[Forestier's syndrome: a rare cause of dysphagia]. / Forestier sendromu: Nadir bir disfaji nedeni.

Forestier's syndrome (diffuse idiopathic skeletal hyperostosis) is characterized by ossification of the anterolateral aspect of at least four contiguous vertebral bodies. The exact etiology is unclear. Diagnosis is made by radiologic examinations. In this report, we present a case of Forestier's syndrome who admitted with complaints of dysphagia, cervical pain and dyspnea. The diagnosis was based on radiological examinations. Clinic and radiological characteristics of our case were discussed in the light of literature data.

The efficiacy of anterior and posterior archs suturation at inferior tonsillar pole for posttonsillectomy pain control.

The aim of our study was to investigate the efficiacy of the suturation technique after completing the tonsillectomy procedure for posttonsillectomy pain control in adult patients. August 2010-February 2011, 44 adult patients, ages ranged from 16 to 41 years old who underwent tonsillectomy at Elazig Training and Research Hospital Otorhinolaryngology Clinic were included to the study. After tonsillectomy procedure, anterior and posterior tonsillar archs were sutured each other and so, the area of tonsillectomy lodges which covered with mucosa were increased. Twenty two patients who applied posttonsillectomy suturation were used as study group and remnant 22 patients who did not applied posttonsillectomy suturation were used as control group. The visual analogue score (VAS) was used to evaluate the postoperative pain degree (0 no pain, 10 worst pain). ANOVA test (two ways classification with repeated measures) was used for statistical analysis of VAS values. P < 0.05 was accepted as statistically significant. The effect of time (each post-operative day) on VAS values was significant. The mean VAS values between study and control group on post-operative day 1st, 3rd, 7th, and 10th were statistically significant (P < 0.05). The severity of posttonsillectomy pain was less in study group patients than control group patients. The suturation of anterior and posterior tonsillar archs after tonsillectomy procedure was found effective to alleviate the posttonsillectomy pain in adult patients.

The relationship between metabolic presbycusis and serum paraoxonase/arylesterase activity.

To determine the presence of a relationship between metabolic presbycusis and serum paraoxonase/arylesterase activity. A total of 30 patients who had been admitted to the Ear, Nose, and Throat (ENT) Clinic of Firat University Medical Faculty and diagnosed as metabolic presbycusis were included in the study. The control group was composed of 30 healthy volunteers. Pure tone audiometry and impedencemeter were performed on all subjects included in the study at the audiometry laboratory of the ENT clinic. The presence of a regular hearing curve, a symmetrical sensorineural hearing loss more than 25 dB with preserved speech discrimination were accepted as criteria for metabolic presbycusis. Blood samples were drawn from the patients prior to the hearing tests. The sera were separated for measurements of total cholesterol, triglyceride, high-density lipoprotein, very low-density lipoprotein, low-density lipoprotein, human serum paraoxonase and arylesterase levels, respectively. No statistically significant difference was found between the patient and the control groups in terms of age and gender. Paraoxonase, arylesterase and paraoxonase/arylesterase, high-density lipoprotein levels were found to decrease in the study group and the difference was found to be statistically significant compared to the control group (P < 0.001). Low-density lipoprotein and total cholesterol levels were found to increase in the patient group and the difference was found to be significant compared to the control group (P < 0.001). This study puts forth that especially the type of nutrition and life style are very important with regard to metabolic presbycusis. Furthermore, the results of this study make us think that there could be a relationship between metabolic presbycusis and cardiovascular diseases. In this case, metabolic presbycusis may be a determining parameter in the early diagnosis of cardiovascular diseases. We consider that this study may be the pioneer for further studies conducted with larger patient numbers.

Does rheumatoid arthritis have an effect on audiovestibular tests?

