Læknablaðið : fylgirit - 01.06.2005, Blaðsíða 34

ABSTRACTS / XXIX CONGRESS OF THE NORDIC ASSOCIATION OF OTOLARYNGOLOGY
age in children with atopic eczema at 6 months, early life atopic
eczema did not increase the risk of otitis media at age 10.
Abstract no.: 082
Digital analysis of skin colours after histamine skin prick
test
Malm L, Dept. of ORL. Maimö University Hospital, Holm O, Dept. of
Ophthalmology, Malmö University Hospital
The colours of the skin after a histamine skin prick test (SPT)
were analysed with a digital image processing technique that
increases the colour differences. Histamine SPT was performed
on the volar side of the forearm of six students in the same way
as in routine SPTs (10 mg/ml). Photographs were taken under
standardized conditions with a non-digital camera every second
minute until the 30th minute. The wheal (oedema) and the flare
were easily seen by the naked eye both directly on the skin and
on the photographs. Analysing the photographs with the digital
technique (named LYYN) suggested zones of skin blood flow dif-
ferences, not seen by the naked eye. Pharmacological aspects will
be discussed.
S-XIII OUTPATIENT SURGERY IN OTORHINOLARYNGOLOGY
Abstract no.: 083
Subject Use of Coblation in ENT: Tonsils, Adenoids, Lingual
Tonsils, Turbinates, UVPP and oral cancer.
Michael S. Timms FRCS Ed, FRCS Eng. Consultant ENT Surgeon,
Blackburn, England
Aims: To demonstrate by video footage and verbal description,
our initial experience with the use of Coblation and the Evac 70
wand, for the removal, of ENT soft tissue pathology in the above
applications.
Method: A review of our large case series of tonsillectomies will
be presented.
Using the above wand, designed for tonsil excision we have
found that more radical traditional operations can be performed.
Rather than shrinking turbinates by submucosal approach, a full
turbinectomy down to bone can be performed with this wand with
more dramatic results for airway improvement.
Similarly, footage of video will demonstrate a classical UVPP
rather than the normal use of radiofrequency simply to carry
out submucosal shrinkage, again with more reliable results in
reduction of snoring.
We have developed radiofrequency adenoidectomy to the
point where it is now a regular, rapid and reliable method of
adenoid removal.
A case of lingual tonsil lymphoma with airway obstruction will
be shown being eradicated prior to chemotherapy, using the same
technology. This method is suitable for removal of all cases of
enlarged lingual tonsils.
Finally, excision of a carcinoma of the lateral border of tongue
will be shown and discussed.
Conclusions: After adopting and developing Coblation tonsillec-
tomy as our routine method we have found that the same technol-
ogy and versatile handpiece can be used with advantages for a
wide range of ENT procedures, worthy of further study.
Abstract no.: 084
Tonsillotomy versus Tonsillectomy - advantages and risks
Hultcrantz E. Linköpings universitet, Ericsson E, Linköpings
universitet, Graf J, Universitetssjukhuset i Linköping, Markström A,
Andningsdispensáren, Danderyd, Linder A, Akademiska sjukhuset,
Uppsala
This presentation will compare the effects of partial resection
of tonsils (TT) with regular tonsillectomy (TE) with respect to
postoperative morbidity and long-term effects in three random-
ized studies.
The first study from Uppsala, consisted of 41 children with
obstructive symptoms with no history of throat infections, ran-
domized to TE or to TT performed with C02 laser [1]. A six year
follow-up has recently shown equally good results for obstructive
problems and no increased tendency for infections in the TT
group [2].
The second study is from Linköping. Children, 5-15 years, with
a history of snoring and a few to several tonsillitis were randomized
to either TE (43) or TT (49) with RF-surgery. Surgitrone®,
Ellman Int l,7mHz was used. A video will be shown.
The TT group recorded less pain from the second hour and
were back in school, pain-free three days earlier than the TE
group. They used less analgesics than the TE group and did not
loose weight postoperatively. The TE group lost a mean of 660g
in 10 days [3].
One year follow-up showed the same positive effect on snoring
for both groups, as well as the same number of infections. The TE
group remembered their pain as a trauma.
The third investigation is ongoing: 60 patients between 16-25
years are randomized to TE or TT with RF. The patients can leave
the hospital six hrs after surgery and their sick-leave is ‘open’,
which allows them to go back to school or work before the one-
week check-up. Preliniinary results will be presented.
Conclusion: Removing the protruding parts of the tonsils seems
to have as good effect on symptoms as a complete TE and can be
done as outpatient surgery. With less postoperative morbidity, a
health economic gain is achived. The Surgitrone® is easier to use
and less costly than C02-laser. Long-term follow-ups are neces-
sary.
References
1. Hultcrantz E, Linder A, Markstrom A. www.ncbi.nlnuiih.gov/entrez/qiicry.fcgi?
cnul=Retrieve&db=pubmed&dopt=Abstract&Ust_uids=l0628543. Tonsillectomy
or Tonsillotomy?-a randomized study comparing postoperative pain and long-
term effects. Int J Pediatr Otorhinolaryngol 1999; 51(3): 171-6.
2. Hultcrantz E, Linder A, Markstrom A. www.ncbi.nlnuiih.gov/entrez/query.fcg
i?cmd=Retrieve&db =pubmed&dopt=A bstract&list_uids=]0628543 2005. Long-
term effects of Tonsillotomy (Partial tonsillectomy) compared to Tonsillectomy.
Int J Pediatr Otorhinolaryngol. In press.
3. Hultcrantz E, Ericsson E. Pediatric tonsillotomy with the radiofrequency
technique: less morbidity and pain. Laryngoscope 2004; 114(5): 871-7.
Support: Financial support from the Research Council of South East Sweden
(FORSS)
34 Læknablaðið/Fylgirit 51 2005/91