Electro Cauterization Research Articles

Dissection Method and Diathermy Cauterization in Tonsillectomy- A Hospital Based Comparative Study

Tonsillectomy is one of the most common procedures performed by otolaryngologists. It is a surgical operation that removes both palatine tonsils from the tonsillar fossa. It is typically performed in youngers for recurrent tonsillitis and tonsillar hypertrophy. This study was done to compare the dissection and diathermy methods of tonsillectomy and evaluate their advantages and disadvantages during surgery and convalescence. This study was a retrospective analysis of 400 patients from January 2015 to January 2020 in Otorhinolaryngology and Head-Neck Surgery department of Bangabandhu Sheikh Mujib Medical College Hospital, Faridpur. Out of 400 patients 200 patients underwent tonsillectomy by dissection method and rest 200 patients underwent electrocautery method. Total 400 patients were analyzed separately their hospital stay, blood loss per-operatively, complications in each method and overall outcome of the patients. The overall hospital staying in both types was 1-3 days. The average intra operative blood loss was 5-7 ml in cautery and average 50 ml in dissection method. The average operative time was 25-30 minutes in dissection method and 10-15 minutes was in electrocautery. We found higher amounts of blood loss and intra - operative time in dissection method than electrocautery. The chance of secondary haemorrhage was more in electrocautery method than dissection method. Pain, scar formation, odynophagia were more in cauterization method. Complete healing time was more in cauterization method than dissection method. There was no death in both methods. Although per-operative blood loss, operation time were less in cauterization method but post operative bleeding, pain, odynophagia and infection were more in electro cauterization method. In both methods, there were some advantages and some disadvantages. Bangabandhu Sheikh Mujib Med. Coll. J. 2023;2(1): 40-44

Managing leukoplakia with diode laser: A report of two cases

Oral leukoplakia is the most common precancerous lesion of the oral mucosa. WHO defined it as a lesion which has a white patch or plaque on the oral mucosa that cannot be removed by scraping and cannot be classified clinically or microscopically as another disease process. Management of oral leukoplakia should begin with elimination of predisposing habit. There are currently different approaches in the management of Leukoplakia such as scalpel surgery, systemic carotenoids and antioxidants, electro cauterization, cryotherapy and Lasers. Even though on-surgical options are preferred choice of treatment, it takes time to achieve complete regression of lesion and sometimes may not achieve complete resolution. On the other hand, conventional surgical techniques are invasive and cause trauma to the patient. Excision of precancerous oral lesions using LASER offers comparative advantages over traditional scalpel excision. Laser is an acronym for Light Amplification by stimulated emission of radiation. It is surgical technique which excises the targeted tissue using emission of a monochromatic light of specific wavelength. Because of this property, laser excision of the tissue results in complete bloodless field of surgery, reduced chances of post-surgical inflammation and infections and hence better treatment compliance of the patients towards the surgery. This is one of the important goals for management of oral potentially malignant disorders. We present two case reports of homogeneous leukoplakia treated using diode lasers of wavelength 810nm with follow-up. Both cases did not report any post-operative discomfort or inflammation. The aim of this case report is to highlight the importance of laser excision with minimal complications and better treatment outcomes.

A Comparison of Dissection Method and Diathermy Cauterization Tonsillectomies

Background: Tonsillectomy is one of the most common procedures performed by otolaryngologists. It is a surgical operationthat removes both Palatine tonsils from the tonsillar fossa. It is typically performed in youngsters for recurrent tonsillitis andtonsillar hypertrophy. Objective: To compared the dissection and diathermy methods of tonsillectomy and evaluate their advantages anddisadvantages during surgery and convalescence. Methods: This is was a retrospective analysis of 400 patients from January 2015 to January 2020 of otorhinolaryngologydepartment in Banga Bandhu Sheikh Mujib Medical Collage Hospital. Out of total 400 patients 200 patients underwenttonsillectomy by dissection method and rest 200 patients underwent electro cautery method. Data were generated through recordreview using a checklist. A total of 400 patients were analyzed in respect of operation methods, operation time, and amount ofblood loss, post operative complications, duration of hospital stay in addition to age & sex distribution separately for comparison. Results: The overall hospital stayinng in both types was 1-3 days. The average intra operative blood loss was 5-7 ml withcautery and average 50 ml with dissection method. The average operative time was 25-30 minutes with dissection method and10-15 minutes with cautery. We found higher amounts of blood loss and intra - operative time with dissection method thanelectrocautery. The Chance of Secondary haemorrhage was more in electro - cautery method than dissection method. Pain,Scar formation, odynophagia were more in cauterization method. Complete healing time was more in cauterization methodthan dissection method. There was no death in both methods.Conclusion: Although per- operative blood loss, operative time were less in cauterization method but post operative bleeding,pain, odynophagia and infection were more in electro cauterization method. In both methods, there were some advantages andsome disadvantages.

