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At least 397 records · Page 22Linked to original sources
PubMed2002

Paediatric epistaxis: Alder Hey experience.

Referrals for epistaxis management constitute a significant proportion of paediatric ENT consultations. A prospective audit of all new referrals to our paediatric ENT department for epistaxis management yielded 88 patients over four months. Parents completed a questionnaire with particular reference to the duration of history and frequency of epistaxis. After assessment some patients were given topical chlorhexidine and neomycin cream (Naseptin), in addition some children also underwent chemical cautery (silver nitrate). Of the 64 children in whom out-patient nasal cautery was attempted it was tolerated by 63 (98 per cent). In response to a follow-up postal questionnaire returned by 65 per cent, most parents (74 per cent) felt that Naseptin was useful. A telephone survey of the patients' general practitioners found that 91 per cent of the children did not consult their general practitioner regarding epistaxis again. We conclude that paediatric epistaxis can be effectively managed with a single out-patient consultation.

Adolescent↗
PubMed1989

An improved approach to evacuation of subungual hematoma.

An improved approach to subungual hematoma evacuation has been presented. Hand-held cautery is a cost-effective, precise method of treatment of subungual hematoma. Its use decreases the likelihood of unnecessary delay in the regrowth of the nail plate and secondary dystrophy that might result from pressure on the matrix caused by accumulated blood under the nail. The high temperature and fine tip make the cautery an excellent instrument to precisely and painlessly burn a small hole in the nail plate, allowing for evacuation of subungual hematoma.

Cautery↗
PubMed1975

Thermotrabeculocanalotomy: preliminary report.

Thermotrabeculocanalotomy is a simplified method of obtaining the results of trabeculectomy. After a corneoscleral flap is made, limbal-based, most of the anterior surface of the posterior corneoscleral lamella is undermined with cautery, and the anterior chamber is entered with knife and cautery. Drainage is by filtration. Preliminary results on 17 patients who underwent this surgical approach have been satisfactory. Follow-up time has been from 9 to 14 months.

Aged↗
PubMed2000

[Comparison of four techniques in the treatment of little's area epistaxis].

OBJECTIVE: To probe the most effective technique in the treatment of little's area epistaxis. METHOD: 851 patients were separately treated with four techniques. The effects of sclerosant mucosa injection, cryotherapy, CO2 laser and chemical cautery in the treatment of epistaxis were compared. RESULT: The effective rate of sclerosant mucosa injection is 92.4%, CO2 laser 75.8%, Cryotherapy 76.4%, Chemical cautery 73.8%. No side effect was found. CONCLUSION: Sclerosant mucosa injection is superior to the others.

Adolescent↗
PubMedDate not supplied

[Advantages of topical therapy with polydeoxyribonucleotide in reparative processes after cauterization: experience at a center for early diagnosis of genital neoplasms].

This paper evaluates the common practice of a topic medical treatment following cautery (or other kinds of microsurgery) of the uterine cervix. Firstly, a controlled clinical trial on 116 patients treated with kanamycin sulphate alternated to polydeoxyribonucleotide vaginal suppositories, and 124 controls has been conducted. Subjective parameters (leukorrhea, bloody discharge, odorous discharge, more than three weeks vaginal discharge, itching, pain, burning) and colposcopy (Schiller test reactivity, squamo-columnar junction location, abnormal transformation zones, vascular striae, deepithelialized areas or frail epithelium) appeared more favorable in the treated group, the colposcopic finding of phlogosis being the only unfavorable finding more frequent among the treated patients. Successively, a controlled double blind clinical trial with kanamycin sulphate alternated to placebo vs PDRN at different dosages has shown an increase in number of epithelial cells in the treated patients and a better stimulation of fibroblasts by higher dosages of active substance. These results show the efficacy of the studied post cautery treatment schedule, and of PDRN in particular.

Administration, Topical↗
PubMed1979

A standard large wound of the corneal epithelium in the rabbit.

A method of iodine vapor cautery was applied to rabbit eyes. The cautery produces an approximately circular area denuded of epithelium of uniform size. The eye is not inflamed, and the very rapid mean healing rate of 1.42 mm2hr-1 was observed.

Burns, Chemical↗
PubMed1992

Endotracheal tube safety during electrodissection tonsillectomy.

