Microdebrider-assisted partial tonsillectomy has gained popularity in recent years. However, no prospective long-term follow-up exists in the literature and the risk of increase in tonsillitis is still a concern. We conducted a prospective randomized controlled study to assess the short-term benefits of microdebrider-assisted partial tonsillectomy (group 1) compared to electrocautery-assisted total tonsillectomy (group 2), to monitor the durability of the improvement and watch for any change in the rate of tonsillitis. Patients with symptomatic tonsillar hyperplasia were included and underwent either technique of tonsillar surgery. Duration of operation, amount of intra-operative blood loss, immediate and late complications, postoperative pain, return to normal activity and diet, and relief of obstructive symptoms were measured. Recurrence of symptoms and change in rate of tonsillitis in group 1 were monitored. We studied 143 patients, 77 in group 1 and 66 in group 2. There was no significant difference in the surgical time (P>0.05) or postoperative bleeding (P>0.05) but more blood loss in group 1 (P<0.05) and more dehydration in group 2 (P<0.05) were encountered. All patients had complete relief of symptoms. Group 1 returned earlier to normal activity (2.19 vs. 5.71 days; P<0.05), to normal diet (5.28 vs. 8.16 days; P<0.05) and needed less frequent analgesics (2.14 vs. 6.1 days; P<0.05). More than two-thirds of group 1 and less than one-third of group 2 were pain free after day 3. Most group 1 parents (96.1%) were highly satisfied, at initial follow-up, regarding the decision to perform the surgery in contrast to group 2 parents (19.7%). No recurrence of symptoms and no increase in rate of tonsillitis were noticed among group 1 after 20 months mean follow-up (median 20.6, range 1-36.2 months). Group 1 showed short-term benefits over group 2 and maintained the resultant improvement on the long-term with no infectious drawbacks.

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SummaryTracheal intubation using direct laryngoscopy has a high failure rate when performed by untrained medical personnel. This study compares tracheal intubation following direct laryngoscopy by inexperienced medical students when initially trained by using either the GlideScope Ò , a video assisted laryngoscope, or a rigid (Macintosh) laryngoscope. Forty-two medical students with no previous experience in tracheal intubation were randomly divided into two equal groups to receive training with the GlideScope or with direct laryngoscopy. Subsequently, each medical student performed three consecutive intubations on patients with normal airways that were observed by a anaesthetist who was blinded to the training method. The rates of successful intubation were significantly higher in the Glidescope group after the first (48%), second (62%), and third (81%) intubations compared with the Macintosh group (14%, 14% and 33%; p = 0.043, 0.004 and 0.004, respectively). The mean (SD) times for the first, second, and third successful tracheal intubations were significantly shorter in the Glidescope group (59.3 (4.4) s, 56.6 (7.1) s and 50.1 (4.0) s) than the Macintosh group (70.7 (7.5) s, 73.7 (7.3) s and 67.6 (2.0) s; p = 0.006, 0.003 and 0.0001, respectively). Training with a video-assisted device such as the GlideScope improves the success rate and time for tracheal intubation in patients with normal airways when this is performed by inexperienced individuals following a short training programme.

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