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Heward E, Rocke J, McNally G, Thompson G, Oladokun D, Timms S, Abbas JR, Chu MMH, Akbar S, Dobbs S, Chudek D, Jaiswal I, Vora D, Harrison A, Oremule B, Sarwar S, Menon SS, Advani R, Daniels J, Ellis S, Abdelaziz M, Husain P, Anmolsingh R, Venugopal A, Beena M, Sheik-Ali S, Saeed H, Shenton C, Ghosh S, Khwaja S, Kumar N. The post-operative tonsillectomy (POPT) study: A multi-centre prospective paediatric cohort study. Clin Otolaryngol 2024; 49:176-184. [PMID: 37915294 DOI: 10.1111/coa.14110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 06/01/2023] [Accepted: 09/23/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVES Tonsillectomy is the most common operation performed by otolaryngologists in the UK, despite this we have a poor understanding of the post-operative recovery. We aimed to investigate post-operative bleeding and pain following paediatric tonsillectomy using a patient diary. DESIGN Prospective observational cohort study. SETTING Multi-centre study involving 12 secondary and tertiary otolaryngology units across the North of England. Patients were recruited from 1st March 2020 to 30th June 2022. Multilevel ordered logistic regression model statistics were performed. PARTICIPANTS Children (≥4 years, ≤16 years) undergoing tonsillectomy (with or without adenoidectomy) for benign pathology. MAIN OUTCOME MEASURES Frequency and severity of post-operative bleeding. Intensity and pattern of post-operative pain. RESULTS In total 297 children were recruited, with 91 (30.6%) diaries eligible for analysis. Post-operative bleeding occurred in 44% of children. Most frequently blood in the saliva was reported (82.9%). Increasing age significantly increased bleeding odds by 17% per year (p = .001). Bleeding frequency decreased with higher surgeon grade (p = .003) and when performing intracapsular coblation tonsillectomy (p = .02) compared with other techniques. Lower age and intracapsular coblation tonsillectomy, against other techniques, significantly reduced rates of pain post-operatively (p < .0001 and p = .0008). CONCLUSION A high level of low-level post-operative bleeding was observed. Pain scores remained high for 5 days post-operatively then gradually reduce to normal by day 13. Intracapsular coblation tonsillectomy appears to be superior to all other techniques in terms of reducing post-operative bleeding and pain. These findings should be used to guide patients in the consent process to inform them of the expected nature of post-surgical recovery.
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Affiliation(s)
- Elliot Heward
- Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
| | - John Rocke
- Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
| | - George McNally
- Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
| | | | - Dare Oladokun
- York and Scarborough Teaching Hospitals NHS Foundation Trust, York, UK
| | | | | | - Michael M H Chu
- Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
| | - Sarah Akbar
- Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
| | - Sian Dobbs
- Northern Care Alliance NHS Foundation Trust, Salford, UK
| | - Dorota Chudek
- Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
| | - Ishank Jaiswal
- Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
| | - Devan Vora
- East Lancashire Hospitals NHS Trust, Blackburn, UK
| | - Anna Harrison
- Manchester University NHS Foundation Trust, Manchester, UK
| | | | - Safdar Sarwar
- Manchester University NHS Foundation Trust, Manchester, UK
| | | | - Rajeev Advani
- Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
| | | | - Sarah Ellis
- Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne, UK
| | - Mohammed Abdelaziz
- Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne, UK
| | | | - Rajesh Anmolsingh
- Manchester University NHS Foundation Trust, Manchester, UK
- Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | | | - Meera Beena
- Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
| | - Shirwa Sheik-Ali
- Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne, UK
| | - Haroon Saeed
- Manchester University NHS Foundation Trust, Manchester, UK
| | - Catriona Shenton
- Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
| | - Samit Ghosh
- Northern Care Alliance NHS Foundation Trust, Salford, UK
| | - Sadie Khwaja
- Manchester University NHS Foundation Trust, Manchester, UK
| | - Nirmal Kumar
- Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
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Menon SS, Tandon P, Ramaswamy B, Pujary K. A Retrospective Study to Assess the Role of Using Fine Needle Aspiration Cytology and Frozen Section in the Diagnosis of Thyroid Swelling. Indian J Otolaryngol Head Neck Surg 2018; 70:471-476. [PMID: 30464900 DOI: 10.1007/s12070-018-1503-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 09/24/2018] [Indexed: 11/25/2022] Open
Abstract
The most cost-effective test is fine needle aspiration cytology (FNAC). Many surgeons use intraoperative frozen section to confirm the FNAC findings and to guide the extent of thyroid surgery. Though it is a valuable tool in the diagnosis of the thyroid lesion and determining the extent of thyroid surgery, still in certain cases diagnosis can be incorrect or inconclusive, so histopathology of the excised specimen remains the most reliable test. The purpose of this study will be to compare the result attained by FNAC and frozen section of the thyroid to the final histopathological diagnosis, in order to establish their role in thyroid surgery today. A retrospective study with a total of 140 patients who underwent thyroid surgery at the ENT department, of a tertiary hospital in coastal Karnataka. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated for FNAC and frozen section. The sensitivity, specificity, positive predictive rate, and negative predictive rate of frozen section was found to be 66.7%, 88.4%,76.6%, 82.4% respectively for detecting malignancy. This was found to be higher than the results of FNAC for the same which were 64.4%, 77.8%, 64.4%, 77.8% respectively. As the sensitivity of FNAC is similar to frozen section in detecting malignant cases, FNAC is a good tool for screening the patient for determining malignancy in thyroid, but frozen section is more specific in confirming the malignancy.
