Utilization and trends in surgical instrument use in pediatric adenotonsillectomy

Walner, David L.; Mularczyk, Christopher; Sweis, Auddie M.

doi:10.1016/j.ijporl.2017.06.019

Cited by 13 publications

(18 citation statements)

References 15 publications

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“…Although numerous surgical modalities are available for paediatric adenotonsillectomy, cold knife dissection remains the preferred technique for both adenoidectomy and tonsillectomy among ENT surgeons 6 . Walner et al 1 . conducted a survey of American Society of Pediatric Otolaryngology members, and found that the preference shifted from cold dissection toward monopolar electrocautery among surgeons in the USA.…”

Section: Discussionmentioning

confidence: 99%

“…Many surgical modalities are available for adenotonsillectomy, which is one of the most commonly performed surgical procedures in paediatric populations. A recent survey conducted among members of the American Society of Pediatric Otolaryngology indicated that monopolar electrocautery was the most common surgical modality used for both tonsillectomy and adenoidectomy 1 …”

Section: Introductionmentioning

confidence: 99%

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Surgeons’ preferences and anxiety levels in paediatric adenotonsillectomy: European perspective

Kılavuz

Bayram²

2019

J. Laryngol. Otol.

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ObjectiveThis study assessed the preferences of surgeons regarding surgical modalities used for adenotonsillectomy, and determined anxiety levels related to the adenotonsillectomy procedure.MethodsA 10-question survey created by the authors was administered to 413 ENT specialists attending the 4th Congress of Otorhinolaryngology Head and Neck Surgery, held in October 2017 in Barcelona, Spain.ResultsCold knife dissection was the preferred surgical modality for both adenoidectomy and tonsillectomy. Most participants reported encountering one to five patients with post-tonsillectomy bleeding throughout their entire career. The mean anxiety levels during surgery and the 10-day post-operative period were 3.39 ± 2.14 and 4.18 ± 2.63, respectively (p < 0.05). There was a significant negative correlation between anxiety level and surgeon's experience (p < 0.05).ConclusionCold dissection is still the preferred surgical modality for adenotonsillectomy, while both suture ligation and electrocautery are used for haemostasis. Paediatric adenotonsillectomy is likely to generate anxiety in ENT surgeons, and the possibility of secondary post-tonsillectomy bleeding increases the anxiety levels of surgeons in the post-operative period.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Surgeons’ preferences and anxiety levels in paediatric adenotonsillectomy: European perspective

Kılavuz

Bayram²

2019

J. Laryngol. Otol.

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“…18 With about 500,000 tonsillectomies done annually in the United States, 17,18 otolaryngologist SP exposure is measurable. 16…”

mentioning

confidence: 99%

“…13,14 While there has been some study of the laser plume in laryngeal surgery, there are limited data regarding otolaryngologist exposure to SP. 6,16 Electrocautery is used by 57% of pediatric otolaryngologists for tonsillectomy. 18 With about 500,000 tonsillectomies done annually in the United States, 17,18 otolaryngologist SP exposure is measurable.…”

mentioning

confidence: 99%

Surgical Team Exposure to Cautery Smoke and Its Mitigation during Tonsillectomy

O’Brien

Lee

Soo

et al. 2020

Otolaryngol.--head neck surg.

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Objectives To assess the exposure of surgical personnel to known carcinogens during pediatric tonsillectomy and adenoidectomy (T&A) and compare the efficacy of surgical smoke evacuation systems during T&A. Study Design Prospective, case series. Setting Tertiary children’s hospital. Subjects and Methods The present study assessed operating room workers’ exposure to chemical compounds and aerosolized particulates generated during T&A. We also investigated the effect of 3 different smoke-controlling methods: smoke-evacuator pencil cautery (SE), cautery with suction held by an assistant (SA), and cautery without suction (NS). Results Thirty cases were included: 12 in the SE group, 9 in SA, and 9 in NS. The chemical exposure levels were lower than or similar to baseline background concentrations, with the exception of methylene chloride and acetaldehyde. Within the surgical plume, none of the chemical compounds exceeded the corresponding occupational exposure limit (OEL). The mean particulate number concentration in the breathing zone during tonsillectomy was 508 particles/cm3 for SE compared to 1661 particles/cm3 for SA and 8208 particles/cm3 for NS cases. NS was significantly different compared to the other two methods ( P = .0009). Conclusions Although the exposure levels to chemicals were considerably lower than the OELs, continuous exposures to these chemicals could cause adverse health effects to surgical personnel. These findings suggest that the use of a smoke-evacuator pencil cautery or an attentive assistant with handheld suction would reduce exposure levels to the aerosolized particles during routine T&A, compared to the use of cautery without suction.

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“…An online survey among members of American Society of Pediatric Otolaryngology showed a changing trend towards using monopolar cautery and coblation for pediatric adenotonsillectomy 13 . However, it has been shown that there is a tendency for less pain and decreased operating time in coblation group as compared to monopolar cautery 14 .…”

Section: Discussionmentioning

confidence: 99%

Peak Plasma Blade and Coblation Adenotonsillectomy: Report Of 2 Cases and Literature Review

Nagarajah¹,

Appannan²,

Lazim³

et al. 2018

MMJ

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Utilization and trends in surgical instrument use in pediatric adenotonsillectomy

Cited by 13 publications

References 15 publications

Surgeons’ preferences and anxiety levels in paediatric adenotonsillectomy: European perspective

Surgeons’ preferences and anxiety levels in paediatric adenotonsillectomy: European perspective

Surgical Team Exposure to Cautery Smoke and Its Mitigation during Tonsillectomy

Peak Plasma Blade and Coblation Adenotonsillectomy: Report Of 2 Cases and Literature Review

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