HNO
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Of the morbidities that follow tonsillectomy, nausea and vomiting, fever, pain and inadequate oral intake are the most commonly encountered. The incidence of postoperative nausea and vomiting (PONV) has been reported as between 40% and 85%. In children, the risk of dehydration is increased owing to the delay in oral intake of fluids in the early postoperative period. In efforts to reduce postoperative morbidity, numerous modifications and adjuncts to the surgical procedure have been suggested, including the use of steroids. ⋯ Preoperative administration of a single dose of dexamethasone to reduce postoperative morbidity resulting from tonsillectomy is supported by several studies. Adverse events have never been reported. However, further studies are warranted to determine the optimum dose required and the effect in adult tonsillectomy patients. In addition, the data should be based on standardised surgical and anaesthetic techniques to allow reliable evaluation of the significance of all outcome measures.
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Review Meta Analysis Comparative Study
[Coblation tonsillectomy: a review of the literature].
Controversy surrounds the question of which technique should be preferred for tonsillectomy in order to reduce postoperative morbidity in terms of pain, bleeding, activity and return to normal diet. This study reviews the current literature on coblation tonsillectomy (CTE). ⋯ The design of the current studies varies in size, age distribution, indications for surgery, the surgical techniques compared and follow-up. The results are heterogenous and further evidence is still required to show that CTE is a safe alternative. Therefore, calculation of cost-effectiveness of a commonly performed expensive CTE as a new standard technique is currently impossible.
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Review Multicenter Study Meta Analysis
[Possibilities and limitations for the representation of ENT medicine in the G-DRG reimbursement system. Results of the DRG evaluation project].
To improve the representation of ENT medicine in the German diagnosis related groups (G-DRG) reimbursement system, the German Association for ENT Medicine and the ENT Professional Medical Association, in cooperation with the DRG-Research Group of the University Hospital of Muenster, undertook a DRG evaluation project. ⋯ The adjustment proposals based on these results will gradually lead to an improved allocation of ENT medical procedures within the G-DRG system in 2006 and later.