The study aimed to determine the characteristics of hearing loss, vestibular responses and the incidence of vestibular disturbances in RA patients. This prospective study was performed at the Otolaryngology Department of Bozok University School of Medicine between May and November 2012. Eighty-one RA patients (69 women and 12 men) with a mean age of 40.8 ± 13.4 years (23-67 years) and 81 healthy controls (67 women and 14 men) with a mean age of 41.3 ± 13.8 years (24-66 years). Each subject was tested with low and high-frequency audiometry by a single experienced investigator under standard audiometric testing conditions. For each set of tests, mean values of air and bone conduction at each frequency and tympanometric values were calculated for the study groups. Videonystagmography (VNG) including smooth pursuit, saccade, positional, and caloric tests were also performed. The mean air conduction threshold values at high frequencies (4,000, 6,000, and 8,000 Hz) in RA group were lower than control groups. The difference between mean air conduction threshold values of the control groups against RA group at high frequencies were statistically significant (p < 0.05). There was no statistically significance between the two groups in tympanometric values (p < 0.05). VNG testing revealed central abnormalities in twenty patients (24.69%), peripheral abnormalities in five patients (6.17%), and mixed abnormalities in six patients (7.4%). There was no association between VNG abnormalities in patients with RA and age, sex, duration of disease, accompanying vertigo complaint, the laboratory findings and hearing levels (p < 0.05). Our findings suggest an association of RA and audiovestibular system dysfunction regardless clinical and demographic situation of patients. We assume the hearing and vestibular disturbances in RA are more prevalent than previously recognized. Also hearing losses in high frequencies in RA patients may be considered as an indicator of cochlear involvement in this disease.

Does bone mineral density have an effect on hearing loss in postmenopausal patients?

OBJECTIVES: An age-related decline in the bone mineral density (BMD) of the temporal bone, specifically in the segments that house the middle and inner ear, has been suggested as an additional risk factor for sensorineural hearing loss. We evaluated the effect of BMD on hearing loss in postmenopausal patients. METHODS: This study involved 120 postmenopausal women who were referred between May 1,2012, and September 1, 2012. The age range was 50 to 55 years (mean, 52.7 +/- 2.3 years). The subjects were divided into three groups according to the results of BMD measurements. Of these, 30 were control subjects with normal BMD values, 45 had osteopenia, and 45 had osteoporosis. Each subject was tested with low- and high-frequency audiometry by a single experienced investigator under standard audiometric testing conditions. For each set of tests, mean values of air and bone conduction at each frequency and tympanometric values were calculated for the osteopenia, osteoporosis, and control groups. RESULTS: All three groups were designed to have similar mean ages and roughly equal durations of menopause and body mass indexes. At low frequencies (0.25, 0.5, 1, and 2 kHz), the differences in the mean air conduction threshold values among the three groups were not statistically significant (p > 0.05). At high frequencies (4, 6, and 8 kHz), the difference in the mean air conduction threshold values between the osteopenia and control groups was not statistically significant (p > 0.05), but that in the osteoporosis group was statistically significantly higher than those in the osteopenia and control groups (p < 0.05). At low frequencies (0.5, 1, and 2 kHz), the differences in the mean bone conduction threshold values among the three groups were not statistically significant (p > 0.05). At 4 kHz, the difference in the mean bone conduction threshold values between the osteopenia and control groups was not statistically significant (p > 0.05), but that in the osteoporosis group was statistically significantly higher than those in the osteopenia and control groups (p < 0.05). There was no statistically significant difference among the three groups in tympanometric values (p > 0.05). CONCLUSIONS: We conclude that patients with low BMD values should routinely be counseled for an audiological assessment to detect any change in hearing thresholds.

The effects of sevoflurane and isoflurane in nasal septal surgery.

