Masters Degrees (Otorhinolaryngology )
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Item The management of acquired cervical tracheal stenosis.(1993) Grundlingh, Theodore, Daniel.; Fernandes, Carlos M. C.Abstract available in PDF.Item Indications for tracheostomy in paediatric patients at a tertiary referral centre, Inkosi Albert Luthuli Hospital (IALCH).(2018) Kissi, Phumelele Bongiwe Nokwazi.; Naidu, Tesuven Krishna.The paediatric tracheostomy is an uncommon procedure, with higher mortality and morbidity rates than the adult tracheostomy. The procedure itself is technically more demanding than in adults due to the smaller more pliable trachea and the limited operatingfield. The paediatric tracheostomy is performed with a different technique than that of an adult tracheostomy, with a formal stoma is fashioned by suturing the tracheal wall to the skin with maturation sutures in addition to safety stay sutures placed in the tracheal wall. The considerations include the growing anatomy of a child and attention is placed on preventing accidental decannulation and preventing long term damage to the growing anatomy of a child. With the increased availability of Paediatric intensive Care Units (PICU), and high trauma burden in children in Durban, South Africa, we plan to determine what the most common indication for performing a tracheostomy in a paediatric population. This will be done by a retrospective chart review of all cases requiring tracheostomy at IALCH between the period of 2004 to 2016. An in-depth analysis of the charts will provide insight in to the most common pathology requiring a tracheostomy and with that knowledge we can add value to the existing Paediatric tracheostomy Care programme at IALCH. This information gathered will further assist in establishing a support system for the parents of a child with a tracheostomy.Item The management of peritonsillar abscess.(1999) Nwe, Thin Thin.Over a four month period from 1 st November 1998 to 28th February 1999 a randomised prospective study was undertaken in 75 patients with peritonsiller abscess (PTA) to determine the treatment modality that is most effective in alleviating the excruiating pain and discomfort associated with the condition. The patients were divided into three treatment groups. There were 25 patients in each group. Group A patients were treated with intravenous antibiotics and intra muscular opiates, Group B aspiration and oral antibiotics and Group C incision and drainage and oral antibiotics. Pain relief was objectively assessed with each treatment modality by measuring the upper to lower incisor distance, 15 mins, 24 hours and 48 hours and oral intake at 2 hours, 24 hours and 48 hours after the initial treatment. The improvement of the mean upper to lower incisor distance 15 minutes after the initial treatment was 5% in Group A, 38% in Group B and 100% in Group C. Twenty four hours later the improvement was 30% in Group A, 111 % in Group B and 125% in Group C. None of the patients in Group A were able to take fluid orally at 2 hours. Only 2 patients (8%) could in Group B and 23 patients (92%) in Group C. 24 hours later, 15 patients (60%) could take fluid orally in group A, 19 (76%) in group B and 25 (100%) in group C. Treatment failures were those patients in whom the trismus, odynophagia and pyrexia failed to subside after 48 hours. There were 8 patients (30 per cent) in group A, 6 (24%) in group B and none in Group C. The 14 failures were successfully treated with incision and drainage. The conclusion derived from this study is that incision and drainage is superior to intravenous antibiotic and aspiration in alleviating the pain and discomfort associated with peritonsillar abscess.