Effect of thyroidectomy in patients with tracheal compression.

OBJECTIVE: Various therapeutic methods are employed to reduce thyroid gland compression of the trachea. Differences in the amount of shrinkage in the thyroid gland, in the amount of amelioration of tracheal compression, and in the amount of fibrosis after treatment may occur with these different methods. Although the compression of the trachea decreases after thyroidectomy, the number of studies showing the extent of this is limited. The purpose of this study was to investigate the effect of thyroidectomy performed due to tracheal compression, to reveal the extent of improvement using magnetic resonance imaging (MRI), and to evaluate our results. METHODS: In total, 30 patients, i.e., 24 women and 6 men, with tracheal compression secondary to thyroid gland enlargement and undergoing total thyroidectomy were included in this study. MRI performed before surgery and 6 months after surgery. The amount of deviation from the tracheal midline and the tracheal lateral and anteroposterior (AP) diameters were measured, compared, and subjected to statistical analysis. RESULTS: Statistical analysis revealed significant differences between pre- and postoperative tracheal deviations, and lateral and AP diameters (p<0.001, p<0.001, and p=0.006, respectively). Histopathologically, benign or malignant pathology caused no significant difference in the postoperative improvement of tracheal anatomy (p=0.348 and p=0.148, respectively). CONCLUSIONS: Thyroidectomy performed due to tracheal compression provides significant improvement in tracheal anatomy. Due to its rapid and effective results, thyroidectomy should be one of the first options considered in the treatment of thyroid diseases with compression findings.

Comparison of the effects of articaine, tetracaine, and lidocaine application on pain and hemorrhage during and after nasal pack removal.

OBJECTIVE: We purposed to compare the effects of certain local anesthetic applications on pain and hemorrhage caused by nasal pack removal. METHODS: Design: Prospective, placebo-controlled study. Setting: Ataturk University Medical Faculty Hospital. This study was done in 90 patients who applied nasal packing after septoplasty. All patients were divided randomly into four groups. Each group was applied 2% lidocaine, 2% tetracaine, 4% articaine or 0.9% sodium chloride (NaCl) into their Merocel packs 15 min before removing. Verbal analog scale (VAS) score was registered from all patients, and the amount of hemorrhage was noted during the removal of the nasal packs and then for 30 min. RESULTS: The study groups had significantly better pain scores than the control group during nasal pack removal and after 5 min (p<0.001). The articaine and the lidocaine groups had also better pain scores than the control group at 15th min after the removal of the nasal packs (p<0.05), but the tetracaine group had no better pain scores than the control group, which is statistically significant at p>0.05. Analysis of bleeding scores after the removal of packs showed that the articaine and the lidocaine groups had better bleeding scores than the control group (p<0.004 and p<0.033, respectively). CONCLUSION: Topical articaine application into nasal packs just before removing in the patients who underwent septoplasty can be safely used for less pain, less hemorrhage, and more patient tolerance.