A case report of an endotracheal tube fire occurring during electrodissection tonsillectomy is presented. The authors believe that this incident occurred because a retrograde leak of ventilating gases around an uncuffed endotracheal tube during positive-pressure ventilation produced a high oxygen concentration in the mouth, allowing indirect ignition of the tube. In vitro testing supported this hypothesis. Ignition tests on polyvinylchloride endotracheal tubes using electrocautery in various oxygen concentrations were performed. As oxygen concentration increased, the endotracheal tube could be moved further from the cautery and still allow ignition of the tube. At 52% oxygen, with the cautery set at 25-W coagulation current, the endotracheal tube could not be ignited. Recommendations to prevent a recurrence of this incident are included.

Child↗
PubMed2004

Interventions for recurrent idiopathic epistaxis (nosebleeds) in children.

BACKGROUND: Recurrent idiopathic epistaxis (nosebleeds) in children is repeated nasal bleeding in patients up to the age of 16 for which no specific cause has been identified. Although nosebleeds are very common in children, and most cases are self-limiting or settle with simple measures (such as pinching the nose), more severe recurrent cases can require treatment from a healthcare professional. However, there is no consensus on the effectiveness of the different clinical interventions currently used in managing this condition. OBJECTIVES: To assess the effects of different interventions for the management of recurrent idiopathic epistaxis in children. SEARCH STRATEGY: We searched the Cochrane ENT Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library Issue 3, 2003), MEDLINE (January 1966 to August 2003), EMBASE (January 1980 to August 2003), CINAHL (January 1982 to August 2003), and reference lists of relevant articles. SELECTION CRITERIA: We identified all randomised controlled trials (with or without blinding) in which any surgical or medical intervention for the treatment of recurrent idiopathic epistaxis in children was evaluated in comparison with either no treatment, a placebo, or another intervention, and in which the frequency and severity of episodes of nasal bleeding following treatment was stated or calculable. The full text articles of all the retrieved trials of possible relevance were reviewed by the two reviewers and the inclusion criteria applied independently. DATA COLLECTION AND ANALYSIS: Trials were graded for methodological quality using the Cochrane approach. Data extraction was performed in a standardised manner by one reviewer and rechecked by the other, and where necessary investigators were contacted to obtain missing information. A meta-analysis was not undertaken because of the heterogeneity of the treatments, procedures and quality of the included trials. A narrative overview of the results is therefore presented. MAIN RESULTS: Three studies - two randomised controlled trials (RCTs) and one controlled clinical trial (CCT) - involving 256 participants satisfied the inclusion criteria. One RCT compared Naseptin antiseptic cream with no treatment, the second RCT compared Vaseline(R) petroleum jelly with no treatment, and the CCT compared Naseptin antiseptic cream with silver nitrate cautery. Overall, results were inconclusive, with no statistically significant difference found between the compared treatments. No serious adverse effects were reported from any of the interventions, although children receiving silver nitrate cautery reported that it was a painful experience (despite the use of local anaesthetic). REVIEWER'S CONCLUSIONS: The optimal management of children with recurrent idiopathic epistaxis is unknown. High quality randomised controlled trials comparing interventions either with placebo or no treatment, and with a follow-up period of at least a year, are needed to assess the relative merits of the various treatments currently in use.

Administration, Intranasal↗
PubMed1991

Contact Nd:YAG tonsillectomy: effects on weight loss and recovery.

Contact Nd:YAG tonsillectomy using synthetic sapphire blades appears to meet or exceed standards established by spot monopolar cautery. Subjects' percentage of weight loss and return to work/social activities was measured and the laser group displayed less percentage of weight loss, faster return to pre-operative weight, and less recovery time than the comparative cautery group. Because of the unique nature of Nd:YAG laser light combined with sapphire blades, special consideration should be given to these accessories by physicians before attempting tissue cutting and vessel coagulation. The author believes that the extent of physician training and proficiency may be key to the success of soft tissue head and neck applications, such as tonsillectomy, which will have an effect on the outcome of clinical data.

Activities of Daily Living↗
PubMed2002

Inhibition of corneal neovascularization by recombinant adenovirus mediated antisense VEGF RNA.

