Tehran University Medical Journal

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Background and Aim: Total laryngectomy following laryngeal cancer has many sequelae , that loss of voice is the most important of them. Tracheoesophageal puncture (TEP) and prosthesis insertion has evolved into the most widely used and accepted technique for vocal rehabilitation.

Materials and Methods: 10 patients that underwent TEP in Amir Alam and Imam Khomeini hospitals from Feb. 2002 through Nov. 2003 were included in this study. Prosthesis insertion in 4 patients is primary and in 6 patients is secondary and all patients are men.

Results: The age of patients was between 50 to 70. 90% of patients had history of cigarette smoking and 10% of them had history of drinking alcohol. Salivary leakage was seen in 30% of patients that was improved with conservative management. Fluency of speech in 30% of patients and intelligibility of speech & voice quality in 40% of patients is good.

Conclusion: We could conclude that TEP has less complication & better speech results of other vocal rehabilitation methods. Carefully selection of patients & size of prosthesis has important role in results of TEP.

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Background: Radiofrequency has recently been used in treating tonsilar hypertrophy in adults. We evaluated the results of partial resection (volume reduction) of tonsil using this method.
Methods: Twenty patients with tonsilar hypertrophy were enrolled in a quasi-experimental before-after clinical trial. Local anesthesia was achieved by utilizing lidocain spray and then injection of lidocain and epinephrine, then radiofrequency was performed at power=7-8w. Bleeding, pain and need for analgesics were assessed during, immediately, 4, 6, and 8 weeks after operation.
Results: The mean pain scale was 2.68±2.11 according to (VAS) and the mean bleeding amount was 1.16±0.24ml during operation. The mean operation time was 7.81±2.56min. Ten percent of our patients did not have pain immediately after surgery while 55% complained of pains that did not warrant using analgesics and the remaining 35% experienced pains that were alleviated by analgesics. During and immediately after operation 95% of the patients experienced mild bleeding and only one patient (5%) had moderate bleeding (2-5ml). Mild bleeding was only reported in 10% of patients during the first 4 weeks after operation and was not seen in patients in following weeks. The grade of tonsilar hypertrophy decreased in all patients and the mean time of symptom disappearance was 7.81±0.36 in 8 weeks. Finally the mean satisfaction rate of the patients was 66.92±12.5% (ranging from 50% to 80%). Mild complications were reported in 15% of patients.
Conclusion: Radiofrequency is a safe procedure with minimum possible complication rate for tonsilotomy.

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Background: Resulting from the rough flow of air through the nose and throat during sleep, snoring can arise from transitory obstruction at various levels, rendering the sufferer feeling sleep deprived. A relatively new method using radiofrequency technology, called palatoplasty (somnoplasty), can be used to reduce the size of obstructive tissues in the nose and throat. In this study, we assess radiofrequency palatoplasty in the treatment of snoring.

Methods: This nonrandomized prospective quasi-experimental study included 28 patients who snored at a level considered bothersome to their bed partner. Snoring and drowsiness were each subjectively scored using 20-point visual analogue scales before and after treatment. Radiofrequency energy was delivered to the soft palate either at the midline or in the lateral soft palate 21 patients were treated once and seven patients twice with an interval of at least seven weeks.

Results: The mean age of the patients was 47 (SD=10.7) years, with a range of 25-65 years, 57% were men, and the mean body mass index was 29 (SD=4.5). Sleep apnea in these patients was subjectively rated mild to moderate. After seven weeks of treatment, snoring was improved in 71.4% of patients (p<0.005). The tongue versus pharyngeal size was improved in 34.4% (p<0.005). The mean patient snoring score was significantly improved from 17.39 (SD=3.02) to 11.50 (SD=6.46) (p<0.005). The mean drowsiness score was also significantly reduced from 6.8 (SD=6.9) to 3.93 (SD=4.19) (p<0.005). No persistent negative impact was observed in speech or swallowing. Pain and bleeding was limited.

Conclusions: Radiofrequency palatoplasty is effective in the treatment of snoring and its consequent drowsiness.