Laser Tonsillectomy

Abstract

Laser is an acronym of light Amplification by Stimulated Emission of Radiation (LASER). Laser is an intense, collimated beam of pure, monochromatic, single wavelength light. There are many applications of laser in medicine, introduced recently in medicine in 2010 including the ENT, Head and Neck for diagnostic and therapeutic uses, in the different disciplines of medicine. Laser has been use in ENT clinically since late 1970. In the Sudan Laser is surgery with various operations mainly larynx, oral cavity, neck and tonsillectomy. This work is a trial to study the laser tonsillectomy and the outcome. Research Objectives: General Objective: To study laser tonsillectomy and the outcome. Specific Objectives: To sort out the possible complications in laser tonsillectomy. To detect the level of pain, fallowing laser tonsillectomy. To find out ability of oral intake fallowing laser tonsillectomy. Research methodology: This is a prospective study was been done at Aldoha ENT Specialized Hospital. During the period from December 2017 to March 2018.There were 13 patients (cases) had been studied in this work, using laser for doing tonsillectomy. Inclusions criteria all patients presented to Aldoha ENT Specialized Hospital with chronic tonsillitis, with indication for surgery and accept or prefer laser tonsillectomy. Exclusions criteria; all patients refused laser tonsillectomy, or patients with concomitant complications. All patients refused to be included in this study. iii The parameters of the laser instrument used in the study Ceram- ptec, is a diode laser with hand pieces designed to be used with bare fibers, medical used for exact and precise guidance of medical probes. The Results The total number of the patients was 13 (cases), using a diode laser to perform tonsillectomy for them. The patient age group ranged from 5 to 60 years. Male were 4patients (31%) and female were 9 patients (69%). Most of the patients were Sudanese 11 (84.6%).The most common presenting symptoms were sore throat, snoring. The most presented signs were hypertrophy of the tonsils bilaterally 11 patients (84.6%). Concern the operations all of the studied laser tonsillectomy done under general anaesthia. Eleven patients (84.6%) bilateral tonsillectomy were done to them, tow patients (15.4) bilateral tonsillectomy with uvulectomy (UPPP) were done and one (7.7%) patients a unilateral tonsillectomy only for biopsy purpose. No intra- operative nor post-operative complications apart of slight intra-operative bleeding in 12 patients (92.3%). In the post –operative follow up in the first week no pain in 7 patients (53.8%), slight pain in 5 patient(38.5%). There was no post- operative bleeding through the study period. There was no infection post- operative. All the studied patients (100%) had good healing, in the third and sixth weeks. Conclusions: From this study we can conclude that laser tonsillectomy is not takes a lot of time, with a less bleeding, intra operative, post-operative, minimum post -operative complication, less post-operative pain, early oral intake and good healing. Recommendation: From this study we recommend that encourage laser tonsillectomy. Do farther study with a larger number to insure and obtain acquired results.