OBJECTIVES: The objective of this study was to evaluate the effect of sevoflurane and isoflurane in nasal septal surgery in terms of intraoperative blood loss, operation time, recovery time, and especially postoperative pain. METHODS: A total of 90 elective nasal septal surgery patients between the ages of 19 and 58 years (mean age, 32.95 years) who were classified as American Society of Anesthesiologists physical status I and II between January 2011 and June 2012 were included the study. Patients were assigned by randomization to receive 1 of 2 anesthetic agents (n = 45 patients each group): balanced general anesthesia with sevoflurane or isoflurane group. In all patients, the amount of intraoperative blood loss, the duration of operation, recovery time, and postoperative pain scores were recorded. RESULTS: The amount of perioperative bleeding in sevoflurane cases was less than that in the isoflurane group, and the difference was statistically significant (P G 0.05). Similarly, mean operative time was shorter in the sevoflurane group, and again the difference between 2 groups was statistically significant (P G 0.05). No statistically significant differences were observed between the 2 groups with respect to the anesthesia duration, extubation time, recovery time, and postoperative pain scores (P 9 0.05). CONCLUSIONS: Sevoflurane, which is one of the volatile anesthetics, leads to a lower amount of intraoperative bleeding, postoperative pain, and operation time than isoflurane during nasal septal surgery.

Fungus ball in concha bullosa: a rare case with anosmia.

Concha bullosa is the pneumatization of the concha and is one of the most common variations of the sinonasal anatomy. The histopathological changes caused by the infections which arise from the impaired aeration of conchal cavity are frequently found. Fungus ball of the nasal cavity is an extremely rare, fungal infection with only three cases reported previously. In this paper, we present the fourth fungus ball case which developed within a concha bullosa and presented with anosmia.

Pseudomeningocele presenting as a cyst of the external auditory canal.

Pseudomeningocele is a cerebrospinal fluid collection in an extradural area after meningeal tear. The etiology of pseudomeningocele development is iatrogenic or traumatic in most cases. In this study, we report a case of the postsurgical pseudomeningocele presenting as a cystic mass in the external auditory canal and complete sensorineural hearing loss with a review of the relevant literature.

The frequency of adenotonsillectomies in relation to socioeconomic status among primary school students in Yozgat province.

The present study aimed to investigate the frequency of tonsillectomy and adenoidectomy and its relation to socioeconomic status (SES) among 6- to 13-year-old primary school students in Yozgat province. Between March 1, 2012 and March 15, 2012, 1098 primary and nursery school students who had complete ear, nose and throat examination in our department were included in the study. The students were queried regarding age, gender and history of tonsillectomy and adenoidectomy via data collection forms. SES was evaluated according to the mean monthly income within the family, educational level of parents and absence or presence of smoking habits. The age of the 1098 students (678 males, 420 females) ranged between 6 and 13 years (mean age: 10.7). Of the cases, 27 (2.5%) had tonsillectomy, 23 (2.1%) had adenoidectomy, and 36 (3.3%) had both tonsillectomy and adenoidectomy. When we compared the SES between the operated and nonoperated subjects in the families with mean monthly income lower than the minimum wage, educational level lower than university degree and in the presence of smoking habits, adenotonsillectomy operation rate was significantly higher than in the non-operated group (p<0.001). We conclude that in children of the lower SES group families, with a mean monthly income lower than the minimum wage, parental educational level lower than university degree and the presence of smoking habit of family members, the rate of adenotonsillectomy operations is higher than in the other SES groups.

The effects of sevoflurane and isoflurane in nasal septal surgery.