The expression of vascular endothelial growth factor has been strongly implicated in the pathogenesis of conditions leading to inappropriate blood vessel growth in the eye. As such, vascular endothelial growth factor is an attractive target for anti-angiogenic therapies designed to treat neovascular eye diseases. One such therapy, antisense gene therapy, is a technique based on the ability of single-stranded DNA or RNA sequences to alter the expression of targeted genes. Recombinant adenoviruses have demonstrated efficient ocular cell transduction with a high level of transgene production. Cauterization of the normally avascular rat cornea results in a strong neovascular response, making it an ideal animal model for the testing of anti-angiogenic therapies. In this study, a recombinant adenovirus system was assessed for the ability to express biologically relevant antisense RNA to reduce vascular endothelial growth factor expression in a rat model of corneal neovascularization. Recombinant adenovirus constructs expressing short and long antisense and sense vascular endothelial growth factor cDNA, under the control of cytomegalovirus major immediate early promoter or the RNA polymerase III promoter, VA1, were constructed. The expression of short and long antisense RNAs was demonstrated by Northern blot hybridization. All constructs were capable of producing RNA, and the highest level of antisense RNA production was detected in retinal pigment epithelial cells which had been transduced with the longer antisense cDNA construct under the control of the VA1 promoter. This construct was also the most efficient in reducing in vitro vascular endothelial growth factor production (P<0.05) and human endothelial cell proliferation. This construct was subsequently injected into rat eyes 24hr prior to cauterization of the cornea and antisense vascular endothelial growth factor expression was demonstrated by in situ hybridization. The resulting neovascular response was clearly inhibited at 4, 7 and 14 days post-cautery, compared to the control injections which demonstrated an intense neovascular response. Only one out of six eyes injected with the long antisense cDNA construct under the control of the VA1 promoter demonstrated any vascular response to cautery. The reduction in the neovascular response was correlated, with significantly lower amounts of vascular endothelial growth factor protein in the corneas (P=0.006). These observations suggest that the specific down-regulation of vascular endothelial growth factor production is sufficient to reduce the corneal neovascular response and that recombinant adenovirus might be a useful vehicle to produce antisense RNA in situ to down-regulate ocular gene expression.

Adenoviridae↗
PubMed1994

Long-term prognosis of well-differentiated adenocarcinoma in endoscopically removed colorectal adenomas.

Thirty-six malignant polyps were identified that met the following criteria: well-differentiated adenocarcinoma and complete excision endoscopically. Location, type, size, distance of the cancer to the cautery mark, and lymphovascular involvement were analyzed to determine if they affected findings at surgery or risk of recurrent cancer. There were 20 patients and 21 polyps in the nonsurgical group, and 15 patients and polyps in the surgical group. One patient from each group had residual cancer after endoscopic removal of the polyp. The only factor that had an adverse effect on outcome was the distance of the cancer to the cautery mark (< 1 mm). Although rectal location was associated with the residual cancer, poor prognosis could have been predicted by the inadequate margins. This long-term follow-up (65 months average) study supports previous observations that an adequate margin is the most important factor in predicting the prognosis of endoscopically resected colorectal adenomas containing well-differentiated adenocarcinomas.

Adenocarcinoma↗
PubMed2006

Healing patterns of bladder injuries incurred at laparoscopic hysterectomy: a histologic assessment.

The objective of this study was to describe histologic healing patterns of bladder injuries during laparoscopic hysterectomy. This was a prospective experimental analysis (Canadian Task Force classification II-1) performed at the Cleveland Clinic Foundation, Minimally Invasive Surgery Center animal laboratory using virgin female mongrels. Sixteen animals divided into groups of four underwent laparoscopic hysterectomy and bladder injury. In group 1, the bladder injury consisted of a 1-cm bladder base injury with bipolar electrosurgical current. In group 2, suture placement through full thickness bladder was performed during closure of the vaginal cuff. A 1-cm bladder base laceration with monopolar cautery was induced and repaired laparoscopically in group 3; group 4 underwent a similar injury to that of group 3 but the repair incorporated full thickness anterior vaginal cuff. Animals were euthanized at least 28 days after the surgery; the bladders and vaginas were harvested en bloc for histologic tissue preparation. Histologic qualifications of inflammation, fibrosis, granuloma formation, necrosis, cautery artifact, granulation tissue, the presence of arteritis, recanalization thrombus, foreign body giant cells, and fistula formation were evaluated at the sites of bladder injury. When analyzed separately, the difference in these post-injury histologic manifestations was not statistically significant. The same was true when comparison was made between groups 1 and 2 (no bladder laceration) vs groups 3 and 4 (monopolar-induced bladder base lacerations). After a healing period of at least 28 days, the histologic manifestations of the various bladder injuries in all groups are similar.