Respiratory symptoms associated with electrocautery smoke: a systematic literature review

The smoke produced by the use of electro cauterization is formed by gaseous chemical compounds (gaseous phase) and by particle components (particulate phase) that can trigger harmful, local or systemic, reversible or irreversible effects in people who use this equipment. These chemicals can trigger genetic mutations and cancer in the human body. In addition to mutation and cancer, particles in the smoke of electro-cauterization can be inhaled and retained in the respiratory tract of workers, causing various respiratory signs and symptoms, including foreign body sensation in the throat, pharyngeal burning, nausea, and nasal congestion. It can also cause headache and eye irritation. Objective: To identify studies related to the presence of respiratory symptoms in health professionals related to the use of electrocautery. Methodology: A bibliographic search was carried out in the databases and indexes: Pubmed, Science Direct, Scopus, Proquest, Scielo, Schoolar Google. Original articles published between 2015-2020 were selected. For the extraction and synthesis of the content of the articles included, an Excel sheet was designed with the following variables: authors, title, year of publication, country and scientific journal; study objective, materials and methods, population and sampling, reported results. Results: A total of 121 articles were retrieved, of these 94 were excluded from the subsequent analysis due to the lack of appropriate data, the remaining 27 full-text studies met the inclusion and exclusion criteria set out in the study, which were included in the review. It was possible to establish that there are risks when inhaling electrocautery smoke that can trigger chronic respiratory pathologies such as lung cancer

Extracorporeal Septoplasty-A Well Proven Technique for Treatment of Crooked Noses.

Crooked noses (noses with complex septal and pyramidal deviations) are an important challenge for both plastic surgeons and otolaryngologists. Extracorporeal septoplasty, described by Gubisch constitutes an effective solution to this problem. The article describes a series of 7 cases (5 males and 2 females) in which this method was used during open rhinoseptoplasty. The technique we used is described in detail. All the patients showed improvement of the nose appearance and good nasal air flow. Hypertrophy of the right inferior turbinate complicated one case, but was resolved with electro cauterization. Although the learning curve is slow and it claims the surgeon’s imagination, the method is sometimes the only solution in complex cases of septal deviation. Our short series demonstrates that good indication and careful dissection are prerequisites for success in difficult cases.

Evaluation of Control of Bleeding by Electro Cauterization of Bleeding Points of Amplatz-Sheath Tract after Percutaneous Nephrolithotomy (PCNL) in Jahrom Peymanieh Hospital during Year 2015 - 2016

Evaluation of Control of Bleeding by Electro Cauterization of Bleeding Points of Amplatz-Sheath Tract after Percutaneous Nephrolithotomy (PCNL) in Jahrom Peymanieh Hospital during Year 2015 - 2016

Prevalence of Epistaxis among Patients Receiving Otorhinolaryngology Services at Muhimbili National Hospital and Muhimbili Orthopedic Institute, Dar es Salaam, Tanzania