OBJECTIVES: The objective of this study was to evaluate the effect of sevoflurane and isoflurane in nasal septal surgery in terms of intraoperative blood loss, operation time, recovery time, and especially postoperative pain. METHODS: A total of 90 elective nasal septal surgery patients between the ages of 19 and 58 years (mean age, 32.95 years) who were classified as American Society of Anesthesiologists physical status I and II between January 2011 and June 2012 were included the study. Patients were assigned by randomization to receive 1 of 2 anesthetic agents (n = 45 patients each group): balanced general anesthesia with sevoflurane or isoflurane group. In all patients, the amount of intraoperative blood loss, the duration of operation, recovery time, and postoperative pain scores were recorded. RESULTS: The amount of perioperative bleeding in sevoflurane cases was less than that in the isoflurane group, and the difference was statistically significant (P < 0.05). Similarly, mean operative time was shorter in the sevoflurane group, and again the difference between 2 groups was statistically significant (P < 0.05). No statistically significant differences were observed between the 2 groups with respect to the anesthesia duration, extubation time, recovery time, and postoperative pain scores (P > 0.05). CONCLUSIONS: Sevoflurane, which is one of the volatile anesthetics, leads to a lower amount of intraoperative bleeding, postoperative pain, and operation time than isoflurane during nasal septal surgery.

Comparison of nasal packs with transseptal suturing after nasal septal surgery.

OBJECTIVES: To investigate the effects of transseptal suturing against two different types of nasal packs with respect to pain, operative time and postoperative complications following nasal septal surgery. PATIENTS AND METHODS: One hundred and fifty patients (aged 18-61 years) scheduled for nasal septal surgery were included. Following surgery, three types of nasal packing systems were utilized: (1) transseptal suturing (Group A: 50 patients); (2) internal nasal splint (Group B: 50 patients); (3) a Merocel standard 8-cm nasal dressing without airway (Group C: 50 patients) to the patients. Postoperative pain, operation time, septal perforation and synechiae formation were evaluated. RESULTS: The difference between mean operative time of groups B and C was not statistically significant (p>0.05). The difference between operative time of the two groups against group A was statistically significant (p<0.05). The mean postoperative pain scores were 2.8 ± 1.2 (median 2) in group A, 6.1 ± 1.3 (median 6) in group B, and 7.3 ± 1.2 (median 7) in group C 1h to 48 h post-surgery. Merocel and internal nasal splint tampons were found to be significantly more painful than transseptal suturing during 48 h (p<0.05). There was no statistically significant difference in terms of infection, hematoma, synechiae formation or perforation between the groups (p>0.05). CONCLUSION: The use of transseptal suturing technique is a useful alternative to packing, with only minor increase in operating time.

The impact of unilateral concha bullosa on mucociliary activity: an assessment by rhinoscintigraphy.

BACKGROUND: In this study, we aimed to compare the differences of nasal mucociliary clearance rate (NMCR) by rhinoscintigraphic examination between the nasal cavities of patients with unilateral concha bullosa (CB). METHODS: The study group consisted of 43 patients (18 men and 25 women), with unilateral CB ranging in age from 20 to 58 years (mean age, 33.5 ± 9.51 years). The nasal mucociliary clearance was described as the velocity (mm/min) of nasal mucociliary transport of the technetium 99m-macroaggragated albumin droplet. Rhinoscintigraphy was performed on each nasal cavity with 2-day intervals in the patients. The mucociliary clearance rates obtained in the unaffected side were accepted as control values. RESULTS: The average values for mucociliary clearance rate were 2.29 ± 0.42 mm/min in the CB side of the nasal cavity, and 3.19 ± 0.52 mm/min in the other side of the nasal cavity. Mucociliary transport took a longer time in the CB side of the nasal cavity than in the other side of the nasal cavity, which was found to be statistically significant (p < 0.001). CONCLUSION: Our study showed that unilateral CB might impair NMCR in the ipsilateral side of the nasal cavity. Thus surgical intervention to reduce the middle concha volume may result in a better mucociliary clearance with possibly a less chance of development of chronic sinus diseases and nasal pathologies. Obviously, it is of utmost importance that new studies be planned with larger patient series to better understand nasal mucociliary transport mechanism and CB relationships.

The effects of lycopene on cisplatin-induced ototoxicity.

