Guillotine vs. classic dissection adenotonsillectomy: What's the ideal technique for children in Tanzania?

Chussi, Desderius; Poelman, Sophie W.; Heerbeek, Niels van

doi:10.1016/j.ijporl.2017.07.003

Cited by 3 publications

(3 citation statements)

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“…Paediatric tonsillectomy, being the major oropharyngeal surgery conducted in Tanzanian consultant hospitals, offers the ideal setting to answer this question. 2,[9][10][11][12] It would also be valuable to determine the rationale of antibiotic treatment in tonsillitis, as evidence for the effectiveness of antibiotics is scarce or even lacking in most cases of acute or chronic tonsillitis. The risks of needless antibiotic exposure and the contributing likelihood of antimicrobial resistance should not be underestimated.…”

Section: Introductionmentioning

confidence: 99%

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Bacterial colonisation of surface and core of palatine tonsils among Tanzanian children with recurrent chronic tonsillitis and obstructive sleep apnoea who underwent (adeno)tonsillectomy

et al. 2023

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Objective Acute and chronic tonsillitis are frequently treated with antibiotics. This study aimed to understand the presence of pathogenic micro-organisms on the surface and core of chronically infected tonsils among Tanzanian children. Methods The study enrolled children undergoing adenotonsillectomy. Surface and core tonsillar swabs were taken. Quantitative polymerase chain reaction was performed for Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus, Neisseria meningitidis and Pseudomonas aeruginosa. Results Surface and core combined, isolated N meningitidis (86.1 per cent) was found the most, followed by H influenzae (74.9 per cent), S pneumoniae (42.6 per cent) and S aureus (28.7 per cent). M catarrhalis and P aeruginosa were only found in a few patients, 5.6 per cent and 0.8 per cent respectively. Conclusion Colonisation of the tonsillar surface and core has been found. Potentially pathogenic micro-organisms are likely to be missed based on a throat swab. Hence, the practice of surface tonsillar swabbing may be misleading or insufficient.

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Section: Introductionmentioning

confidence: 99%

“…Paediatric tonsillectomy, being the major oropharyngeal surgery conducted in Tanzanian consultant hospitals, offers the ideal setting to answer this question. 2 , 9 – 12 …”

Section: Introductionmentioning

confidence: 99%

Bacterial colonisation of surface and core of palatine tonsils among Tanzanian children with recurrent chronic tonsillitis and obstructive sleep apnoea who underwent (adeno)tonsillectomy

et al. 2023

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“…In otorhinolaryngology, tonsillectomy is among the most often performed operations ( 1 ). Recurrent tonsillar infections and tonsillar hypertrophy are the most prevalent reasons for tonsillectomy procedures because the tonsils act as a septic focus and obstruct the upper airway ( 2 , 3 ).…”

Section: Introductionmentioning

confidence: 99%

Thermal Welding Tonsillectomy versus Monopolar Electrocautery Tonsillectomy: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Albazee,

Alshammari,

Alotaibi

et al. 2023

TAO

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Objective: In hopes of contributing to the decision about the best surgical option in tonsillectomy, we performed this work to compare the effectiveness of the thermal welding system (TW) and monopolar electrocautery (ME) tonsillectomy in terms of postoperative pain, postoperative bleeding, and operation time in patients undergoing tonsillectomy, to determine which procedure is most expected to enhance the postoperative quality of life. Methods: Digital databases, including PubMed, Scopus, Cochrane, Web of Science, and Google Scholar, were systematically screened from inception up to October 2022. The included randomized controlled trials (RCTs) were evaluated for risk of bias via the Cochrane tool (version 2). The outcomes were summarized as risk ratio (RR) or mean difference/standardized mean difference (MD/SMD) with a 95% confidence interval (CI) in a random-effects model. Results: The three RCTs that met our criteria were included in the study. Overall, 151 patients had been enrolled in these three RCTs, in which 75 and 76 were allocated to the TW and ME groups, respectively. The postoperative pain levels were substantially reduced, favoring the TW arm over the ME arm [n=2 RCTs, SMD=-0.39, 95% CI (-0.67, -0.12), p=0.005]. Also, the analysis revealed a substantial variation between the TW and ME arms in terms of operation time [n=2 RCTs, MD=3.29 minutes, 95% CI (1.42, 5.17), p=0.0006]. However, the analysis revealed no substantial variation between the TW and ME arms in term of postoperative bleeding [n=3 RCTs, RR=0.40, 95% CI (0.06, 2.62), p=0.34]. Conclusion: This meta-analysis revealed that postoperative bleeding for tonsillectomy were similar between the ME and TW techniques. However, TW showed lower postoperative pain levels than ME statistically but without achieving significant clinical advantage.

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An Evidence-Based Practical Approach to Pediatric Otolaryngology in the Developing World

Belcher

Molter

Goudy

2018

Otolaryngologic Clinics of North America

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Guillotine vs. classic dissection adenotonsillectomy: What's the ideal technique for children in Tanzania?

Cited by 3 publications

References 9 publications

Bacterial colonisation of surface and core of palatine tonsils among Tanzanian children with recurrent chronic tonsillitis and obstructive sleep apnoea who underwent (adeno)tonsillectomy

Bacterial colonisation of surface and core of palatine tonsils among Tanzanian children with recurrent chronic tonsillitis and obstructive sleep apnoea who underwent (adeno)tonsillectomy

Thermal Welding Tonsillectomy versus Monopolar Electrocautery Tonsillectomy: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

An Evidence-Based Practical Approach to Pediatric Otolaryngology in the Developing World

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