1.Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) for thyroid nodules: A series of the first 10 patients in a single institution
Lawrence Y. Maliwat ; Rowald Rey G. Malahito ; Erasmo Gonzalo D.V. Llanes
Philippine Journal of Otolaryngology Head and Neck Surgery 2020;35(1):39-45
Objective:
To present the perioperative data of patients with solitary or multinodular goiter and/ or papillary thyroid carcinoma who underwent Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) in a single tertiary medical center.
Methods:
Design: Case series.
Setting: Tertiary Government Hospital.
Participants: Records of 10 patients who underwent TOETVA from June 2018 to July 2019 (9 thyroid lobectomies, 1 total thyroidectomy) were reviewed. Outcomes and measures included conversion to open surgery, operative time, intraoperative blood loss, size of the thyroid gland, postoperative hospital stay, visual analogue pain scores (VAS), and postoperative complications.
Results:
None of the 10 patients were converted to an open procedure. The average preoperative thyroid size was 4.73 cm in widest diameter using thyroid ultrasound (±1.88 cm, range 3.6 to 6.5 cm). Mean operative time for thyroid lobectomy and total thyroidectomy was 4 hours and 29 minutes and 4 hours and 15 minutes, respectively. Mean intraoperative blood loss was 140 ml (±47.96 ml, range 80 to 200 ml) for thyroid lobectomy and 100 ml for total thyroidectomy. The average intraoperative size of the thyroid gland measured in widest diameter (larger lobe for total thyroidectomy) was 4.48 cm (±0.919 cm, range 3 to 5.5 cm). Median postoperative hospital stay was 2 days (±1.55 days, range 2 to 12 days). Mean VAS pain scores for postoperative days 1, 2, 3, and 7 were 5, 3, 2, and 0, respectively. Transient recurrent laryngeal nerve injury (of 3 months duration) occurred in 1 patient. Two cases had surgical site infection, 2 had wound dehiscence, 1 had seroma and 1 had skin burn as a complication. None had hypocalcemia or mental nerve injury in the series.
Conclusions
TOETVA was replicated in the local setting and a presentation of the perioperative data of all the patients who underwent this novel technique, the indications, as well as surgical and patient outcomes, were described.
Thyroidectomy
;
Endoscopy
2.Post-tonsillectomy dysgeusia: A case report.
Lawrence Y. Maliwat ; Rosario R. Ricalde
Philippine Journal of Surgical Specialties 2021;76(2):87-91
The authors report a case of post-tonsillectomy dysgeusia and discuss
the pathogenesis, diagnostics, as well as treatment options done in
several reported cases. A 37-year-old man who was diagnosed with
recurrent tonsillitis underwent bilateral palatine tonsillectomy, and
on the second post-operative day, post-tonsillectomy hemorrhage
ensued which required emergency hemostasis at the operating room.
Intra-operative findings include active bleeding on the left tongue
base, wherein hemostasis was achieved via electrodissection. After the
procedure, patient noted a disturbance to taste that persisted for several
months. Dysgeusia is an unusual complication of tonsillectomy,
occurring in 0.3% to 9% of cases.
Tonsillectomy
;
dysgeusia