To investigate the potential preventive effect of lycopene in cisplatin-related ototoxicity. Thirty-five healthy 3-3.5-month adult female Sprague-Dawley rats were randomly divided into three groups and treated as follows: Group 1 (n = 10), received no cisplatin or lycopene. Both group 2 (n = 10) and; Group 3 (n = 15) received a single dose of 12 mg/kg cisplatin intraperitoneally. Lycopene was administered via gavage feeding in group 2 for 15 days. Prior to any medication administration, the baseline distortion product emissions were obtained in three groups. The animals were tested again at 15th day. The resulting distortion product otoacoustic emissions (DPOAE) were evaluated at 1.5, 2, 3, 4, 5, 6, 7, 8, 10, and 12 kHz. On day 0, prior to any medications, the initial DPOAEs measurement results gave similar values in the three groups (p > 0.05). In group 2 and 3, statistically significant differences were recorded for all frequencies between day 0 and day 15 values (p < 0.05). Lycopene group demonstrated significantly higher DP-grams except for 1.5 kHz frequency when compared to cisplatin group (p < 0.05). There was a statistically significant difference in basal and mid turn external ciliated cells number (p < 0.05), but there was no statistically significant difference in apical turn between three groups (p > 0.05). Stria vascularis changes were statistically significant between the groups, and the median score for stria vascularis injury was significantly greater in group 3 than in group 2 (p < 0.05). The median scores for spiral ganglion cells changes were significantly greater in group 3 than in group 2 (p < 0.05). The analyses of the results revealed statistically significant differences between two groups (p < 0.05), suggesting lycopene's possible protective effect against cisplatin ototoxicity. The present study revealed that administration of lycopene may demonstrate a protective role against cisplatin-induced ototoxicity in rats.

Comparison of three techniques in adult tonsillectomy.

This study aimed at investigating the thermal welding (TW), classic dissection (CD) and bipolar cautery dissection (BCD) tonsillectomy in adults. 120 adults with chronic tonsillitis, who were scheduled for elective tonsillectomy between January 2009 and April 2012, were randomized to tonsillectomy with the TW, CD and BCD methods. Operation time, intraoperative blood loss, post-operative haemorrhage rate and especially post-operative pain were evaluated. The difference between operative time of the TW and BCD groups against CD group was statistically significant (p < 0.05). The difference between intraoperative blood loss of the TW and BCD groups against CD group was statistically significant (p < 0.05). No significant difference was found in the incidence of post-tonsillectomy haemorrhage between the three groups (p > 0.05). The difference between post-operative pain score between CD and TW was not statistically significant (p > 0.05). The difference between post-operative pain score of the two groups against BCD group was statistically significant (p < 0.05). TW technique is a relatively safe and reliable method with significantly less post-operative morbidity than CD and BCD tonsillectomy. When we compared TW with the CD and BCD tonsillectomy, we found significant reduction in the surgical time and the intraoperative blood loss without any increase in the post-operative pain.

Comparison of two different adenoidectomy techniques with special emphasize on postoperative nasal mucociliary clearance rates: coblation technique vs. cold curettage.

OBJECTIVE: To compare the cold curettage and coblation techniques for pediatric adenoidectomy by means of intraoperative blood loss, operation time, and pre- and postoperative nasal mucociliary clearance rates. METHODS: The study included 60 consecutive patients undergoing adenoidectomy operation upon the diagnosis of adenoid hypertrophy ranging in age 4-8 years (mean age: 5.82±1.25 years). Two groups consist of 30 patients. The two different adenoidectomy techniques were compared by means of intraoperative blood loss, operation duration, preoperative and postoperative nasal mucociliary clearance rate (NMCR) values. The nasal mucociliary clearance was described as the velocity (mm/min) of nasal mucociliary transport of the 99mTc-MAA droplet. Rhinoscintigraphy was performed on right nasal cavity before and after the surgery in all the patients. RESULTS: The average NMCR of the curettage adenoidectomy and coblation adenoidectomy groups before surgery was 1.33±0.20mm/min and 1.35±0.19mm/min, respectively. There was no statistically significant difference between the two groups before surgery (p=0.615). In the six weeks of the post-operative period, the average NMCR of the curettage adenoidectomy and coblation adenoidectomy groups were 1.80±0.21mm/min and 2.06±0.31mm/min, respectively. The NMCR differences of preoperative and postoperative periods in coblation adenoidectomy group were higher than curettage adenoidectomy group (p<0.001). Mean operative time was 20.5±5.5min for coblation adenoidectomy group (n: 30), and 13.5±5.2min for curettage adenoidectomy group (n: 30). Mean intraoperative blood loss was 5.25±3.5ml for coblation adenoidectomy group, and 21.55±8.2ml for curettage adenoidectomy group. The difference between mean intraoperative blood loss and operative time of two groups were statistically significant (p<0.05). CONCLUSION: The coblation technique provides a less bleeding surgical bed but a longer operation time when compared to curettage technique. Also the better NMCR values that we have found with coblation adenoidectomy may be translated to a more rapid recovery of ciliary function of the surface mucosa.

