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ABSTRACTS / XXIX CONGRESS OF THE NORDIC ASSOCIATION OF OTOLARYNGOLOGY
Abstract no.: 085
Turbinate surgery by submucosal reduction techniques, as
outpatient treatment under local anesthesia
Tvinnereim M, Bergen Sleep Center & EuroSleep Ltd., Bergen, Norway
Chronic nasal obstruction is a frequent symptom, thus being the
complaint of a large number of patients in an otolaryngologic
practise.
Although much attention is drawn to the septum and func-
tioning of the nasal valve areas, the inferior turbinates represent
intriguing structures often causing nasal stenosis.
They consist of a bony framework holding a stroma filled
with arteriovenous channels into the middle of the nasal passage.
Regulation is by the autonomic nervous system, and the function
is to cause nasal obstruction with subsequent slowing of the nasal
airflow.
In the outpatient setting objective assessment combined
with application of decongestive vasoactive agent gives the
diagnosis, and a trial of medical treatment (local corticosteroids,
antihistamines, decongestants) are most often recommended
before surgical intervention.
A wide variety of treatment strategies, from mucosal and
stromal ablation to partial or subtotal turbinate excision has
been advocated. Although most are effective in improving nasal
airway passage, some leave the nose released from the regulating
capacity.
In a review of the 13 most used treatments for this purpose
through the last 130 years, Hol and Hiuzing concluded with
intraturbinal reduction being the methods of choice.
These include chemical, electrical and diathermy coagulation,
and among the most recently developed mucosal sparing
techniques; microdebriding volume reduction and radiofrequency
techniques with or without ionized field ablation.
These methods, their advantages as well as disadvantages, will
be described and discussed also regarding the use in an outpatient
setting being performed under local anesthesia.
Abstract no.: 086
The effect of Gabapentin on postoperative pain after tonsil-
lectomy in adults
Spren Mikkelsen1, Karen Lisa Hilsted2, Pia Juul Andersen1, Thomas
Enggaard', Morten Hansen1, Dorthe G Jprgensen2, Jprgen Henriksen2,
Niels Christian Hjortsp2 Jprgen B. Dahl'
'Odense Universitets Hospital, 2KAS Glostrup
It is well know that patients suffer from pain after tonsillectomy
and that the treatment of these may be difficult. The pain typically
reaches its maximum the 3th. and 4th. day after the operation but
they may continue for two weeks. Several previously studies have
shown that treatment of postoperative pain may present difficul-
ties.
We would like to present the results of our study witch includes
75 patients. The patients were randomized in to two groups and
were given either gabapentin or placebo. All patients were given
a COX 2 inhibitor (Vioxx). We used a visual analog scale (VAS)
and measured the postoperative pain two and four hours after the
operation and the following five days. The patients were asked
to fill out a booklet for the first five days after the operation in
witch they used VAS to scored pain-level, ability to work, use of
painkillers, sleep-quality and side-effects.
The study is just finished and the results of the study will be
presented at the congress.
S-XIV VOICE THERAPY
Abstract no.: 087
‘Speech therapist treatment of gender change’
Christina Askman, Sweden
Aspects to consider in communication therapy with transgender
patients are the patients’ conditions, expectations, and needs.
In therapy, the speech therapist works with traditional voice
therapy, including vocal hygiene, as well as with changes to dif-
ferent aspects of the voice, articulation, and non-verbal behavior.
Comments are given on prognosis and outcome.
Abstract no.: 088
RoS-index - a Swedish Adjustment of Voice Handicap Index.
An instrument for quantitative measurement of patients’
subjective voice and throat symptoms
Viveka Lyberg Ahlander, Lucyna Schalén, Dep. of Logopedics, Phoniatrics
and Audiology, University Hospital, S-221 85 Lund, Sweden. Phone: +46
46 17 17 56/ +46 46 222 31 55; viveka.lybergjihlander@logopedi.lu.se
In 1996 Jacobson et al developed the now well-known Voice
Handicap Index, an instrument for describing and quantifying
patients’ subjective voice related symptoms. The VHI has there-
after been translated to several languages. We found, however,
that some patients, although complaining of voice disturbances,
appear to have problems related to the throat rather than to the
larynx. We thus found it to be of interest to record these symp-
toms parallel with the VHI and added a ‘throat-scale’, designed
as the original VHI subscales; ten questions within each subscale
designed to quantify patient’ self-assessment of various aspects
of voice handicap. The ‘throat-scale’ consists of questions about
throat-related complaints, not included in the VHI protocol,
symptoms mainly related to supraglottal parts of the vocal tract.
As in the VHI the patients were asked to rate occurrence of
their symptoms as either 0= never occurring, l=once in a while,
2=sometimes, 3=most of the time, 4= all the time. The protocol,
‘RoS-index’, was tested for reliability and validity in four groups
of patients with voice disorders: phonastenia (N=20), functional
dysphonia (N=20), benign lesion of vocal fold (N=41) and unilat-
eral vocal fold paresis (N=20). As reference we used two groups
of patients without primary voice disorders i.e. those with benign
goitre (N=41) as well as out patients in the orthopaedic clinic
with no voice complaints or diseases within the throat region
(N=20). Ratings with grades 3 or 4 were considered as clinically
relevant, since these described more persisting symptoms. The
reporting of the higher grades also varied distinctly between the
groups. Results from the testing and applying of the scales will be
discussed.
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