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Biomedical subjects

C J Newbegin

Publications and source records attributed to C J Newbegin.

8 recordsLinked to original sources
PubMed2001

Effectiveness of the ultrasonic harmonic scalpel for tonsillectomy.

The Ultracision harmonic scalpel (UHS) cuts and coagulates tissue with high-frequency ultrasound. We describe the results of our use of the UHS to perform tonsillectomies in 59 patients. The mean operative blood loss was 7 ml (range: 0 to 75); 56% of patients experienced no measurable blood loss. The mean length of operating time was 8 minutes and 10 seconds (range: 3:45 to 20:25). Patients were assessed for 2 weeks for postoperative pain on the basis of a 10-point linear analog scale. The mean pain score on postoperative day 1 was 4.7; the score peaked at 6.0 on day 4 and fell to less than 3.0 by day 11. Patients returned to full function in an average of 10.9 days (range: 3 to 15). Three patients experienced secondary hemorrhage, one of whom required surgical intervention. We found the UHS to be a well-designed and easy-to-use instrument. Operating time was short, blood loss was minimal, and the degree of early postoperative pain was low. We believe that our findings are encouraging and that the UHS might well have a place in the surgical armamentarium for tonsillectomy.

Adolescent↗
PubMed2000

Endoscopic stapling of pharyngeal pouches in patients from the Yorkshire region.

The treatment of pharyngeal pouches by endoscopic stapling diverticulotomy has gained popularity over the last few years. We assessed the results of this technique in 44 patients by means of a clinical questionnaire and by reviewing case records. Thirty-six (82 per cent) patients commenced oral intake within 18 hours of the procedure and 37 (84 per cent) patients were discharged within 48 hours. Five patients had complications that included throat discomfort, a loose incisor tooth, shoulder pain, pharyngeal perforation and one mortality due to mediastinitis. Of the 37 patients that completed the questionnaire, nine (24 per cent) had some residual symptoms although only two (five per cent) felt that there had been no improvement at all following the stapling procedure. Thirty-five (95 per cent) of the patients stated that they would undergo the procedure again. It appears that pharyngeal pouches can be successfully treated by endoscopic stapling, with patients commencing oral intake within a few hours of surgery and having a short hospital stay. However, as there can be serious complications, we recommend that the procedure be performed by an experienced surgeon.

Aged↗
PubMed1995

Right vocal fold paralysis as a result of central venous catheterization.

Invasive peri- and post-operative monitoring is being increasingly utilized, and a corresponding increase of concomitant complications are becoming apparent. Two cases of complete right vocal fold paralysis are reported as a possible complication of right central venous catheterization. The underlying aetiology of this complication is presumed to be either direct trauma at the time of introduction of the central venous catheter, or by thrombosis and fibrosis around the recurrent laryngeal or vagus nerve. It is suggested that multiple attempts at cannulation and leaving the central line in situ for long periods increases the risk of this complication. When the integrity of the left recurrent laryngeal nerve or vagus is jeopardized or must be sacrificed during surgery, it is suggested that ipsilateral central lines are inserted to minimize the risk of bilateral vocal fold paralysis. Cases of vocal fold paralysis secondary to central line insertion should be followed expectantly and surgical intervention only be considered after 12 months review.

Adult↗