Outcomes of shunt insertion for the treatment of hydrocephalus:A single centre analysis

Aim: Shunt insertion is a universal treatment used in tackling the presence of Hydrocephalus (HC). Despite this, many shunts are prone to failure requiring surgical revision. The outcomes of shunts inserted within our cohort were analysed.Method: Retrospective analysis of patients treated with a shunt for HC from 2016-2018 was performed. Data was collected from medical records. Mann-Whitney and Chi-Square tests were used for statistical analysis.Result:44 patients (Adults≥18yrs: 75%; Children (c) Conclusion: Shunts remain an effective treatment in tackling Hydrocephalus. Common complications of insertion include infection which children are more susceptible to. Further work is encouraged to reduce these rates

Patient satisfaction on drainless outpatient parotidectomy

Background: Parotidectomy is commonly performed as an inpatient procedure due to drain insertion. However recent evidence suggests that drainless outpatient parotidectomy is a safe option with comparable postoperative complication and hospital readmission rates to inpatient parotidectomies. Objective: Patient satisfaction on outpatient parotidectomy is unclear and this study aims to report patients’ perspective and satisfaction on drainless outpatient parotidectomy.Design, participants and outcome measures: Anonymous Core questionnaire for the assessment of Patient Satisfaction’ (COPS) for general Day care(COPS-D) questionnaire survey was completed by patients who underwent drainless same day parotidectomy at Ninewells Hospital, Dundee from June2018 to October 2020. Patient satisfaction on different aspects of their outpatient parotidectomy journey (e.g. pre-admission, admission on ward, in-theatre experience, nursing care, pain control and overall satisfaction) were scored using a five-point Likert scale. Results: A total of 31 drainless outpatient parotidectomies were performed and 28patients completed the patient satisfaction survey. The majority of patients were highly satisfied (i.e. scored 5/5) with their preadmission visit (79.5%), admission on the ward (84.5%), operating room experience (96.4%), nursing care (83.9%), medical care (87.5%),information received (75.0%), autonomy (79.8%) and discharge and aftercare (61.9%). Despite preferring drainless parotidectomy, 16/28(57.1%) patients either stayed for less than 23 hours or preferred to stay overnight in the hospital for non-surgical reasons. Conclusion: Outpatient parotidectomy is well received by patients and the majority preferred drainless parotidectomy over inpatient parotidectomy with drains. Careful consideration should be given when selecting patients for day case parotidectomy

Diagnostic Accuracy Outcomes of Office-Based (Outpatient) Biopsies in patients with Laryngopharyngeal Lesions:A Systematic Review

BACKGROUND: In‐office biopsies (IOB) using local anaesthetic for laryngopharyngeal tumours has become an increasingly popular approach since the advent of distal chip endoscopes. Although a wide range of studies advocate use in clinical practice, the widespread application of the procedure is hampered by concerns regarding diagnostic accuracy. OBJECTIVE: To assess the diagnostic accuracy of IOB performed via flexible endoscopy. In addition, to analyse modifiable factors that may affect diagnostic accuracy of IOB. DESIGN: A systematic review following the PRISMA guidelines was conducted. PubMed, EMBASE, the Cochrane Library, Web of Science and CINAHL were used in the literature database search. Quality assessment of included studies was perfomed using the Newcastle‐Ottawa Scale. RESULTS: A total of 875 studies were identified, 16 of which were included into the systematic review; 1572 successful biopsies were performed using flexible endoscopy; 1283 cases were accurately diagnosed in the outpatient setting (81.6%) and 289 samples did not provide an accurate diagnosis (18.4%). The median sensitivity of IOB was 73%, and the specificity was 96.7%. Analysis of variable factors did not show any significant differences in method of approach, size of equipment (forceps) and additional lighting system or learning curve. CONCLUSION: IOB are a viable tool for diagnostic workup of laryngopharyngeal tumours. Clinicians should be wary of reported limitations of IOB when benign or pre‐malignant diagnoses are made. In cases suspicious of malignancy, confirmatory investigation should be conducted