Ototoxicity of different concentrations povidone-iodine solution applied to the middle ear cavity of rats.

To investigate the ototoxic effects of different concentrations of povidone-iodine solutions applied to the middle ear cavity of rats using distortion product otoacoustic emissions. 24 healthy 3-3.5-month-old adult female Sprague-Dawley rats were randomly divided into three groups. The group A (n = 8 ears) received 5 % povidone-iodine solution to the right ear, the group B (n = 8 ears) received 7.5 % povidone-iodine solution to the right ear and the group C (n = 8 ears) received 10 % povidone-iodine solution to the right ear. All animals received saline solution to the left ear as a control (n = 24 ears). The animals were tested before, 1 and 10 days after solutions administration to the middle ear. The resulting distortion product otoacoustic emissions were evaluated at 1.5, 2, 3, 4, 5, 6, 7, 8, 10 and 12 kHz. Statistically significant reductions in DP-gram amplitudes were noted at high frequencies (7, 8, 10, 12 kHz) in the group A at day 1 but this effect return at day 10. In group B and group C statistically significant differences were recorded for low and high frequencies (1.5, 2, 7, 8, 10, 12 kHz) according to the control group at day 1 and 10. 7.5 and 10 % povidone-iodine showed a significant ototoxic effect on day 1 and 10. But this toxic effect could not be elicited in 5 % povidone-iodine group on day 10. The present study revealed that commercially available high concentration povidone-iodine solution may cause significant ototoxic effects when applied topically through a perforated ear drum in rats. Based on results of this experiment, high concentration povidone-iodine solutions should not be used for preoperative surgical site cleansing for otologic surgery.

Protective role of bilberry extract against Cisplatin induced ototoxicity in rats.

To investigate the potential preventive effect of bilberry extract in cisplatin-induced ototoxicity. Thirty-five 3-3.5-month healthy adult female Sprague-Dawley rats were randomly divided into three groups and treated as follows: Both, group 1 (n = 10) and group 2 (n = 15) subjects received a single dose of 12 mg/kg cisplatin intraperitoneally; while in group 2, bilberry extract was also administered via gavage feeding for 15 days. Group 3 (n = 10), received no cisplatin or bilberry extract. Baseline distortion product otoacoustic emissions testing were performed in all subjects prior to administration of any medication. The test was repeated at 15th day following administration of any medication. The distortion product otoacoustic emissions were evaluated at 1.5, 2, 3, 4, 5, 6, 7, 8, 10 and 12 kHz. Histopathological changes in the cochlea of rats were observed by light microscopy. There was no statistically significant difference in apical turn between three groups but there was a statistically significant difference in basal and mid turn external ciliated cells number. Stria vascularis changes were statistically significant between three groups. The median score for stria vascularis injury and spiral ganglion cells changes were significantly greater in group 1 than in group 2. The initial distortion product otoacoustic emissions measurement results gave similar statistically insignificant values in the three groups (p > 0.05). In contrast to initial measurements statistically significant differences were recorded between day 0 and 15 otoacoustic thresholds (p < 0.05). Bilberry extract group had a significantly higher DP-gram except for 1.5 and 2 kHz frequencies when compared to cisplatin group. The analyses of the results revealed statistically significant differences between two groups (p < 0.05), suggesting that bilberry extract had shown a protective effect against cisplatin ototoxicity. The results of our study revealed that treatment with bilberry extract affords significant protection to the cochlea from cisplatin toxicity and thus, oral experimental dose of bilberry extract administration may have a protective effect against cisplatin ototoxicity in rats.