Background
 Epistaxis is the commonest ear, nose and throat emergency. It’s mostly self-limited but it may be severe such that medical attention is sought and in such cases it may be life threatening. There is paucity of data on the prevalence and management options for epistaxis in Tanzania and at Muhimbili National Hospital (MNH) and Muhimbili Orthopedic Institute (MOI), no any published study has unveiled it despite being the commonly encountered emergency in our department. The aim of this study was thus to determine the prevalence, aetiology and treatment modalities of epistaxis among patients receiving otorhinolaryngology services at MNH and MOI.
 Materials and Methods
 A cross-sectional, hospital based study was done to 427 patients at Muhimbili National Hospital (MNH) and Muhimbili Orthopedic Institute (MOI). Data was collected using structured questionnaires from June to December 2015 and it was then analyzed using SPSS program.
 Results
 A total of 427 patients aged 1-82 years were recruited with majority of the patients being females (54.6%). The mean age at diagnosis was found to be 27±23 years.The prevalence of epistaxis was found to be lower among patients below 20 years (12.5%) of age and higher among patients over the age of 40years (34.9%). Prevalence of epistaxis was found to be higher among males (29.9%) compared to females (18 %). Majority of patients had anterior epistaxis (73%) whereas the remaining percentage was constituted by those with posterior epistaxis.Posterior epistaxis was more common among patients aged 21-40 years (40.7%) compared to patients aged 0-20 years (20%). 75% of the patients had epistaxis due to local etiologies while 25% was due systemic causes. Majority of patients with epistaxis had history of trauma (25%). Other reported aetiologies were malignancy of nasal and post-nasal space (22%) and hypertension (15%). Anterior nasal packing was the most commonly used method in management of patients with epistaxis compared to conventional posterior nasal packs. Fewer number of patients required surgery as the treatment modality where 3% of the patients undergone electro cauterization and only 1% required external carotid artery ligation.
 Conclusion
 Epistaxis is quite prevalent at MNH and MOI with males being more affected than females. Trauma resulting from road traffic crashes remain the common etiological factor for epistaxis in our setting is the leading cause of epistaxis among the patients studied. Efforts directed at reduction in the incidence of road traffic crashes will reduce the prevalence of epistaxis in our hospital settings.

Otorhinolaryngology Services at Muhimbili National Hospital and Muhimbili Orthopedic Institute, Dar es Salaam, Tanzania

Background: Epistaxis is the commonest ear, nose and throat emergency. It's mostly self-limited but it may be severe such that medical attention is sought and in such cases it may be life threatening. There is paucity of data on the prevalence and management options for epistaxis in Tanzania and at Muhimbili National Hospital (MNH) and Muhimbili Orthopedic Institute (MOI), no any published study has unveiled it despite being the commonly encountered emergency in our department. The aim of this study was thus to determine the prevalence, aetiology and treatment modalities of epistaxis among patients receiving otorhinolaryngology services at MNH and MOI.Materials and Methods: A cross-sectional, hospital based study was done to 427 patients at Muhimbili National Hospital (MNH) and Muhimbili Orthopedic Institute (MOI). Data was collected using structured questionnaires from June to December 2015 and it was then analyzed using SPSS program.Results: A total of 427 patients aged 1-82 years were recruited with majority of the patients being females (54.6%). The mean age at diagnosis was found to be 27±23 years.The prevalence of epistaxis was found to be lower among patients below 20 years (12.5%) of age and higher among patients over the age of 40years (34.9%). Prevalence of epistaxis was found to be higher among males (29.9%) compared to females (18 %). Majority of patients had anterior epistaxis (73%) whereas the remaining percentage was constituted by those with posterior epistaxis.Posterior epistaxis was more common among patients aged 21-40 years (40.7%) compared to patients aged 0-20 years (20%). 75% of the patients had epistaxis due to local etiologies while 25% was due systemic causes. Majority of patients with epistaxis had history of trauma (25%). Other reported aetiologies were malignancy of nasal and post-nasal space (22%) and hypertension (15%). Anterior nasal packing was the most commonly used method in management of patients with epistaxis compared to conventional posterior nasal packs. Fewer number of patients required surgery as the treatment modality where 3% of the patients undergone electro cauterization and only 1% required external carotid artery ligation.

Giant condyloma acuminatum of vulva

In this paper, A 23 year old married woman who was diagnosed as a case of giant condyloma acuminatum of vulva measuring about 15 x 8 x 3 cm, irregular surface with multiple projections, oval in shape, firm to hard in consistency, mildly tender, exophytic, cauliflower like growth involving the whole vulva (lower part of mons pubis, labia, vestibule, clitoris, around vaginal opening). Another multiple small lesions were present at perineal region but there was no inguinal lymphadenopathy. She underwent a combined electro cauterization and cryotherapy for small to moderate size multiple primary and recurrent warty lesions and wide surgical excision with fasciocutaneous advancement flaps procedure for a giant lesions in the vulva. Excisional biopsies were performed to detect potential malignancy but malignancy was not found histologically. The patient was advised to first follow-up 1 month after operation when multiple small warty lesions were developed and treated and the subsequent follow-ups for 3 months.

