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Six years of evidence-based adult dissection tonsillectomy with ultrasonic scalpel, bipolar electrocautery, bipolar radiofrequency or ‘cold steel’ dissection

Published online by Cambridge University Press:  19 September 2012

S M Ragab
S M Ragab*
Affiliation:
Department of Otolaryngology, Tanta University Hospital, Egypt
*
Address for correspondence: Mr Sameh M Ragab, Department of Otolaryngology, Tanta University Hospital, El Bahr St, Tanta, Gharbia, Egypt Fax: +20 403416781 E-mail: sragab@doctors.org.uk
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Abstract

Objective:

To conduct an adequately powered, prospective, randomised, controlled trial comparing adult dissection tonsillectomy using either ultrasonic scalpel, bipolar electrocautery, bipolar radiofrequency or ‘cold steel’ dissection.

Methods:

Three hundred patients were randomised into four tonsillectomy technique groups. The operative time, intra-operative bleeding, post-operative pain, tonsillar fossa healing, return to full diet, return to work and post-operative complications were recorded.

Results:

The bipolar radiofrequency group had a shorter mean operative time. The mean intra-operative blood loss during bipolar radiofrequency tonsillectomy was significantly less compared with cold dissection and ultrasonic scalpel tonsillectomy. Pain scores were significantly higher after bipolar electrocautery tonsillectomy. Patients undergoing bipolar electrocautery tonsillectomy required significantly more days to return to full diet and work. The bipolar electrocautery group showed significantly reduced tonsillar fossa healing during the first and second post-operative weeks.

Conclusion:

In this adult series, bipolar radiofrequency tonsillectomy was superior to ultrasonic, bipolar electrocautery and cold dissection tonsillectomies. This method combines the advantages of ‘hot’ and ‘cold’ tonsillectomy.

Keywords

TonsillectomyAdultElectrocoagulationRandomized Controlled Trial
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 10 , October 2012 , pp. 1056 - 1062
Copyright
Copyright © JLO (1984) Limited 2012

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