. In one group patients received local application of therapeutic laser immediately after surgery while patients received nothing in the control group. The mean age was 5.22 years ± 2.53 SD in the laser group and 6.42 years ± 0.76 in the control group. Postoperative pain was assessed by using visual analog scale scores and by recording the need of analgesics. The degree of postoperative edema was also recorded. RESULTS: The pain scale showed significantly less postoperative pain in the laser group than in the control group from the first day (P-value = 0.006) to the 6th day (P-value = 0.014). The number of postoperative analgesic doses needed were significantly less in the laser group in the second and third days (P-value = 0.014). The postoperative edema was significantly higher in the control group from the 2nd (P-value = 0.004) to the 7th (P-value = 0.014) postoperative days. CONCLUSIONS: Preliminary results showed that low-level laser therapy is effective in the reduction of postoperative pain and edema, and minimizing the need of analgesic medication after secondary palatal operations.

Using low level laser therapy to reduce early postoperative airway obstruction following modified Hogan's flap.

INTRODUCTION AND OBJECTIVE: The most common postoperative complications of velopharyngeal insufficiency surgery are postoperative bleeding and airway obstruction or obstructive sleep apnoea. Consequently, the aim of this study was to evaluate the effect of low level laser therapy (LLLT) during the first postoperative days in children undergoing superiorly based pharyngeal flap (SBF) surgery. MATERIALS AND METHODS: A randomized double blind clinical study on 30 children divided on two groups 15 patients each, who underwent SBF. LLLT was used in a group and the other was a control group. The study was conducted in academic tertiary care medical centres between 2013 and 2015. The degree of edema, oxygen saturation, occurrence of obstructive sleep apnoea (OSA) and steroid administration were recorded. RESULTS: The mean of the average oxygen saturation was significantly less in the control group in the 1st and 2nd day as compared to the laser group. The need for oxygen and the incidence of OSA in the first 3 days were significantly higher in the control group as compared to the laser group. The degree of edema showed no significant difference in the first day but was significantly higher in the control group in the 2nd and 3rd days. Hence, the need of steroids was significantly higher in the control group in the first 3 days. CONCLUSIONS: Preliminary results showed that low level laser therapy is effective in reducing the incidence of early postoperative airway obstruction after SBF operations.