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Biomedical subjects

T R Nielsen

Publications and source records attributed to T R Nielsen.

8 recordsLinked to original sources
PubMed2000

Meningitis following stapedotomy: a rare and early complication.

Controversy exists concerning stapedotomy for patients with small unilateral air-bone gaps. Surgical treatment of otosclerosis involves an opening to the labyrinth and accordingly, a risk of complications, usually vertigo and sensorineural hearing loss and infrequently anacusis. In this paper we present a 33-year-old woman with a small unilateral air-bone gap, who developed bacterial labyrinthitis with meningitis and anacusis three days after stapes surgery. The patient had a stapedotomy with the small fenestra piston prosthesis technique. Due to the potential for serious complications, patients with unilateral otosclerosis and mild hearing loss should be given the possibility to choose between a hearing aid and surgery. Although stapedotomy in the vast majority of interventions is a highly successful procedure and the best method of treatment for otosclerosis if successful, there is a high price to pay in the event of failure.

Adult↗
PubMed1999

[Is the use of surgical microscope justified in thyroid surgery? 10-year experience with thyroid surgery performed by means of microsurgical technique].

Paralysis of the recurrent laryngeal nerve is the most disastrous complication following thyroid surgery. In order to minimize this complication, different devices have been used to identify the recurrent laryngeal nerve during surgery. The presently available devices are reviewed and we present our results with the device we used, the surgical microscope. Five hundred and seventy-three patients had thyroid surgery, 451 had benign lesions and 122 malignant. Calculated as nerves at risk, primary surgery in benign/malignant disease resulted in 0.6 per cent/3.5 per cent permanent paralysis and in recurrent and completion surgery this complication rate was 4.5 per cent/2.9 per cent. These results are pleasing but also stress that primary surgery should be radical so as to avoid completion or recurrent surgery.

Adolescent↗
PubMed1999

[A 7-year experience with goiter surgery in an otorhinolaryngologic department. A retrospective study of the the period 1990-1996].

The aim of this study was quality assurance and to analyse the frequency of complications following thyroid surgery. The most dreaded surgical complications are permanent injury to the recurrent laryngeal nerve or persistent hypocalcaemia. Our surgical procedure included the use of the surgical microscope in connection with thyroid grand surgery. Our materiel includes 122 patients who underwent surgery for benign thyroid diseases in our department from 1990-1996. In nearly 50% of all cases a lobectomy was performed, reserving resections and subtotal thyroidectomy to special cases. Resections were primarily done in the beginning of the period. The surgical microscope was used as a standard procedure to identify and expose the recurrent laryngeal nerve and the parathyroid glands. Primary thyroid grand surgery in benign disease resulted in permanent unilateral laryngeal nerve palsy in one case or in 0.83% of the patients. When calculated as nerves at risk, the complication rate was reduced to 0.67%. In benign completion surgery the complication rate was 0%. No patient developed persistent hypocalcaemia.

Adult↗
PubMed1998

Microsurgical technique in thyroid surgery--a 10-year experience.

OBJECTIVE: To report the results of thyroid surgery in a University department of ENT--head and neck surgery, and to evaluate the benefits of the use of the surgical microscope in thyroid surgery. DESIGN: A retrospective evaluation of the records of all patients who underwent thyroid surgery in the 10-year period 1987-1996. METHODS: In addition to standard surgical principles the Zeiss multi-discipline universal surgical microscope with a 250 mm ocular lens was used in all cases. Total thyroidectomy was performed in all malignant cases, while unilateral lobectomy plus isthmus resection was the standard procedure in benign cases. PATIENTS: There were 573 patients, aged 11-87 years, 444 females and 129 males. Four hundred and fifty-one had benign lesions, 122 malignant. Four hundred and eighty-nine had primary surgery, 84 underwent completion surgery or surgery for recurrent disease. RESULTS: Primary thyroid gland surgery in benign/malignant disease resulted in permanent recurrent laryngeal nerve palsy in 0.6 per cent/3.5 per cent of the patients respectively, when calculated as nerves at risk (NAR). In benign recurrent or malignant completion surgery this complication rate was 4.5 per cent/2.9 per cent respectively. CONCLUSION: Thyroid surgery in our University ENT--Head and Neck Department with the use of the surgical microscope provides pleasing results, especially considering the diversity of surgeons, due to the departments' teaching responsibilities.

Adolescent↗
PubMed1996

[Patient assessment in ambulatory surgery. A questionnaire study].

In our department, from the beginning of December 1994 to the end of February 1995, we operated upon a selected group of 199 patients, hospitalized as day surgery patients. Each patient was given a questionnaire to fill in after discharge. We asked them to evaluate day surgery from the consumer's point of view. We did not record any data which could identify the single patient. We received 158 questionnaires (79%) of which 151 were accepted. One hundred and seven patients (71%) found day surgery acceptable and a good alternative to conventional hospitalization, 82% preferred having the same doctor and primary nursing during the treatment. One hundred and sixteen patients were discharged as planned (77%). There were no serious complications. Provided that patients are carefully selected, we find day surgery a highly satisfactory method of management which is safe and efficient.

Adolescent↗
PubMed1996

Mediastinitis-a rare complication of a peritonsillar abscess.

We report a case of mediastinitis, in an otherwise healthy 25-year-old man, resulting from a peritonsillar abscess with extension through the parapharyngeal and retropharyngeal spaces. In our case the patient was primarily treated with needle aspiration, a method described in many publications as a safe alternative to incision and drainage. We emphasize that for peritonsillar abscesses a tonsillectomy or wide incision and drainage, instead of needle aspiration, might prevent the extension of the condition, thus preventing serious complications.

Adult↗
PubMed1994

[Extrapulmonary tuberculosis--important differential diagnosis].

In this paper, we present two cases of extrapulmonary tuberculosis, the first case with tuberculosis of the larynx and the second with tuberculosis lymfadenitis. In both cases malignant lesions were primarily proposed. We emphasize that definitive diagnosis requires culture and specification of Mycobacterium tuberculosis. We draw attention to the fact that extrapulmonary tuberculosis is still a differential diagnostic consideration.

Adult↗