Publications (6) View all
-
Article: Coblation adenotonsillectomy in children.
[show abstract] [hide abstract]
ABSTRACT: Objective: To determine re-admission rate for post-tonsillectomy pain; the primary and secondary post-tonsillectomy bleeding rate; the percentage requiring control of post-tonsillectomy bleeding in children undergoing coblation tonsillectomy. Study Design: A descriptive study. Place and Duration of Study: Royal Hospital for Sick Children (Yorkhill Hospital) between 2004 and 2006. Methodology: All patients who underwent tonsillectomy with or without adenoidectomy by coblation technique. Patients were identified from operation theatre log book and electronic data base of theatre activity. The hospital case notes were reviewed retrospectively to collect data, regarding demographics, indication and type of surgery, grade of operating surgeon, duration of hospital stay, re-attendance and re-admission, and management of complications. Results: A total of 106 children; males (n = 53, 50%), females (n = 53, 50%) with a mean age 6.3 years underwent surgery using coblation technique. Thirty-one percent had a tonsillectomy while 69% underwent an adenotonsillectomy. Of these, 48% had history of recurrent tonsillitis, 43% had obstructive sleep apnoea and 9% suffered predominantly from obstructive symptoms. Eighty-two percent of patients were discharged on the first postoperative day. Only one patient had primary bleeding requiring re-operation. After discharge, 7 patients (6.7%) were re-admitted with secondary bleeding, 3 (2.8%) of whom were taken back to theatre to control the bleeding under general anaesthesia. Conclusion: Coblation tonsillectomy is a useful technique in having a low primary and secondary bleeding rates in children undergoing tonsillectomy and adenotonsillectomy.Journal of the College of Physicians and Surgeons--Pakistan : JCPSP. 09/2012; 22(9):579-81. -
Article: Quality of life after surgery for Graves' disease: comparison of those having surgery intended to preserve thyroid function with those having ablative surgery.
[show abstract] [hide abstract]
ABSTRACT: Postoperative quality of life (QoL) after surgery for Graves' disease is not well documented, and the effect of different surgical operations has not been compared. This study examines the impact on QoL of a shift in policy from operations intended to preserve thyroid function (PF) to those ablating thyroid function (AF). A cross-sectional assessment was performed on patients who underwent surgery for Graves' disease between 1986 and 2008 in a tertiary endocrine surgical unit. Patients completed the Short Form 36 (SF-36) questionnaire by post. SF-36 scores, including the physical and mental component summaries, were compared with the general population and by operative intent (AF vs. PF). Statistical analyses were performed using SPSS 16.0. Of 150 patients, 3 had died of unrelated causes and 14 were not contactable. In the remaining 133 patients, the median age at time of assessment was 46 years (interquartile range 42-50) and 43 years (interquartile range 33-47) in the PF and AF groups, respectively. From these patients, 87 questionnaires (65.4% response rate) were completed with an item completion rate of 99.3%. The median follow-up was 18.4 years for PF and 7.9 years for AF surgery. Of 87 respondents, 38 (43.7%) underwent PF and 49 (56.3%) AF surgery. Study participants reported lower scores across all SF-36 subscales than British norms (p<0.05). Comparisons on operative intent showed no significant difference in long-term QoL (p>0.05). The shift to ablative surgery simplifies postoperative management with no adverse effect on QoL, justifying this practice from a patient perspective.Thyroid: official journal of the American Thyroid Association 03/2012; 22(5):494-500. · 2.60 Impact Factor -
Article: Retrospective review of three antiemetic regimens versus no therapy in the prevention of postoperative and vomiting following adenotonsillar surgery.