Animals↗
PubMed2002

[Surgical and interventional use of radiofrequency current: is there interference with implantable cardioverter/defibrillators?].

BACKGROUND: During surgical and interventional procedures, interactions between implantable cardioverter defibrillators (ICD) and electrical cautery, respectively, application of radiofrequency (RF) energy may occur. Induction of inadequate shock therapies or device malfunction may result and represent a potential perioperative hazard for the patient. METHODS: Hence, we analyzed the intraoperative interactions in 23 consecutive ICD patients with regard to different surgical and interventional procedures. Sixteen surgical operations (general surgery n = 7, urologic n = 5, abdominal n = 2, gynecological n = 1, thoracic n = 1) and 7 interventional therapies (RF catheter ablation n = 5, endoscopic papillotomy n = 2) were performed. The ICD devices were all located in the left pectoral position and consisted of 15 single and 8 dual chamber defibrillators. During the procedure tachyarrhythmia detection (VF 295 +/- 21 ms, VT 370 +/- 55 ms) of the devices was maintained active (monitoring mode); only ICD therapies were inactivated. The indifferent electrode of the electrical cauter/RF generator was placed in standard positions (right mid femoral position n = 18, thoracic spine area n = 5). After the procedure, the ICD memory was checked for detections, respectively, for changes of the programming. RESULT: There was no misdetection or reprogramming of the ICD caused by electrical cautery or RF energy. CONCLUSIONS: Despite the lack of undesired interactions ICDs should be inactivated preoperatively to assure maximum patient safety. However, should inactivation be ineffective or not manageable, electromagnetic interference is highly unlikely.

Adult↗
PubMed2002

Avoidance of biliary injury during laparoscopic cholecystectomy.

Biliary injury during laparoscopic cholecystectomy is still a serious problem. Injury occurs as a result of technical errors or misidentification of ducts. Inexperience, inflammation, and aberrant anatomy are key risk factors. The most serious technical problem is cautery-induced injury. This problem may be avoided by use of cautery under very low power settings in the triangle of Calot. Misidentification injuries occur when the surgeon mistakes the common bile duct or an aberrant right hepatic duct for the cystic duct. This error usually occurs when the surgeon uses the "infundibular" technique to identify the cystic duct. This technique, which depends on seeing the cystic duct flare as it becomes the infundibulum, is especially prone to be misleading in the face of acute inflammation. This technique is unreliable and should not be used alone for anatomic identification of the ducts. It is preferable to use the critical view technique or to perform a cholangiogram.

Bile Ducts↗
PubMed1981

Reversal of female sterilization: comparison of microsurgical and gross surgical techniques for tubal anastomosis.

Between 1977 and 1979, 34 consecutive, unselected patients had a reversal of tubal sterilization. The characteristics of 23 patients with more than a 6-month follow-up after end-to-end anastomosis are given, as are details of the operative procedures used. The overall intrauterine pregnancy rate was 56%, and the most reversible sterilization procedures, in terms of intrauterine pregnancies, were the Pomeroy, Uchida, and Falope ring (67%). The least reversible were unipolar tubal cautery (42%) and fimbriectomy (50%). Eleven patients had a microsurgical procedure (with the microscope) and 12 a gross surgical procedure. The use of the microscope was not associated with a significantly better pregnancy rate in cases matched for poststerilization tubal length, proximal and distal to the uterus. But insufficient numbers of tubal cautery reversals have been performed for an evaluation of the use of the microscope in this particular situation. The site of the anastomosis and the postoperative length of the tube were good predictors of intrauterine pregnancies. Five of six patients who had isthmus-isthmus anastomoses on at least one side had term vaginal deliveries. Likewise, 10 of 16 patients in whom the length of the longest tube was 6 cm or more had viable pregnancies, but only one of seven patients had a viable pregnancy with tubes of 5 cm or less.

Adult↗
PubMed1990

Long-term follow-up of laparoscopic sterilizations by electrocoagulation, the Hulka clip and the tubal ring.

