Comparison of Three Tonsillectomy Techniques: Cold Dissection, Monopolar Electrocautery, and Coblation.

Introduction Tonsillectomy is among the most common otolaryngological surgeries. Objective To evaluate and compare three tonsillectomy techniques: cold steel dissection (CSD), monopolar electrocautery (MEC), and coblation. Methods The present study retrospectively reviewed the medical records of patients who underwent tonsillectomy between January 2014 and January 2016. Postoperative visual analog scale (VAS) pain scores, analgesic use, surgical duration, time to return to normal activity, and postoperative bleeding status were noted. Results The CSD group had less analgesic use and shorter return to normal activity than the MEC group ( p = 0.037 and p < 0.001, respectively). The coblation group had lower VAS pain scores than the MEC group only at 1 hour to 4 hours postsurgery ( p < 0.016). The postoperative bleeding rate was similar in all groups ( p = 0.096). Conclusion Cold steel dissection tonsillectomy is associated with less postoperative pain and shorter recovery than MEC. Coblation is better than MEC in terms of postoperative pain at 1 hour to 4 hours only, whereas CSD is associated with less postoperative pain than coblation at 2 days to 7 days.

The Efficacy of Gabapentin + Dexamethasone for Postoperative Analgesia Following Septoplasty: A Prospective Randomized Placebo-Controlled Trial.

AIMS: This study aimed to compare the efficacy of gabapentin, dexamethasone, and gabapentin + dexamethasone for pain control after septoplasty. MATERIALS AND METHODS: This prospective randomized trial included 120 patients that underwent septoplasty and were randomly divided into 4 groups: group G (preoperative gabapentin 600 mg p.o.); group D (intraoperative dexamethasone 8 mg i.v.); group GD (preoperative gabapentin 600 mg p.o. + intraoperative dexamethasone 8 mg i.v.); group C (placebo control). RESULTS: The median VAS score was significantly lower in groups G and GD at 1, 2, 4, 6, 12, and 24 hours postsurgery than in group C (P < .008 for all). The median VAS score was significantly lower in group D than in group C at 1, 2, and 4 hours postsurgery (P < .008 for all). There weren't any significant differences in the VAS score between groups D, G, and GD at any time point. Groups G, D, and GD had a significantly lower frequency of rescue analgesic use than group C; however, there were no differences between groups G, GD, and C (P < .001 and P = .108, respectively). CONCLUSION: Gabapentin, dexamethasone, and gabapentin + dexamethasone are equally more effective analgesics during the first 4 hours postsurgery than placebo. The addition of dexamethasone to gabapentin does not provide extra analgesia. Both gabapentin and gabapentin + dexamethasone have a more prolonged analgesic effect than dexamethasone alone.

Powered Micro-saw Versus Conventional Osteotome for Septorhinoplasty: A Prospective, Double-Blind, Comparative Study.

BACKGROUND: Various powered instruments are used to perform osteotomy. A consensus on the best method has not been established due to discrepancies in previous studies. This study aimed to compare the conventional osteotome and a powered micro-saw during septorhinoplasty. METHODS: The single-center, prospective cohort study included 60 patients that were grouped into two groups of 30 each. Group 1 underwent open septorhinoplasty using a conventional osteotome, and group 2 underwent open septorhinoplasty using a powered micro-saw. Postoperative edema, ecchymosis, pain, and nasal blockage were compared between groups. Preoperative and postoperative (6 months) functional and aesthetic outcomes were compared based on FACE-Q, SNOT-22, and T-NOSE scores. RESULTS: There were not any differences in age, gender, follow-up duration, the Brinkman index, or level of education between groups. Postoperative pain scores were significantly lower in group 2 on d 1 and d 3 postsurgery. Nasal blockage scores were significantly higher in group 1 on d 3 and d 7 postsurgery. Edema and ecchymosis scores were similar in both groups at all time points. Preoperative and postoperative (6 months) functional and aesthetic outcomes were also similar in both groups. CONCLUSION: Osteotomy using a powered micro-saw is an effective technique that results in less postoperative pain and nasal blockage than when using conventional osteotome. Early postoperative period edema and ecchymosis scores and long-term functional and aesthetic outcomes are similar when using a powered micro-saw and a conventional osteotome. Osteotomy using a powered micro-saw can be considered an alternative to using a conventional osteotome. LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Comparison of Three Tonsillectomy Techniques: Cold Dissection, Monopolar Electrocautery, and Coblation

