Uvula injury in Tonsillectomy: A Comparative Study between the Use of Gauze to Hold the Uvula and Conventional Method in Yasothon Hospital
Keywords:
Uvula protection gauze, Tonsillectomy, Reduction of injury of uvulaAbstract
Background: Tonsillectomy is one of the most common surgeries performed in ear, nose and throat patients. However, all surgeons feel uncomfortable with uvula due to uvula shaded the operation. Injury of uvula will be occurred by suction and electric cautery and it will affect to operation. This research studied and created the uvula protection gauze to hold the uvula during operation.
Objective: To study efficacy of the use of gauze to hold the uvula during tonsillectomy in reducing injury of the uvula.
Method: Non-randomized controlled trial was used in this study during 1st January 2018 and 9th June 2019. There were 2 groups of patients. The first group was the experiment group (E group), all patients used the gauze to protect uvula during tonsillectomy. The second group was the control group (C group) used the conventional method without the use of gauze. The levels of uvula trauma were recorded as level 0 to 3 : 0- no injury; 1- uvula swelling and redness below 1/3 of length of uvula; 2- same as 1 but more than 1/3 of length of uvula; 3- evidences electric cautery. The data such as the number of uvula injury from the suctions and electric cautery including the level of uvula trauma were analyzed by statistic.
Results: All 117 patients undergoing tonsillectomy were enrolled to the study. The experimental group (E group) was 70 patients, 31 men and 39 women with their ages ranging from 4 to 53 years. The control group (C group) consisted of 42 patients, 27 men and 15 women with their ages ranging from 3 to 38 years. The average times used the gauze to protect uvula were 2.8 minutes. The average operative times in both groups were 21 minutes in E group and 22.7 minutes in C group. The number of patients with uvula injuries from suction and electric cautery was 0 (0%) in E group and 33 (78.57%) in C group. The most frequencies of suction use were 5-6 times in the operation. The number of the uvula injuries from electric cautery was 0 patient (0%) in E group and 5 patients (11.9 %) in C group. The levels of uvula injuries after operation were found as level 0 and 1 (81% and 13%) in E group and level 0,1,2,3 (21.43%, 38.10%, 28.75% and 11.9% respectively) in C group. This study showed that there were statistically significant differences in E group and C group between the number of uvula injuries from the suctions and electric cautery and also the level of uvula trauma that p-values were 0.000, 0.003 and 0.000, respectively.
Conclusion: There were statistically significant differences of the use of gauze to hold the uvula during tonsillectomy in reducing the uvula injury.
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