No abstract

Background Performing nasal surgery on children has been the subject of controversy among surgeons. Specifically, the indications for and timing of septoplasty in children have been debated for the last several decades. In this study, we access the efficacy of the modified Goldman’s technique in dealing with caudal septal deviation in pediatric population suffering from severe nasal obstruction and its effect on nasal functions postoperatively. In this study, 30 pediatric patients suffering from deviated nasal septum who are candidate for septoplasty were included and underwent open septoplasty using modified Goldman’s technique. They were subjected to detailed assessment protocol preoperatively including NOSE scale, anterior rhinomanometry, and CT scans. Follow-up assessment was done at second week postoperative including anterior rhinoscopy and nasal endoscopy and 3 months postoperative including NOSE scale and anterior rhinomanometry. Results There was a statistically significant decrease of the NOSE scale severity to none in 90% of cases. Three months postoperative, all of the patients performed postoperative anterior active rhinomanometry with statistically significant decrease in the postoperative total nasal resistance values with inspiratory values ranging from 0.1 to 0.5 Pa/cm3/s with mean of 0.26 Pa/cm3/s and expiratory nasal resistance values ranging from 0.1 to 0.6 Pa/cm3/s with mean of 0.31 Pa/cm3/s. Conclusions Open septoplasty in children using the modified Goldman’s technique has enabled accurate and conservative approach for correction of nasal septal deviation especially those located in the caudal septal region. The technique also offers a significant reduction of the nasal symptoms postoperatively with marked improvement of the nasal resistance and quality of life in severe cases of deviated nasal septum.

Background Elective neck dissection with salvage laryngectomy was associated with decreased quality of life, increased operative time, and increased incidence of complications; some surgeons prefer wait-and-see observation policy. However, lymph nodes recurrence after salvage total laryngectomy during follow-up period carry very poor quality of life and very poor survival rate. The aim of this study is to investigate the risk of nodal metastases in patients undergoing salvage laryngectomy and to search for predictors of occult metastases in this group of patients. Our study included 30 patients presented with recurrent laryngeal cancer after failure of organ preservation protocol. All selected patients were without detected lymph nodes both clinically and radiologically, classified as N0 according to The TNM classification. All patients were candidate for salvage total laryngectomy and had elective neck dissection performed during surgery to detect the possible occult cervical lymph node metastasis. Results The positive nodal metastasis incidence was 14% in glottic, 29% in supraglottic, and 57% in trans-glottic tumors of all positive patients. The previously indicated results showed statistically significantly increased incidence of positive LN in the supraglottic tumor site and increased incidence of negative LN in the glottic site. Regarding the recurrence T stage in our study, lymph nodes were negative for metastasis in one patient with rT1 representing 4%, 6 patients with rT2 representing 26%, and for rT3 and rT4 were 65% and 4%, respectively. The nodal metastasis was positive in 3 patients with rT3 representing 43% and 4 patients with rT4 representing 57%. No patients with rT1 or rT2 showed nodal metastasis. Conclusions Our findings demonstrated that patients with advanced local disease at recurrence undergoing salvage total laryngectomy may benefit from an elective neck dissection.

No abstract

Background Bipolar electrocautery tonsillectomy has been the preferred technique for many otolaryngologists, yet coblation tonsillectomy is gaining popularity in the current practice. This study aims at comparing both techniques in terms of pain, bleeding, and healing. Results A total of 120 patients were randomly divided into two equal groups. Overall mean pain score associated with coblation tonsillectomy was statistically less than that caused by bipolar electrocautery throughout the follow-up period (p < 0.001). The difference in pain duration was statistically longer for the bipolar group. The incidence of postoperative hemorrhage—both reactionary and secondary—was statistically higher in the bipolar group. Coblation tonsillectomy showed statistically shorter duration of healing (p < 0.001). Conclusions Coblation tonsillectomy is associated with less pain severity and shorter pain duration, fewer bleeding incidents, and more prompt healing.