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ABSTRACTS / XXIX CONGRESS OF THE NORDIC ASSOCIATION OF OTOLARYNGOLOGY
necessitating tracheotomy can occur, especially in patients under
anticoagulant therapy. Therefore drainage and observation for at
least one night is advocated in all but the simplest (crico-thyroid
approximation as isolated procedure) LFS procedures.
Abstract no.: 049
Surgical treatment of sulcus vocalis
Roland Rydell, Phoniatrics/ENT, Lund, Sweden
Sulcus vocalis is a form of advanced vocal fold pathology. It is
frequently difficult to detect with indirect laryngoscopy and often
the diagnosis is not evident until microlaryngoscopy is performed.
Sometimes a typical voice deviation may lead to the suspicion of
a sulcus vocalis.
Long term voice therapy is the first treatment, but surgery may
be indicated after intensive discussion with the patient. I Lund
we have experience with three different methods. Excision of the
sulcus sack according to Dr. Bouchayer, slicing mucosa according
to Pontes and Behlau and dissection of the sulcus at the ligament
border have been used.
In a pilot study the outcome of the 3 different methods will be
compared.
Abstract no.: 050
Management of external laryngeal trauma
Richard Kuylenstierna, Sweden
Abstract missing
O-IV THE TROUBLESOME MIDDLE EAR
Abstract no.: 051
Treatment of Acute Otitis Media in Sweden today.
Hermansson AK, Jonsson P. Department of Oto-rhino-laryngology,
University of Lund, Lund, Sweden
Background: In 2000 new Guidelines for treatment of Acute
purulent Otitis Media (AOM) in children were issued in Sweden.
In these guidelines recommendations were given for diagnostic
methods and criteria, treatment and follow up. Until these new
guidelines were given the recommendation in Sweden was that all
AOM should be treated with antibiotics. Now the possibility to
abstain from treatment was given in certain instances.
Objective: To study if these new guidelines have been accepted
and if they have changed the treatment pattern. At the same time
the type of antibiotics prescribed and the diagnostic methods used
was recorded as well as the microbiology.
Methods: All children with AOM seen during the six ‘winter
months’ in 2001/2002 at the outpatient clinics of the ENT-depart-
ment and Paediatric department at the University Hospital in
Lund and at two Outpatient-clinics were recorded retrospectively.
In all, 474 patients were included. When the treatment recom-
mendations of the new guidelines were applied a total of 167
patients fulfilled the requirements for ‘non-treatment’. Type of
treatment, treatment failures, microbiology, age, sex and number
of previous infections were recorded.
Results: The recommendations concerning type of antibiotics,
length of treatment and check-up were closely followed. A total
of 15 patients (9%) were not treated at the first visit.
Conclusions: New guidelines should be monitored and it is impor-
tant to discuss how to present them to physicians and patients.
The treatment policy and the microbiology closely resemble the
earlier results in Sweden.
Abstract no.: 052
Adenotonsillectomy and ventilation tube insertion in
Norway: a national study
Karevold G, Kværner KJ, ENT-department, Akershus University
Hospital, University of Oslo, Norway
Background: Adenotonsillectomies and ventilation tube inser-
tion are the most common operative procedures in children.
Considerable variation in surgery rates has been shown. The
range of surgical combinations in the treatment of secretory otitis
media is an example of the variability in surgical approaches.
Objectives: To compare regional and national rates of adeno-
tonsillectomy, tympanotomy and ventilation tube insertion, and
combinations of these, in children less than 16 years of age using
the Nomesco Classification of Surgical Procedures.
Methods: National Norwegian data on outpatient and inpatient
otolaryngologic surgical procedures in 2003 were used to estimate
rates of adenotonsillar surgery and ventilation tube insertion and
combinations of these in Norway.
Results: In Norway, approximately 1% of all national surgery was
childhood otolaryngologic surgery. Large regional variation in
surgery rates and procedural combinations were shown. Regional
comparisons will be presented and discussed in terms of existing
guidelines and national priorities.
Conclusion: Considerable variation in surgery rates was found.
Abstract no.: 053
Five-year follow-up of transmyringeal ventilation tube
treatment
Knutsson J, von Unge M, Dept of Otorhinolaryngology, Vasterás Central
Hospital, Sweden
There are several different types of transmyringeal ventilation
tubes with various shapes, sizes and materials. Little is known
about the differences as for the time to extrusion, percentage of
retained tubes and persistent perforations.
We retrospectively reviewed the charts of 156 tympanic
membranes for five years following the insertion of single-flanged
straight ventilation tubes.
The mean time to extrusion was 16 months, which is equivalent
to other types of tubes. 17 percent of the tubes were removed due
to being retained too long. The number of retained tubes that
called for an operative removal was much higher than reported
for other kinds of tubes. Six tympanic membranes had a persistent
perforation, which seems to be higher than reported for other
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