The Impact of Pressure Dressing on Post-Thyroidectomy Hypocalcemia: Prospective Randomized Controlled Clinical Study

Objective:The aim of the study was to evaluate the efficacy of pressure dressing on complications after total thyroidectomy and its correlation with serum calcium levels.Methods:The study involved 112 patients who underwent total thyroidectomy. Patients were randomized into two groups-with and without pressure dressing-and followed prospectively. The calcium levels were measured at 6, 24, and 48 hours postoperatively, respectively. Hypocalcemia was diagnosed when patients were symptomatic or calcium level was below 8.0 mg/dL. Dressing and drain were removed at the 48th hour of postoperatively.Results:No statistically significant difference was found between the two groups in terms of age; gender; thyroid gland weight; calcium concentrations at the 6th, 24th, and 48th hours; total drain liquid; and hypocalcemia rates. Postoperative hematoma developed in 7.1% of the cases and was statistically higher in the without-dressing group compared to with-dressing group. Thyroid gland weight was correlated positively with total drain liquid. There was no correlation between thyroid gland weight and total drain liquid level and 6th-, 24th-, and 48th-hour calcium levels.Conclusion:Pressure dressing after total thyroidectomy significantly reduces postoperative hematoma. Postoperative serum calcium levels were slightly higher in the pressure dressing group but not statistically significant

Long-Term, High-Frequency Tympanometry and Audiometry Results after Cartilage and Fascia Tympanoplasty

Objective:Fascia or cartilage can be used as grafts in tympanoplasty; however, the disadvantage of cartilage is that it causes stiffness and rigidity in the newly formed tympanic membrane. The aim of this study was to compare the long-term high-frequency tympanometry and audiometry outcomes of tympanoplasty using cartilage and fascia.Methods:Forty patients in whom tragal cartilage was used in type 1 tympanoplasty and 40 patients in whom temporal muscle fascia was used were included in the study. The preoperative and postoperative audiometries of the two groups were compared. Postoperative high-frequency tympanometry (224, 668, 800, and 1000 Hz) and air volume, compliance, and pressure differences of the two groups were also compared.Results:The mean age of the patients was 31.3±4.5 year. The success rates were 96% in the cartilage group and 92% in the fascia group. In the fascia group, the preoperative mean air bone gap was 27.9±97 decibels (dB), and the postoperative mean air bone gap was 19.1±7.6 dB. The postoperative mean air bone gap improvement was 8.8±9.9 dB; the difference was statistically significant. In the cartilage group, the preoperative mean air bone gap was 28.2±9.6 dB, and the postoperative mean air bone gap was 17.2±10.5 dB. The postoperative mean air bone gap improvement was 10.9±10.3 dB; the difference was statistically significant. When postoperative mean air bone gap improvement was compared, there was no statistical difference between the two groups. When high-frequency tympanogram values were compared, there were no significant differences between the two groups at 224, 668, 800, or 1000 Hz frequencies in terms of air volume, compliance, or pressure values.Conclusion:The use of temporal muscle fascia and cartilage in tympanoplasty is statistically similar when compared in terms of tympanic membrane repair, hearing gain, air volume, pressure, and compliance. For this reason, cartilage graft can easily be preferred in tympanoplasty, especially in revision cases and adhesive otitis media, without fear of stiffness or rigidity effects