Variant of the Technique for Laryngeal Microsurgery in Cases of Difficult Laryngoscopy

Abstract Introduction Low exposure of the larynx can make laryngeal microsurgery difficult or even impossible. The application of rigid and contact endoscopy enabled oblique and retrograde angled visualization, allowing transoperative staging with greater reach of the anatomical areas. However, there is difficulty or even impossibility of performing the surgical act, due to the incompatibility of the angled path with the straight surgical tools. Objective To demonstrate the efficiency of the variant of the technique for laryngeal microsurgery in cases of difficult laryngoscopy and to analyze the new surgical instruments specific to the endoscopic procedure. Methods This is a cross-sectional retrospective study, based on the analysis of 30 medical records of patients treated surgically at a philanthropic hospital in the state of Sergipe, Brazil, between the years of 2014 and 2015. Results The technical variant used 30- and 70-degree endoscopes that provided complete oblique view of the endolarynx. The association of angled instruments (forceps, suction pumps, retractors and scissors) enabled the execution of the surgical procedures. Conclusion The association of rigid endoscopy with angled instruments promoted full visualization of the surgical lesion and operative resolution. (AU)

Variant of the Technique for Laryngeal Microsurgery in Cases of Difficult Laryngoscopy.

Introduction Low exposure of the larynx can make laryngeal microsurgery difficult or even impossible. The application of rigid and contact endoscopy enabled oblique and retrograde angled visualization, allowing transoperative staging with greater reach of the anatomical areas. However, there is difficulty or even impossibility of performing the surgical act, due to the incompatibility of the angled path with the straight surgical tools. Objective To demonstrate the efficiency of the variant of the technique for laryngeal microsurgery in cases of difficult laryngoscopy and to analyze the new surgical instruments specific to the endoscopic procedure. Methods This is a cross-sectional retrospective study, based on the analysis of 30 medical records of patients treated surgically at a philanthropic hospital in the state of Sergipe, Brazil, between the years of 2014 and 2015. Results The technical variant used 30- and 70-degree endoscopes that provided complete oblique view of the endolarynx. The association of angled instruments (forceps, suction pumps, retractors and scissors) enabled the execution of the surgical procedures. Conclusion The association of rigid endoscopy with angled instruments promoted full visualization of the surgical lesion and operative resolution.

Study of weight and height development in children after adenotonsillectomy.

UNLABELLED: The daily clinical observation of weight-height growth delays in children with obstructive hypertrophy of the pharyngeal and palatine tonsils is a workaday practice in pediatric otorhinolaryngology, and the surgical correction of this condition, when properly done in time, through adenotonsillectomy, can lead to a "catch up growth". AIM: To investigate the real weight-height gain present in this population when they are surgically treated. MATERIALS AND METHODS: Through a clinical prospective study, two groups of children carrying pharyngopalatine hypertrophy were followed up: group 1 was submitted to surgical intervention, and group 2 was not. All patients underwent standardization of anthropometrical measurements (weight and height), including their age-related percentiles, in the beginning and at the end of 06 (six) months. RESULTS: While group 1 increased its height average in relation to the initial average in 6.66 cm, the control group increased its average in 1.9 cm (p=0.0004). In relation to weight, group 1 increased 2150 g in average, while group 2 presented an average increase of 690 g (p=0.0010). CONCLUSIONS: The children that underwent adenotonsillectomy acquired a higher weight-height growth potential in relation to those children who were not operated.

Estudo das medidas pôndero-estaturais em crianças adenotonsilectomizadas / Study of weight and height development in children after adenotonsillectomy

A observação clínica diária do retardo de crescimento pôndero-estatural em crianças portadoras de hipertrofia obstrutiva das tonsilas faríngeas e palatinas é prática rotineira na otorrinolaringologia pediátrica e a correção cirúrgica dessa condição, em tempo hábil, através da adenotonsilectomia permite a retomada desse crescimento ("catch up growth"). OBJETIVO: Investigar o real ganho pôndero-estatural presente nessa população quando tratadas cirurgicamente. MATERIAL E MÉTODO: Através de um estudo clínico prospectivo, acompanhou-se durante 6 (seis) meses dois grupos de crianças portadoras de hipertrofia tonsilar faringopalatina, sendo o grupo 1 submetido à intervenção cirúrgica e o grupo 2, não. Todos os pacientes passaram pela aferição das medidas antropométricas (peso e altura), incluindo seus percentis para idade, no início e ao fim dos 6 (seis) meses. RESULTADOS: Enquanto o grupo 1 aumentou sua média final de altura em relação à média inicial em 6,66cm, o grupo controle aumentou sua média em 1,9cm (p=0,0004). Em relação ao peso, o grupo 1 aumentou em média 2150g, sendo que o grupo 2 apresentou aumento médio de 690g (p=0,0010). CONCLUSÃO: As crianças submetidas à adenotonsilectomia adquirem um maior potencial de crescimento pôndero-estatural em relação às crianças que não foram tratadas cirurgicamente.

The daily clinical observation of weight-height growth delays in children with obstructive hypertrophy of the pharyngeal and palatine tonsils is a workaday practice in pediatric otorhinolaryngology, and the surgical correction of this condition, when properly done in time, through adenotonsillectomy, can lead to a "catch up growth". AIM: To investigate the real weight-height gain present in this population when they are surgically treated. MATERIALS AND METHODS: Through a clinical prospective study, two groups of children carrying pharyngopalatine hypertrophy were followed up: group 1 was submitted to surgical intervention, and group 2 was not. All patients underwent standardization of anthropometrical measurements (weight and height), including their age-related percentiles, in the beginning and at the end of 06 (six) months. RESULTS: While group 1 increased its height average in relation to the initial average in 6.66cm, the control group increased its average in 1.9cm (p=0.0004). In relation to weight, group 1 increased 2150g in average, while group 2 presented an average increase of 690g (p=0.0010). CONCLUSIONS: The children that underwent adenotonsillectomy acquired a higher weight-height growth potential in relation to those children who were not operated.