Introduction Tonsillectomy is one of the most common surgical procedures performed in the ear, nose, and throat (ENT) practice. 1 Over the last few years, different techniques for performing tonsillectomy have been proposed as attempts to lower the inherent morbidity of this surgery. 2 These techniques include blunt cold steel dissection, guillotine excision, monopolar diathermy, bipolar diathermy, laser dissection, bipolar scissor dissection and recently coblation tonsillectomy. 3 Any new tonsillectomy procedure needs to be comparable, or even better than present technique in terms of morbidity, mortality, safety of use, short learning curve, and cost-effectiveness. It should also be associated with less postoperative pain and intraoperative blood loss, and result in a more rapid return to normal diet and activity and carry a lower risk of both reactive and secondary hemorrhage. 4 There is still controversy over which is the optimal technique of tonsillectomy with the lowest morbidity rates. 5 In contrast to the majority of operative procedures associated with primary wound closure, Background and objective: Tonsillectomy with or without adenoidectomy is an operation done frequently in all otolaryngology departments all over the world. Many new surgical techniques found over the last few decades to decrease the morbidity of this surgery. This study aimed to compare intraoperative efficiency and postoperative recovery between coblation and bipolar electrocautery tonsillectomy. Methods: This prospective study was carried out on 60 patients that underwent tonsillectomy over six months from 1(st) August 2014 to 31(st) January 2015 in Rizgary Teaching Hospital, Erbil city. They patients equally divided into two groups; coblation tonsillectomy (30 patients) and bipolar electrocautery tonsillectomy (30 patients). Their age ranged between 2.5-12 years. The operative time and intraoperative blood loss were recorded for each patient and compared. The parents were given a pain diary to record the level of pain each morning for ten days. Also, they were asked to report any complication like bleeding. Results: There was no statistically significant difference in the mean operation time between the coblation group and bipolar electrocautery group (6.89 min vs. 7.83 min, P = 0.11). The mean intraoperative blood loss was statistically lower for the bipolar electrocautery group versus the coblation group (1.43 ml vs. 15.37 ml, P <0.001). There was a statistically significant difference in the daily pain scores between the two groups in which the coblation group was associated with lower mean pain score. No episodes of primary or secondary hemorrhage were recorded. Conclusion: Bipolar electrocautery tonsillectomy offers the same operative speed, less intraoperative blood loss, more postoperative pain scores when compared with coblation tonsillectomy.

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Background: decongestants whether systemic or topical nasal are widely used in the treatment of acute otitis media but there is still controversy about their effectiveness. The aim of this study is to evaluate the effectiveness of topical nasal decongestants in the treatment of acute otitis media and their role in the resolution of middle ear effusion after acute otitis media attack. Subject and Methods: The current study involved 100 children ranging from 4-12 years of both sexes with acute otitis media that need antibiotics in treatment and the study done in Rizgary teaching hospital in Erbil during the period of 2015-2017. Patients subsequently divided into two groups for treatment. Group A treated with oral co-amoxiclav, oral paracetamol, and topical nasal xylometazoline drop. Group B treated with the same antibiotic but without topical nasal xylometazoline drop. The children are followed up three months by 5 visits; in the first and second follow up visits the children are examined clinically for the improvement in the signs and symptoms of acute infection. In the last three visits the children are followed up for the resolution of middle ear effusion by otoscopic examination and tympanometry test. Pure Tone Audiometry (PTA) test done for children in the first and fifth visits, to know the hearing gain between the two visits and the difference between group A and group B. Results: The mean age + SD of the children were 7.26 + 2.4 years, ranging from 4 to 12 years. The median was 7 years. 58% of the patients were boys and 42% were girls. In the first visit, we found better results in group A that was near significant for pain relief (p=0.067). During subsequent visits we found good resolution in both groups with non significant better results in group A. Conclusions: there is no significant benefit from the use of topical nasal decongestant in the treatment of AOM. J 2018; 12 (1): 96-105 Duhok Med