Document Detail


Monopolar electrocautery in adenoidectomy as a possible risk factor for Grisel's syndrome.
MedLine Citation:
PMID:  12172260     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES/HYPOTHESIS: Grisel syndrome is a nontraumatic atlantoaxial subluxation after an inflammatory process in the upper cervical region. It results from a peripharyngeal infection as well as a rare complication following adenotonsillectomy. After the introduction of monopolar suction electrocautery in adenoidectomy, an increased incidence of Grisel's syndrome has been observed. The purpose of the study was to evaluate monopolar suction electrocautery as a possible risk factor. STUDY DESIGN: Retrospective chart review along with current measurements of monopolar and bipolar electrocautery during adenoidectomy. METHODS: The charts of 1431 consecutive cases of adenoidectomy were reviewed before (n = 710) and after (n = 721) the introduction of monopolar suction electrocautery for intraoperative hemostasis. Moreover, energy of delivered current of electrocautery was measured in 30 pediatric patients during adenoidectomy. RESULTS: Three cases of Grisel's syndrome occurred as a postoperative complication in 721 adenoidectomies (0.4%) after the introduction of monopolar suction electrocautery. In contrast, no Grisel's syndrome was observed in 710 procedures before the use of monopolar electrocautery. Current measurements demonstrate an almost fourfold higher level of electrical energy using monopolar electrocautery compared with bipolar coagulation for bleeding control in adenoidectomy. CONCLUSION: Monopolar suction cautery in adenoidectomy may be considered as a risk factor for Grisel's syndrome.
Authors:
Kurt Tschopp
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Laryngoscope     Volume:  112     ISSN:  0023-852X     ISO Abbreviation:  Laryngoscope     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-08-12     Completed Date:  2002-09-27     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8607378     Medline TA:  Laryngoscope     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1445-9     Citation Subset:  IM    
Affiliation:
Department of Otorhinolaryngology, Kantonsspital Liestal, Liestal, Switzerland. kurt.tschopp@ksli.ch
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MeSH Terms
Descriptor/Qualifier:
Adenoidectomy / adverse effects*,  methods*
Atlanto-Axial Joint*
Child
Dislocations / epidemiology*,  etiology*
Electrocoagulation / adverse effects*
Humans
Incidence
Retrospective Studies
Risk Factors
Syndrome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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