Search PubMed⌕ Search

Biomedical subjects

K T Tzifa

Publications and source records attributed to K T Tzifa.

8 recordsLinked to original sources
PubMed2005

Endoscopic treatment of congenital H-Type and recurrent tracheoesophageal fistula with electrocautery and histoacryl glue.

OBJECTIVE: Congenital H-Type tracheoesophageal fistulae (H-Type TEF) and recurrent fistulae after primary repair of esophageal atresia represent a difficult problem in diagnosis and management. The treatment traditionally involved an open technique via a cervical or thoracic route, approaches with high morbidity and mortality rates of up to 50%. Endoscopic closure of fistulae has been reported with various techniques such as tissue adhesives, electrocautery, sclerosants and laser. However, the published case series contain a small number of patients with usually short-term follow-up. The aim of this paper is to present the experience of a decade at Toronto's Hospital for Sick Children, using diathermy and histoacryl tissue adhesive and discuss the indications and limitations of this technique. METHODS: Since 1995, 192 patients have been managed in this institution with tracheoesophageal fistulae of which 10 patients have been treated endoscopically. The fistulae were both of H-Type and recurrent tracheoesophageal fistulae following surgery for esophageal atresia and fistula division. One fistula occurred following trauma. The procedure was undertaken under general anesthesia in the image guided therapy suite under fluoroscopic control. Flexible ball electrocautery and injection of histoacryl glue were used either on their own or in combination. RESULTS: Fistula closure was achieved in 9 out of 10 fistulae. Four patients had a second endoscopic procedure. No major respiratory or other complications were encountered in association with the procedure. Follow-up has been between 3 months and 9 years. CONCLUSION: We conclude, endoscopic treatment of tracheoesophageal fistulae with electrocautery and histoacryl glue has been a safe and successful technique of managing H-Type and recurrent tracheoesophageal fistulae. In this paper, we discuss the indications and the surgical steps of the procedure. We highlight that diathermy should be carefully controlled and applied preferably in the small non-patulous fistulae. A fistula that has not closed after two endoscopic attempts is not suitable for further endoscopic treatment and therefore an external approach should be recommended.

Child↗
PubMed2005

A large and uncharacteristically aggressive cholesterol granuloma of the middle ear.

Cholesterol granulomas of the middle ear tend to be benign in nature, frequently seen by otologists during cholesteatoma or chronic otitis media surgery and easily dealt with by evacuation. In contrast, cholesterol granulomas of the petrous apex appear to have a more aggressive nature and present significant pathological threats. We present a case of a large destructive cholesterol granuloma of the middle ear eroding the middle and posterior cranial fossa bone and dura to exert a mass effect upon the temporal lobe. We emphasize the destructive potential of this extremely rare middle-ear cholesterol granuloma, and draw attention to the distinction between this variant and the commonplace and benign form of the lesion more usually found at this site. We also present the current theories of the aetiology of cholesterol granuloma formation with possible explanations for the rare aggressive behaviour.

Adult↗
PubMed2004

A survey on the management of reactionary haemorrhage following adenoidectomy in the UK and our practice.

We present the results of a nation-wide survey in the management of reactionary haemorrhage following adenoidectomy, in the absence of specific national guidelines for this complication in the UK. We have reported the practice of the consultant members of the BAO-HNS through a confidential postal questionnaire with regard to their preferred method of management and experience. Valid replies were received from 285 ENT surgeons, of which 87.3% (249) prefer to manage reactionary haemorrhage with post-nasal packs and 223 (78.2%) would use an overnight post-nasal pack. 7.7% (22) use other techniques, and 9.1% (26) leave post-nasal packs for as short time as possible. Our experience of using a post-nasal pack for 4 h appears equally as effective as a post-nasal pack left for 24 h and reduces the discomfort and subsequent risks related to overnight post-nasal packing.

Adenoidectomy↗
PubMed2001

Endoscopic repair of unilateral choanal atresia with the KTP laser: a one stage procedure.

This paper, describes the endoscopic repair of unilateral choanal atresia with the KTP laser, a one-stage procedure, with no requirement for stenting. Three patients are presented with unilateral choanal atresia, aged six, nine and 38-years-old. The procedure combines the excellent endoscopic visualization, with the good haemostatic and penetrating properties of the KTP laser. Follow up was between 12 months and four years with all choanae remaining patent, no dilatation was required. No surgical complications were noted.

Adult↗
PubMed2001

Peri-orbital surgical emphysema following functional endoscopic sinus surgery, during extubation.

We present a case of peri-orbital surgical emphysema following functional endoscopic sinus surgery (FESS), due to extubation with simultaneous manual inhalation with a closed expiratory valve. This complication has not been previously reported in association with general anaesthetic and FESS. Patients undergoing FESS are advised against nose blowing. However, we recommend that the anaesthetist working with a surgeon who performs FESS should also be warned not to use manual inhalation with a closed expiratory valve while extubating, as this can cause peri-orbital surgical emphysema.

Aged↗
PubMed2000

Cosmetic tracheostomy locket: an attempt to improve the aesthetic component of tracheostomy tubes.

This paper demonstrates the need for a cosmetic device as a necessary adjunct to long-term tracheostomy care. Such devices are not available, at present, from tracheostomy tube manufacturers. The cosmetic tracheostomy cover plate is based on a silver Negus tracheostomy tube, to which the silver chain and cover plate (locket) are attached. The result, for the patient who tried it, was excellent.

Adult↗
PubMed1998

The relation between tonsillectomy and snoring.

The aim of this study was to determine the relation between snoring and tonsillectomy. The grossly enlarged tonsils of a heavily snoring child or adult with upper airway obstruction is usually sufficient indication for tonsillectomy. The authors wondered if tonsillectomy could affect snoring, no matter what the age and the indication for surgery. One thousand people took part in this study: a random sample of patients aged between 2 and 89 years of age, and those accompanying them in the ENT outpatients. The prevalence of snoring was 12.5-48%, mainly in men. The degree of snoring was graded from non-snorers to mild, moderate and severe snorers. In 19.8% of the sample tonsillectomy had already been performed, usually in childhood. The authors conclude that tonsillectomy does not reduce the likelihood of becoming a snorer.

Adolescent↗