Year: 1998 Vol. 64 Ed. 6 - (3º)
Artigos Originais
Pages: 571 to 576
Assessment of the Effectiveness Human Beings of na otologic Microcautery with a Device for Aspiration and Detachment.
Author(s):
Luiz Lasinslry, AIS, MD, PhD* ;
Paulo Roberto S. Sanches ** ;
Ubirajara M. da Cunha**,
Paulo Ricardo O. Thomé** ;
André F. Müller** ;
Danton Pereira Jr. ** ;
Ugo L. Guimarães Filho ***
Rafael Fraga ****
Daniela B. da Silva****
Marcelo de Souza ****.
Keywords: electrosurgery, microcauthery, middle ear
Abstract:
This work evaluated middle-ear surgeries performed in human beings using a novel microcautery with a device for aspiration and detachment, eonceived by the fírst author, in comparison to procedures of the same type performed without use of a cautery. Twenty-four patients referred for unilateral or bilateral stapedectomies and tympanoplasties were selected for the study. Patients with systemic diseases, sueh as noncontrolled arterial hypertension and blood dyscrasia had been previously excluded. The patients were randomly divided into two groups: surgery was performed with the microcautery in 12 patients; and without the cautery in 12 patients. The microcautery enables time- and heat-controlled low-power (maximum 35 W) microcauterizations. The concentrated electric current can explode tissue cells or heat tissue locally. This enables cutting, cauterization and detachment of tissuein regions that are difficult to acesss. The procedures were vídeotaped and evaluated by two otologic surgeons. The evaluation process was blind: the surgeons did not know which procedures had been performed with the microcautery. Procedures were qualified as Excellent, Good, Regular or Poor. The parameter used in the evaluation was homeostasis. Both evaluators qualified as °Excellent" the procedures performed with the microcautery. For the control group, evaluator 1 qualified 42% of the procedures as "Poor", and 58% as "Regular". Evaluator 2 qualified 25% of the control group procedures as "Poor" and 75% as "Regular". The microcautery showed concreto advantages in comparison to conventional methods. Therefore, we consider its application commendable for this type of surgery.
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