Ultrasound diathermy is widely used for the treatment of musculoskeletal disorders and other soft tissue injuries. Its use as a therapeutic modality is believed to be safe, with very few reported complications. Here, we report two patients who developed focal bone marrow abnormalities after receiving ultrasound diathermy. Both patients' magnetic resonance (MR) evaluations revealed linear subchondral bone lesions of the superolateral humeral head similar to those in osteonecrosis. The patients' symptoms subsequently improved, and available follow-up MR evaluation revealed near complete resolution of bone lesions. These findings suggest that ultrasound diathermy, and its interaction with bone tissue through thermal mechanisms, can cause focal bone marrow abnormalities. Furthermore, the bone marrow abnormalities seem to be transient, resolving upon cessation of ultrasound diathermy, therefore osteonecrosis should be differentiated from this temporal lesion.
Bone and Bones ; Bone Marrow ; Diathermy ; Follow-Up Studies ; Humans ; Humeral Head ; Magnetic Resonance Imaging ; Osteonecrosis ; Soft Tissue Injuries ; Ultrasonography

The burn center in our hospital is a national and regional (Southeast Asia) center. Of all admissions, 10% are related to blast explosions, and 8% due to chemical burns. In the acute burn management protocol of Singapore General Hospital, early surgical debridement is advocated for all acute partial-thickness burns. The aim of early surgical debridement is to remove all debris and unhealthy tissue, preventing wound infection and thereby expediting wound healing. In chemical burns, there can be stubborn eschars that are resistant to traditional debridement. We would like to present a novel technique using the diathermy scratch pad as a cheap and efficient tool for the dual purpose of surgical debridement and dermabrasion.
Burn Units ; Burns ; Burns, Chemical ; Debridement ; Dermabrasion ; Diathermy ; Explosions ; Foreign Bodies ; Hospitals, General ; Singapore ; Wound Healing ; Wound Infection

Electrocautery of nasal septum is a very common treatment of epistaxis in Otorhinolaryngology. However, serious complications of electrocautery are rare. We encountered a 52-year-old female patient who presented with nosebleeds. A definite focus of bleeding was identified by nasal endoscopy, thus electrocautery by bipolar diathermy was performed in the area of Kisselbach's plexus of nasal septum. There were no abnormal findings in the nasal septum during the three weeks of outpatient visit. However, the patient noticed a depression near the tip of her nose 12 weeks later. Saddle nose deformity after electrocautery has not yet reported in the literature. Therefore, we present this case with a brief review of literature.
Congenital Abnormalities* ; Depression ; Diathermy ; Electrocoagulation* ; Endoscopy ; Epistaxis ; Female ; Hemorrhage ; Humans ; Middle Aged ; Nasal Septum* ; Nose* ; Otolaryngology ; Outpatients

The present circuit was designed to apply to human tissue impedance tuning and matching device in ultra-short wave treatment equipment. In order to judge if the optimum status of circuit parameter between energy emitter circuit and accepter circuit is in well syntony, we designed a high frequency envelope detect circuit to coordinate with automatic adjust device of accepter circuit, which would achieve the function of human tissue impedance matching and tuning. Using the sampling coil to receive the signal of amplitude-modulated wave, we compared the voltage signal of envelope detect circuit with electric current of energy emitter circuit. The result of experimental study was that the signal, which was transformed by the envelope detect circuit, was stable and could be recognized by low speed Analog to Digital Converter (ADC) and was proportional to the electric current signal of energy emitter circuit. It could be concluded that the voltage, transformed by envelope detect circuit can mirror the real circuit state of syntony and realize the function of human tissue impedance collecting.
Diathermy ; instrumentation ; Electric Impedance ; Humans ; Radio Waves ; Signal Processing, Computer-Assisted