The evaluation of nasal mucociliary activity after septoplasty and external septorhinoplasty.

The aim of this study was to evaluate the nasal mucociliary activity after septoplasty (SP) and external septorhinoplasty (eSRP). Twenty patients who had SP operation (group 1) and 15 patients who had eSRP operation (group 2) were enrolled in the study. On each case, mucociliary clearance (MCC) measurement was performed by saccharine test before surgery, and on the first and third months of postoperative period. Saccharine clearance time (SCT) of 28 healthy volunteers were measured to establish control values. The mean SCT in control group was 8.79 ± 2.63 min, in group 1 patients before surgery was 14.03 ± 1.68 min, in group 2 patients before surgery was 14.34 ± 1.70 min. The preoperative SCT values of the group 1 and group 2 were significantly higher than healthy controls (p < 0.05). While there were statistically significant differences between preoperative and postoperative third month SCT values of group 1 patients, and postoperative first month and postoperative third month SCT values of group 1 patients (p < 0.05), there was no statistically significant difference between preoperative and postoperative first and third months SCT values of group 2 patients. Nasal septal deviation impairs the nasal mucociliary activity. Septoplasty operation positively affects the MCC mechanism. On the other hand, we observed no significant effect of eSRP operation on mucociliary activity on the first and third months of postoperative period as compared with preoperative.

Comparison of ropivacaine, bupivacaine and lidocaine in the management of post-tonsillectomy pain.

OBJECTIVES: To compare the efficacy of preoperative peritonsillar injection of ropivacaine, bupivacaine and lidocaine for pediatric tonsillectomy. PATIENTS AND METHODS: Between March 2009 and April 2012, 120 patients (66 males and 54 females) between ages of 4 and 13 years were included to the study. After informed consent was obtained from the parents, the patients were randomized into four groups. In Group 1 (31 patients, mean age 8.40 ± 4.05 years) received topical lidocaine hydrochloride with 1:100,000 epinephrine was applied to surgical bed following tonsillectomy. Group 2 (29 patients, mean age 8.15 ± 4.20 years) and group 3 (31 patients, mean age 7.75 ± 3.95 years) were administered 0.25% bupivacaine hydrochloride with 1:200,000 epinephrine and 0.5% ropivacaine respectively. In Group 4 (29 patients, mean age 8.15 ± 4.20 years) topical 0.9% saline was used. The operation time, postoperative pain, amount of intraoperative blood loss, postoperative hemorrhage and complications were assessed. The intensity of pain was scored on a visual analogue scale. The patients were followed up for 3 weeks after surgery. RESULTS: The difference between mean operative time of the three groups against saline injected group was statistically significant (p<0.001). The difference between mean intraoperative blood loss of the lidocaine group against three groups was statistically significant (p<0.001). None of the patients in four groups experienced primary and secondary hemorrhage. The difference between mean pain score between ropovacaine and bupivacaine groups was not statistically significant (p>0.001). The difference between mean pain score of the two groups against lidocaine and saline groups was statistically significant (p<0.001). CONCLUSION: Ropivacaine infiltration is as effective as bupivacaine for post-tonsillectomy pain management in children. In view of potential side effects of bupivacaine-epinephrin combination, ropivacaine is a safer choice, for post-tonsillectomy pain relief.