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Affiliation(s)
- Shalini S Menon
- 1Department of ENT-Head and Neck Surgery, Kasturba Medical College, Manipal, Karnataka India
| | | | - Balakrishnan Ramaswamy
- 1Department of ENT-Head and Neck Surgery, Kasturba Medical College, Manipal, Karnataka India
| | - Kailesh Pujary
- 3Department of ENT, Kasturba Medical College, Manipal, Karnataka India
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Menon SS, Nayak DR, Monappa V, Mathew N. Inflammatory myofibroblastic tumour mimicking a vocal cord polyp. BMJ Case Rep 2018; 2018:bcr-2018-226128. [PMID: 30077984 DOI: 10.1136/bcr-2018-226128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Shalini S Menon
- ENT-Head and Neck Surgery, Kasturba Medical College, Manipal, Karnataka, India
| | - Dipak Ranjan Nayak
- Otolaryngology-Head and Neck Surgery, Kasturba Medical College, Manipal, Karnataka, India
| | - Vidya Monappa
- Pathology, Manipal University Kasturba Medical College Manipal, Manipal, Karnataka, India
| | - Nikhil Mathew
- ENT-Head and Neck Surgery, Manipal University Kasturba Medical College Manipal, Manipal, Karnataka, India
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Abstract
Neuroblastic tumours are common in childhood and adrenal glands are the most common site. Head and neck ganglioneuroblastomas are extremely rare and nose is a very uncommon site for a ganglioneuroblastoma. The management of this primitive sympathogonic tumour may vary depending on the age of the patient and stage of the tumour. We present a middle-aged man with a ganglioneuroblastoma of skull base, management of this tumour and a review of literature.
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Affiliation(s)
- Balakrishnan Ramaswamy
- Professor and Head of Department, Department of Otolaryngology-Head and Neck Surgery, Kasturba Medical College, Manipal University , Manipal, India
| | - Ajay M Bhandarkar
- Assistant Professor, Department of Otolaryngology-Head and Neck Surgery, Kasturba Medical College, Manipal University , Manipal, India
| | - Shalini S Menon
- Assistant Professor, Department of Otolaryngology-Head and Neck Surgery, Kasturba Medical College, Manipal University , Manipal, India
| | - Ashish Chandra Agarwal
- Senior Resident, Department of Otolaryngology-Head and Neck Surgery, Kasturba Medical College, Manipal University , Manipal, India
| | - Suraj S Nair
- Junior Resident, Department of Otolaryngology-Head and Neck Surgery, Kasturba Medical College, Manipal University , Manipal, India
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Sengupta S, Deodhar L, Kapoor H, Badrinath S, Menon SS. Spectrum of antibiogram against pathogens related to respiratory tract infections with a special reference to ceftibuten: a multicentric study. J Indian Med Assoc 2000; 98:196-7. [PMID: 11016192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
In a multicentric study at several leading hospitals of this country, microbiological assessment was carried out in 500 specimens from patients suffering from respiratory tract infections (RTIs; both upper and lower) for a period of 6 months from January, 1999 to June, 1999. The antibiotic sensitivity study was done in 201 isolates from 500 different specimens of throat swab, postpharyngeal swab, sinusitis drainage fluid, sputum, broncho-alveolar lavage (BL), etc. Ceftibuten, an orally active third generation cephalosporin showed encouraging results when compared with seven other selected antibiotics used for RTI. The majority of the patients with acute or chronic RTIs showed an excellent in vitro response to ceftibuten in the analysis of the isolates. Seventy to ninety per cent of the isolated respiratory pathogens were found to be sensitive to ceftibuten in vitro; which offers a promising alternative to other antibiotics included in this study.
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Thomas J, Pandhi RK, Oberoi C, Bandopadhyay D, Rajendran SC, Menon SS, Marquis S. A multicentric trial of loratadine and cetirizine in urticaria. Indian J Dermatol Venereol Leprol 1998; 64:12-16. [PMID: 20921702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Two hundred and ten patients with chronic urticaria were divided into two groups; one group was treated with Loratadine 10mg daily while the other with cetirizine 10mg daily. The total duration of treatment was four weeks. Pretreatment and post-treatment evaluations were made. It was noticed that loratadine was superior to cetirizine in terms of a rapid onset of actions, overall clinical efficacy and minimal side effects.
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Affiliation(s)
- J Thomas
- Skin Specialist 2, West Mada Church Road, Royapuram, Madras 600013, India
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