Hakura Hashimoto described Hashimoto’s Thyroiditis (HT) in 1912. In HT, there occurs formation of antibodies against the self (thyroid), which causes enlargement of the thyroid gland as a whole and decreased thyroid hormone levels. Most of the patients with HT are given medical line of management (hypo/hyperthyroidism). The indications for surgical line of management for HT are due to pressure symptoms over the trachea and oesophagus, pain in the thyroid gland and for chance of malignancy. Surgical treatment gives complete relief from pain and pressure symptoms and also prevents the risk of malignancy. To evaluate the outcome and complications of total thyroidectomy in painful (symptomatic) Hashimoto’s thyroiditis. It was a Hospital based Descriptive study conducted in tertiary care teaching hospital by ENT Department, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry from Nov 2017 to May 2019. Sample size was 30. All patients with symptomatic (painful) HT was given trail of medical therapy (steroids and NSAIDS), following repeated attempts of failed medical therapy, surgical management (total thyroidectomy) was preferred. Visual Analog Scale (VAS) was used to assess the pain grading pre and post operatively. MS Excel and SPSS trial version 20 software was used to analyze the data. The Wilcoxan Signed Ranked test was used as test of significance to identify the difference between ordinal variables. In this study, all the 30 patients had pain as the predominant symptom. Visual Analog Scale was used to grade the pain in all the patients preoperatively and 2 weeks postoperatively. All the patients had significant reduction in the pain following total thyroidectomy, when compared to pre-operative VAS grading. Total thyroidectomy is the technique of choice in surgical treatment of symptomatic Hashimoto’s thyroiditis (pain, tenderness and pressure symptoms) which warrants a radical and definitive control of the disease, without any risk of relapse and without the side effects of medical management. Moreover in longstanding cases of HT, the risk of malignant transformation is prevented due to total thyroidectomy. In experienced hands it assures total relief of compressive and painful symptoms and low incidence of/nil major complications.
OSA is clinically associated with obesity epidemic globally, and it is characterized by repetitive, partial or complete collapse of the upper airway during sleep, causing impaired gaseous exchange and sleep ABSTRACT Background: Snoring is an important social problem seen in both men and women. Snoring occurs as a result of soft tissue vibration caused by a partial upper airway collapse during sleep. The aim of the study was to analyse the morbidity and efficacy of radiofrequency thermal ablation of upper airway in patients suffering from OSA. Methods: In the Department of ENT, Pondicherry, 40 patients between the age group of 20 to 60 years who were diagnosed to have OSA were operated according to the site of obstruction including RFVTR. Various parameters including ESS, partner scores, post-op pain, bleeding, pharyngeal dryness voice change were measured accordingly on the 1st day, 45th day, 90th day and 180th day postoperatively for the efficacy of treatment and also for assessing the morbidity of treatment provided. Results: There is a statistically significant reduction in ESS scores and partner scores between pre-operative period and post operatively on the 45th day, 90th day and 180th day. Post-operative pain assessment also showed that patients who underwent RFVTR had lesser pain when compared to other surgeries like zetaplasty, LAUP, etc. Conclusions: Radiofrequency surgery should be considered as the treatment of choice for mild OSA and hypopneic snorers. The important advantage of these procedures is technically simple and minimally invasive. RFTA of the soft palate leaves the mucosa intact contrary to LAUP, hence the pain comparably less. Relatively cost effective when compared to LASER and Coblator.
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