BACKGROUND AND OBJECTIVES: Optimal electrical power required for diathermy during tonsillectomy has not been determined. The aim of this pilot study was to evaluate and compare surgical outcomes of using diathermy power settings at 15 watts (W) and 25W for monopolar microdissection and bipolar hemostasis during tonsillectomy. SUBJECTS AND METHOD: This prospective, single-center, single-blind, randomized study was conducted on 92 patients who underwent 15W or 25W monopolar microdissection and bipolar hemostasis for tonsillectomy. Operation times, post-operative pain severities, and rates of hemorrhage were compared between the 15W and 25W groups. RESULTS: The 92 patients were randomized equally into two study groups. The mean operation duration for the 15W group was significantly longer than in the 25W group (18.5±6.11 versus 13.4±6.04 minutes, p<0.01). The rate of minimal hemorrhage (defined as an episode of bleeding not significant enough for hospital visitation) for the 15W group was significantly higher than for the 25W group (41.3% versus 20.5%, p<0.05). No significant intergroup difference was observed between the rates of primary or secondary hemorrhage or postoperative pain scores. CONCLUSION: Twenty-five watt monopolar microdissection and bipolar hemostasis for tonsillectomy had a shorter mean operation time and a lower post-operative minimal hemorrhage rate than 15W monopolar microdissection and bipolar hemostasis.
Diathermy* ; Hemorrhage ; Hemostasis* ; Humans ; Methods ; Microdissection* ; Operative Time ; Pain, Postoperative ; Pilot Projects ; Prospective Studies ; Tonsillectomy*

OBJECTIVETo investigate the pathogenesis and treatment of penile necrosis resulting from microwave diathermy following circumcision.

METHODSWe retrospectively analyzed the clinical data about 9 cases of penile necrosis resulting from postoperative microwave diathermy following circumcision. The 9 males, aged 20 - 39 (mean 26) years, underwent traditional circumcision for redundant prepuce or phimosis in other hospitals, followed by microwave diathermy for 30 - 60 minutes daily, which resulted in penile necrosis. With no response to conservative therapy, the patients were referred to our hospital at 3 -30 days postoperatively. Of the 9 patients, 5 presented with dry gangrene and 4 with moist gangrene. Six of the patients underwent partial penectomy, including 1 that received penis lengthening.3 months later, while the other 3 underwent total penectomy for total penile necrosis followed by penile reconstruction 3 months later, with deep inferior epigastric perforator (DIEP) flaps and by implantation of the 12th costal cartilage in 2 cases and with epigastric groin island flaps and by urethroplasty in the other.

RESULTSThe patients were followed up for 2 - 8 years, and all could urinate smoothly in the standing position. Of the 6 men treated by partial penectomy, 1 received penis lengthening and achieved a penile length of 7 cm and 5 had the remaining penile length of 3 -5 cm, 4 with erectile function and the other 2 capable of sexual intercourse. The 3 men treated by total penectomy achieved nearly normal external appearance of the penis, with a finalized length of (11.7 ± 1.3) cm, a circumference of (11.4 ± 2.1) cm, and a normal feel of the skin. Of the 3 cases of penile reconstruction, 2 achieved sufficient erectile hardness of the penis (grade 3) for sexual intercourse, while the other 1 remained impotent.

CONCLUSIONPost-circumcision microwave diathermy may result in penile necrosis, for the management of which, early debridement is necessitated and penile lengthening or reconstruction can be performed according to the severity of the lesion and needs of the patient.

Adult ; Circumcision, Male ; methods ; Coitus ; Costal Cartilage ; transplantation ; Diathermy ; adverse effects ; methods ; Humans ; Male ; Microwaves ; adverse effects ; Penis ; abnormalities ; surgery ; Phimosis ; surgery ; Postoperative Period ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Young Adult