A follow-up study of 499 women who underwent sterilization between August 1973 and May 1976 at the Siriraj Hospital in Bangkok, Thailand, and had long-term (4-12 years post-surgery) follow-up is described. Women were sterilized through participation in one of three studies conducted at this hospital. In the first study, 124 underwent sterilization using the Hulka clip via laparoscopy; 67.7% of these women returned for a long-term follow-up visit. In the second study, 300 women were randomly allocated to the Hulka clip or to unipolar electrocoagulation (cautery) via laparoscopy; 70.7% of the women from this study returned for a long-term follow-up visit. The final study was a randomized trial comparing the tubal ring and unipolar electrocoagulation occlusion techniques in 300 cases. Long-term follow-up visits were recorded for 207 women (69.0%) from this study. Five technical failures (procedures not performed or completed as planned) and six non-interval cases were excluded from follow-up analyses. A total of 713 interval patients were eligible for follow-up. Long-term follow-up was initiated in 1978 and continued through 1986. Late sequelae of sterilization, including pregnancies and pelvic surgery, are discussed with regard to type and time of tubal occlusion. One intrauterine and two ectopic pregnancies were reported among women who were sterilized with cautery; one ectopic pregnancy was reported by a woman sterilized with the Hulka clip. Pelvic or abdominal surgeries were reported in 27 cases. Most (greater than 98%) women indicated that they were satisfied with their sterilization procedure.

Adult↗
PubMed2006

Arthroscopic patellar release for the treatment of chronic patellar tendinopathy.

We describe an arthroscopic technique for the treatment of chronic patellar tendinopathy (jumper's knee). Preoperatively, tendon necrosis or rupture is excluded by sonography. Diagnostic arthroscopy is performed and hypertrophic synovitis around the inferior patellar pole is removed with a bipolar cautery system. Two outside-in cannulas mark the clinically symptomatic region, mainly found between the tendon insertion site and the lateral aspects of the patellar tendon. The bipolar cautery is used for a release of the paratenon and a bone denervation at the inferior patellar pole including the tendon insertion site within the marked area. No tendon or bone material is removed or excised throughout the procedure. We treated 15 athletes with stage 3 and 4 chronic patellar tendinopathies on a modified version of the Blazina score (0-5). Patients' mean age was 29 years and the mean follow-up period was 41 months. In 13 cases, clinical symptoms subsided completely within 3 months after surgery. The mean preoperative Blazina score was 3.7 (SD, 0.5) and the mean postoperative Blazina score was 0.4 (SD, 1.0; paired 2-tailed t test, P < .01). Ultrasound showed a reduction of tendon edema within 3 weeks and no signs of edema within a mean period of 5 weeks after surgery. The minimal surgical impact to the tendon allows early and functional rehabilitation. The technique is effective, easy to perform, and safe to apply.

Adrenal Cortex Hormones↗
PubMed2006

Coblation adenotonsillectomy: an improvement over electrocautery technique?

OBJECTIVES: To compare postoperative complication rates of coblation and electrocautery adenotonsillectomies. STUDY DESIGN: Retrospective chart review. RESULTS: From January 2000 to June 2004, 1997 pediatric patients underwent adenotonsillectomy. 745 coblation, and 1252 electrocautery tonsillectomies were performed. Primary bleed, secondary bleed, and dehydration were seen in 3, 35, and 23 coblation, and 9, 41, and 64 electrocautery tonsillectomies, respectively. Data analysis revealed no significant difference in primary and secondary hemorrhage rate, but a higher dehydration rate in the electrocautery group (P=0.0423). A total of 602 coblation, 763 curette/cautery, and 632 electrocautery adenoidectomies were performed. Neck pain was seen in 0, 17, and 3 patients, respectively. Data analysis showed a higher incidence of neck pain with the curette/cautery technique compared with coblator and cautery techniques (P=0.0006 and P=0.0119, respectively). CONCLUSIONS: Coblation tonsillectomy had similar rates of primary and secondary hemorrhage when compared with electrocautery tonsillectomy but a lower incidence of postoperative dehydration. Coblation adenoidectomy caused less postoperative neck pain than curette/cautery adenoidectomy without significant advantage over cautery adenoidectomy. EBM RATING: B-3b.

Adenoidectomy↗