Evaluation of Stump Pressure in Three Types of Appendectomy: Harmonic Scalpel, LigaSure, and Conventional Technique.

Appendectomy is one of the most common operations carried out by general surgeons. The recent introduction of the alternative energy-based devices in surgery and their use in the laparoscopic appendectomy shortened the duration of operations, but these devices are used generally for meso dissection. These devices did not receive wide acceptance among surgeons as there is not enough evidence confirming their use in appendicular lumen operations. Our objective in this study was to test the safety of three types of appendectomy. Twenty-four cases with right hemicolectomy or subtotal colectomy were enrolled into this study. The patients were distributed in three groups. After the colectomy specimen was removed, in Group 1 conventional appendectomy (it was dissected with mesoappendiceal fixation and with electro cauterization) was performed in the operating room, the appendicular stump was ligated with a silk suture; in Group 2 appendectomy was performed with LigaSure™ and the stump was closed also with LigaSure; in Group 3 appendectomy was performed with Harmonic Scalpel™ and the stump was closed also with Harmonic Scalpel. Stump opening pressures were measured in all patients in the groups. Three groups were compared in terms of age, gender, concomitant diseases, clinical diagnosis, previous operations, pathological findings, and applied maximum pressure levels. No statistical difference was detected among the groups. Appendectomies carried out with LigaSure and Harmonic Scalpel are as safe as appendectomies carried out with the conventional methods.

Rapid Healing of Cutaneous Leishmaniasis by High-Frequency Electrocauterization and Hydrogel Wound Care with or without DAC N-055: A Randomized Controlled Phase IIa Trial in Kabul

BackgroundAnthroponotic cutaneous leishmaniasis (CL) due to Leishmania (L.) tropica infection is a chronic, frequently disfiguring skin disease with limited therapeutic options. In endemic countries healing of ulcerative lesions is often delayed by bacterial and/or fungal infections. Here, we studied a novel therapeutic concept to prevent superinfections, accelerate wound closure, and improve the cosmetic outcome of ACL.Methodology/Principal FindingsFrom 2004 to 2008 we performed a two-armed, randomized, double-blinded, phase IIa trial in Kabul, Afghanistan, with patients suffering from L. tropica CL. The skin lesions were treated with bipolar high-frequency electrocauterization (EC) followed by daily moist-wound-treatment (MWT) with polyacrylate hydrogel with (group I) or without (group II) pharmaceutical sodium chlorite (DAC N-055). Patients below age 5, with facial lesions, pregnancy, or serious comorbidities were excluded. The primary, photodocumented outcome was the time needed for complete lesion epithelialization. Biopsies for parasitological and (immuno)histopathological analyses were taken prior to EC (1st), after wound closure (2nd) and after 6 months (3rd). The mean duration for complete wound closure was short and indifferent in group I (59 patients, 43.1 d) and II (54 patients, 42 d; p = 0.83). In patients with Leishmania-positive 2nd biopsies DAC N-055 caused a more rapid wound epithelialization (37.2 d vs. 58.3 d; p = 0.08). Superinfections occurred in both groups at the same rate (8.8%). Except for one patient, reulcerations (10.2% in group I, 18.5% in group II; p = 0.158) were confined to cases with persistent high parasite loads after healing. In vitro, DAC N-055 showed a leishmanicidal effect on pro- and amastigotes.Conclusions/SignificanceCompared to previous results with intralesional antimony injections, the EC plus MWT protocol led to more rapid wound closure. The tentatively lower rate of relapses and the acceleration of wound closure in a subgroup of patients with parasite persistence warrant future studies on the activity of DAC N-055.Trial RegistrationClinicalTrails.gov NCT00947362

Therapeutic Effect of Common Salt (Table/ Cooking Salt) on Umbilical Granuloma in Infants