Rhinogenic headache is a headache or facial pain syndrome secondary to mucosal contact points or rhinogenic causes in the absence of rhinitis/sinusitis. The authors report a case of atypical rhinogenic headache in a 72-year-old woman who presented with recurrent right side headache, which was aggravated by nasal breathing. A computed tomographic scan showed no evidence of rhinosinusitis and mucosal contact points. However, during nasal endoscopy, she had multiple pain-trigger points on the septum and lateral nasal wall. Treatment involved endoscopic reduction and radiofrequency diathermy of the pain-trigger point. Postoperatively, the headache was successfully relieved, and there was no evidence of recurrence. In this article, the authors present surgical option for the treatment of atypical rhinogenic headache.
Aged ; Diathermy* ; Endoscopy ; Facial Neuralgia ; Female ; Headache* ; Humans ; Recurrence ; Respiration

Tracheostomy is a relatively common surgical procedure that is performed easily in an operating room or intensive care unit. Open tracheostomy is needed in patients requiring prolonged ventilation when percutaneous tracheostomy is inappropriate. Sometimes, it is difficult to achieve bleeding control in the peritracheal soft tissue, and in such cases, we usually use diathermy. However, the possibility of an electrocautery-ignited surgical field fire can be overlooked during the procedure. This case report serves as a reminder that the risk of a surgical field fire during tracheostomy is real, particularly in patients requiring high-oxygen therapy.
Diathermy ; Fires* ; Hemorrhage ; Humans ; Intensive Care Units ; Operating Rooms ; Oxygen* ; Tracheostomy* ; Ventilation

This study provides a systematic review of the literature on nipple-sparing mastectomy and necrotic complications in order to estimate the prevalence of necrotic complications and to investigate their significant predictors. A literature search was conducted using the MEDLINE and Ovid databases. A pooled analysis was performed for calculation of the prevalence of nipple-areolar complex (NAC) necrosis, mastectomy flap necrosis, and overall necrotic complications and to evaluate the relationships between necrotic complications and potential risk factors. A total of 44 papers were analyzed. The prevalence of overall necrotic complications was 13.7%, including 7.5% for NAC necrosis and 7.8% for mastectomy flap necrosis. Types of incisions showed significant association with the rates of NAC necrosis and mastectomy flap necrosis. Incisions involving the NAC showed a significantly higher rate of NAC necrosis than those not involving it. The prevalence of NAC necrosis was higher in the autologous tissue reconstruction group than in the prosthesis group. Active smoking and diathermy dissection were significant predictors of both NAC necrosis and mastectomy flap necrosis. The findings of this review suggest that there are several predictors of necrotic complications in nipple-sparing mastectomy. Appropriate patient selection, careful operative planning, and surgical technique refinements may reduce the risk of necrotic complications.
Diathermy ; Female ; Mammaplasty* ; Mastectomy* ; Necrosis ; Patient Selection ; Postoperative Complications ; Prevalence ; Prostheses and Implants ; Risk Factors ; Smoke ; Smoking

OBJECTIVETo evaluate the effect of linearly polarized near-infrared irradiation (Super Lizer) combined with aerothermotherapy in the treatment of patients with frozen shoulder and diabetes.

METHODSEighty-four diabetic patients with frozen shoulder were randomized into 3 groups to receive a 20-day treatment with drug therapy and shoulder exercise (control group), daily linearly polarized near-infrared irradiation in addition to the control therapy (Super Lizer group), or daily Super lizer and aerothermotherapy (S+P group) in addition to the control therapy. Visual analogue scale was used to assess the changes in the pain intensity, and the shoulder movement was assessed using shoulder movement disorder degree integral scores.

RESULTSAfter the 20-day treatment, the VAS scores and shoulder movement disorder degree integral scores in the 3 groups all significantly decreased (P<0.05), and these scores in Super Lizer group and S+P group were significantly lower than those in the control group (P<0.05). The cure rate in S+P group was significantly higher than that in the other two groups (P<0.01).

CONCLUSIONLinearly polarized near-infrared irradiation combined with aerothermotherapy is effective for treatment of patients with frozen shoulder and diabetes with a high cure rate and short treatment course.

Bursitis ; complications ; therapy ; Diabetes Complications ; therapy ; Diathermy ; Female ; Humans ; Infrared Rays ; therapeutic use ; Laser Therapy ; Male ; Middle Aged ; Treatment Outcome