[show abstract] [hide abstract]
ABSTRACT: To study the effect of intraoperative ondansetron and dexamethasone on postoperative vomiting in children undergoing tonsillectomy, adenotonsillectomy, or adenoidectomy. Retrospective chart review. Academic tertiary care referral centre in the west of Scotland. A retrospective chart review was conducted on 432 children admitted to our institute between 2004 and 2006. Of these, 285 (66%) patients underwent a tonsillectomy, 50 (11.6%) an adenotonsillectomy, and 97 (22.4%) an adenoidectomy. There was an equal gender distribution, with a mean age of 7.4 years (interquartile range 4.6-10.0). Patients were divided into four groups: group 1 received ondansetron plus dexamethasone (n = 64, 14.7%), group 2 received ondansetron only (n = 189, 43.6%), group 3 received dexamethasone only (n = 17, 3.9%), and group 4 did not receive ondansetron or dexamethasone (n = 162, 37.4%). Overall, 98 (22.7%) patients experienced postoperative vomiting (5 at the time of recovery and 93 on the ward). Patients in group 1 had a significantly lower incidence of postoperative vomiting than those in group 2 (10.9% vs 22.8%, p = .04) and group 4 (10.9% vs 27.2%, p < .01). The incidence of postoperative vomiting was also lower in group 1 than in group 3, but this did not reach statistical significance (10.9% vs 23.5%, p = .18). The combined intraoperative use of ondansetron and dexamethasone appears to be superior to no antiemetic or ondansetron alone in reducing the incidence of vomiting in children undergoing adenotonsillar surgery.Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale 02/2012; 41(1):35-40. · 0.71 Impact Factor -
Article: Revision nasal surgery after septoplasty: trainees versus trainers.
[show abstract] [hide abstract]
ABSTRACT: Otolaryngology trainees are expected to be able to successfully perform septoplasty early in their career. An important parameter to assess the success of an operation is to look at the revision surgery rate. This study aimed to investigate the revision nasal surgery rate after septoplasty based on the grade of the primary surgeon. Retrospective review of hospital records of all patients who underwent septoplasty with or without inferior turbinate reduction over 12 years (1998-2010) in a tertiary referral centre in North-East Scotland. Patients were identified from theatre log books and were excluded if they underwent any other simultaneous nasal procedure. Data were collected on demographics, type of primary and revision surgery, grade of surgeon and duration of hospital stay. 2,168 eligible patients (70 % male, 30 % female) with a mean age of 39 years were investigated. Surgeons were divided into four categories: junior trainee (Group A), senior trainee (Group B), staff grade (Group C) and consultant (Group D). There were 753, 644, 298 and 473 patients in Groups A, B, C and D, respectively. The revision rate in Group A was 4.4 % compared to 3.2 % for Group D and this difference was not statistically significant. For their operation, patients in Group A stayed for 1.54 nights compared to 1.47 nights in Group D, the difference being insignificant. Grade of the surgeon does not appear to strongly affect the need for revision nasal surgery and our patients do not appear to be disadvantaged if operated on by trainees.Archives of Oto-Rhino-Laryngology 03/2013; · 1.29 Impact Factor -
Article: Quality of life after surgery for Graves' disease.
[show abstract] [hide abstract]
ABSTRACT: Background: Postoperative quality of life (QoL) following surgery for Graves' disease is not well documented and the effect of different surgical operations has not been compared. This study examines the impact of a shift in policy from operations intended to preserve thyroid function (PF) to those ablating function (AF) on QoL. Methods: A cross-sectional assessment was performed on patients who underwent surgery for Graves' disease between 1986 and 2008 in a tertiary endocrine surgical unit. Patients completed the Short Form 36 (SF-36) questionnaire by post. SF-36 scores, including the physical (PCS) and mental component summaries (MCS), were compared with the general population and by operative intent (AF versus PF). Statistical analyses were performed using SPSS 16.0 (Chicago, IL). Results: Of 150 patients, three had died of unrelated causes and 14 were not contactable. In the remaining 133 cases, the median age at time of assessment was 46 years (Interquartile range 42 - 50) and 43 years (Interquartile range 33 - 47) in the PF and AF groups respectively. From these patients, 87 questionnaires (65.4% response rate) were completed with an item completion rate of 99.3%. The median follow-up was 18.4 years for PF and 7.9 years for AF surgery. Of 87 respondents, 38 (43.7%) underwent PF and 49 (56.3%) AF surgery. Study participants reported lower scores across all SF-36 subscales than British norms (P < 0.05). Comparisons on operative intent showed no significant difference in long-term QoL (P > 0.05). Conclusion: The shift to ablative surgery simplifies postoperative management with no adverse effect on QoL, justifying this practice from a patient perspective. Thyroid: official journal of the American Thyroid Association 01/2012; · 2.60 Impact Factor