Abstract Introduction Tonsillectomy is among the most common otolaryngological surgeries. Objective To evaluate and compare three tonsillectomy techniques: cold steel dissection (CSD), monopolar electrocautery (MEC), and coblation. Methods The present study retrospectively reviewed the medical records of patients who underwent tonsillectomy between January 2014 and January 2016. Postoperative visual analog scale (VAS) pain scores, analgesic use, surgical duration, time to return to normal activity, and postoperative bleeding status were noted. Results The CSD group had less analgesic use and shorter return to normal activity than the MEC group (p =0.037 and p < 0.001, respectively). The coblation group had lower VAS pain scores than the MEC group only at 1 hour to 4 hours postsurgery (p <0.016). The postoperative bleeding rate was similar in all groups (p = 0.096). Conclusion Cold steel dissection tonsillectomy is associated with less postoperative pain and shorter recovery than MEC. Coblation is better than MEC in terms of postoperative pain at 1 hour to 4 hours only, whereas CSD is associated with less postoperative pain than coblation at 2 days to 7 days.

Olfactory acuity based on Brief Smell Identification Test (BSITⓇ) in migraine patients with and without aura: A cross-sectional, controlled study.

OBJECTIVE: The aim of this study was to evaluate olfactory acuity in migraine patients with and without aura (MwA and MwoA) MATERIAL AND METHODS: The study included 30 MwA patients, 30 MwoA patients, and 30 age- and gender-matched controls. Demographic features and odor-related symptoms (osmophobia, odor offensiveness, and odor-triggered attack status) were noted. Olfactory acuity was measured using the Brief Smell Identification Test (BSIT®), a 12-item derivative of the University of Pennsylvania Smell Identification Test (UPSIT®). BSIT® scores were compared between the migraine patients and controls. RESULTS: The mean BSIT® score did not differ significantly between the MwA patients (8.7 ± 0.9) and MwoA (9.17 ± 0.9) patients (P = 0.094); however, the mean score in the control group was higher (10.4 ± 0.6) than in the MwA and MwoA patients (P < 0.001). The mean BSIT® score did not differ significantly between patients with and without odor-triggered migraine attacks (9 ± 0.9 and 8.8 ± 0.8, respectively) (P = 0.4). Osmophobia and odor-triggered attacks were more common in the MwA patients than in the MwoA patients (odor-triggered attacks: 66% vs. 40% [P = 0.04]; osmophobia: 76.6% vs. 60% [P = 0.16]) CONCLUSION: Olfactory acuity is lower during attack-free periods in migraine patients, as compared to controls. Migraine aura status does not affect olfactory acuity. Odor-triggered attacks, osmophobia, and offensive odors between attacks were more common in the MwA patients than in the MwoA patients.

Solar driven Stirling engine - chemical heat pump - absorption refrigerator hybrid system as environmental friendly energy system.

Aim of this paper is to present an alternative environmental friendly energy system consisting of solar driven Stirling Engine, chemical heat pump and absorption refrigeration system. Solar energy is the main energy source and waste heat is rejected by the Stirling engine is utilized by the chemical heat pump and absorption refrigerator. This system presents an alternative environmental friendly energy system that produces electricity, cooling and heating same time. A parametric research is conducted considering power output, energy efficiency and exergy destruction rate. Results are obtained numerically and discussed. According to the results, system operates most efficiently at the high temperature ratio of the working fluids of the Stirling engine and high collector surface temperature. Maximum power output is 9.463 kW, maximum energy efficiency of the hybrid system is 0.337. Comparing these results with Stirling engine, maximum power output of the hybrid system increases 14% and energy efficiency increases 13% for the hybrid system.