To compare postoperative pain between monopolar cautery tonsillectomy and harmonic scalpel tonsil... more To compare postoperative pain between monopolar cautery tonsillectomy and harmonic scalpel tonsillectomy (HST).Randomized controlled trial using paired organs.Community hospital with academic affiliation.One hundred and fourteen consecutive patients six years of age or older undergoing tonsillectomy for indications of hypertrophy or recurrent infection.For each subject, monopolar cautery tonsillectomy was performed by four senior surgeons on one side and HST was performed on the other side. Allocation of technique to side was randomized and revealed to the surgeon at the start of the operation. Validated visual analog pain scales were used to quantify pain at rest and with swallowing for each side and were completed daily for 14 days. All subjects were prescribed weight-equivalent doses of analgesics. Secondary outcome measures included postoperative complications (hemorrhage and readmission).Pairwise comparisons of pain scores revealed no significant difference between monopolar cautery tonsillectomy and HST (P < 0.05).Subjects undergoing monopolar cautery tonsillectomy do not experience increased postoperative pain in comparison to HST.
Image-guided surgery of the paranasal sinuses has become a valuable tool in endoscopic sinus surg... more Image-guided surgery of the paranasal sinuses has become a valuable tool in endoscopic sinus surgery. Optical image-guided systems using infrared tracking technology are widely used. We present our experience with new angulated, hand-activated, wireless instruments in an optical tracking system for endoscopic sinus surgery. Case series. Community university teaching hospital. Sixty-five consecutive patients underwent computer-assisted endoscopic sinus surgery using a Stryker Navigation System (Stryker Canada LP, Burlington, ON). Patients underwent preoperative fine-cut axial computed tomography. At the time of surgery, anatomic fiducials were registered and the measured fiducial registration error (FRE), which is an indicator of the accuracy of the optical system, was recorded. Angulated battery-powered active instrumentation was used during the surgery. FRE, the number of anatomic fiducials used, complication rates pre- and postuse of computer-assisted sinus surgery. The mean FRE was 2.02 +/- 0.48 mm. The mean number of anatomic fiducials used for registration was 5.98. There were no major orbital or intracranial complications. Use of angulated instruments rarely caused a line of sight problem. The new optical system has a measured FRE comparable to that of other image guidance systems. Our clinical experience shows that the instrumentation decreases the &quot;line of sight&quot; problem and is easy to navigate and manipulate without a wire attachment to the main computer.
To compare postoperative pain between monopolar cautery tonsillectomy and harmonic scalpel tonsil... more To compare postoperative pain between monopolar cautery tonsillectomy and harmonic scalpel tonsillectomy (HST).Randomized controlled trial using paired organs.Community hospital with academic affiliation.One hundred and fourteen consecutive patients six years of age or older undergoing tonsillectomy for indications of hypertrophy or recurrent infection.For each subject, monopolar cautery tonsillectomy was performed by four senior surgeons on one side and HST was performed on the other side. Allocation of technique to side was randomized and revealed to the surgeon at the start of the operation. Validated visual analog pain scales were used to quantify pain at rest and with swallowing for each side and were completed daily for 14 days. All subjects were prescribed weight-equivalent doses of analgesics. Secondary outcome measures included postoperative complications (hemorrhage and readmission).Pairwise comparisons of pain scores revealed no significant difference between monopolar cautery tonsillectomy and HST (P < 0.05).Subjects undergoing monopolar cautery tonsillectomy do not experience increased postoperative pain in comparison to HST.
Image-guided surgery of the paranasal sinuses has become a valuable tool in endoscopic sinus surg... more Image-guided surgery of the paranasal sinuses has become a valuable tool in endoscopic sinus surgery. Optical image-guided systems using infrared tracking technology are widely used. We present our experience with new angulated, hand-activated, wireless instruments in an optical tracking system for endoscopic sinus surgery. Case series. Community university teaching hospital. Sixty-five consecutive patients underwent computer-assisted endoscopic sinus surgery using a Stryker Navigation System (Stryker Canada LP, Burlington, ON). Patients underwent preoperative fine-cut axial computed tomography. At the time of surgery, anatomic fiducials were registered and the measured fiducial registration error (FRE), which is an indicator of the accuracy of the optical system, was recorded. Angulated battery-powered active instrumentation was used during the surgery. FRE, the number of anatomic fiducials used, complication rates pre- and postuse of computer-assisted sinus surgery. The mean FRE was 2.02 +/- 0.48 mm. The mean number of anatomic fiducials used for registration was 5.98. There were no major orbital or intracranial complications. Use of angulated instruments rarely caused a line of sight problem. The new optical system has a measured FRE comparable to that of other image guidance systems. Our clinical experience shows that the instrumentation decreases the &quot;line of sight&quot; problem and is easy to navigate and manipulate without a wire attachment to the main computer.
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Papers by Albino Chiodo