Background: Umbilical granuloma is a common inflammatory reaction which occurs during falling of umbilicus. Some treatments of umbilical granuloma includes cauterization with silvernitrate and coppersulphate, use of alcohol, Cryo and electro cauterization and granuloma ligators. Objective: To evaluate the therapeutic effect of common salt (table/ cooking salt) on umbilical granuloma in infants. Methods: This was a clinical trail carried out on 48 infants with umbilical granuloma. The parents of 48 infants with umbilical granuloma were given instruction to treat their infants at home. The treatment consisted of application of common salt on the lesion twice a day, washed 30 minutes later and repeated for 3 days. Results: 44 out of 48 cases had perfect cure after the three day course of treatment. Conclusion: Our data showed that use of common salt in treating umbilical granuloma is simple, cost effective, curative and safe. DOI: http://dx.doi.org/10.3329/bjch.v34i3.10360 BJCH 2010; 34(3): 99-102

Oropharyngeal Leech Infestation and Therapeutic Options

This is a case report about a rare oropharyngeal foreign body causing oropharyngeal symptoms such as sore throat, dysphagia and hemoptysis. We reported a 7 year-old boy who had ingested a leech from a bottle which had been filled with water and it had attached to the palate within 4 days. The leech was identified as approximately 3 cm in length. Leech was removed under premedication by using monopolar cauterization. Although child infestation by a leech in the upper respiratory tract is very rare, it should be investigated when contaminated liquids are ingested. Electro cauterization should be borne in mind as a therapeutic option in the treatment of leech infestations in the upper respiratory tract under pre-medication in pediatric patients.

Haemostatic effect and tissue reactions of methods and agents used for haemorrhage control in apical surgery

To compare the haemostatic effect and tissue reactions of different agents and methods used for haemorrhage control in apical surgery. Six standardized bone defects were prepared in the calvaria of six Burgundy rabbits. Five haemostatic modalities were tested for their haemostatic effect and tissue reactions, and were compared with untreated control defects: Expasyl + Stasis, Expasyl + Stasi + freshening of the bone defect with a bur, Spongostan, Spongostan+ epinephrine, and electro cauterization. The haemostatic effect was analysed visually and compared using Wilcoxon's signed rank test. Two groups of three animals were evaluated histologically for hard and soft tissue reactions related to the different haemostatic measures, after 3 and 12 weeks of healing respectively. Expasyl + Stasis and electro cauterization proved most effective in reducing bleeding (P < 0.05), but were accompanied by unfavourable tissue reactions, as indicated by the presence of necrotic bone, inflammatory cells and the absence of bone repair. These adverse tissue reactions did not recover substantially over time. However, adverse reactions were not observed when the superficial layer of bone had been removed with a rotary instrument. In contrast, Spongostan + epinephrine showed only a moderate haemostatic effect, but elicited also only mild adverse tissue reactions. Haemostasis in experimental bone defects is most effectively accomplished by using Expasyl + Stasis or electro cauterization. However, the bone defects should be freshened with a rotary instrument before suturing so as not to compromise healing.

Efficacy and cost effectiveness of harmonic scalpel compared with electrocautery in posterior instrumentation of the spine

Different methods to reduce blood loss during spinal surgery have been described already. Although the use of the harmonic scalpel (HS), an ultrasonically activated coagulator, has been described in endoscopic spinal surgery, its efficacy in posterior instrumentation of the spine remains unclear. The aim of this study was to determine if blood loss was lower using the HS than electrocauterization (EC) and to evaluate the cost effectiveness of the HS in reducing the need for transfusion in patients undergoing posterior instrumentation of the spine. The two groups were matched in a blinded manner, without knowledge of blood loss and were similar with respect to mean age, diagnosis and operation data. All instrumentations were done by the same surgeon. After matching was completed (HS group n = 50, EC group n = 50) blood loss and overall costs for blood products were analyzed by independent observers. The following were significantly lower with the HS than with EC: (1) blood loss (1106+/-985 ml vs 2176+/-1764 ml, P < 0.001), (2) frequency of cell saver use (13 vs 28 patients, P = 0.001), (3) average cost of blood products (Euro 72 vs Euro 219, P < 0.001), (4) predonation of autologous fresh frozen plasma (2.58+/-2.78 vs 4.5+/-2.2 U, P = 0.002) and red blood cells (0.38+/-0.75 vs 0.88+/-1.1 U, P = 0.009). The overall costs, including the costs for the HS, remained neutral. The use of the HS in posterior spinal surgery leads to significantly lower blood loss, and less need for and cost of blood products, compared to EC in cases with major anticipated blood loss.