The Outcomes of 4 Different Techniques of Tonsillectomy

Abstract

Objective: Compare 4 different techniques of tonsillectomy reagarding operative time, intra-operative blood loss, and pain scores.

Method: A total of 160 patients were randomly assigned to the cold dissection tonsillectomy (CDT), bipolar elecrocautery tonsillectomy (BPT), Harmonic Scalpel tonsillectomy (HST), and Thermal Welding tonsillectomy (TWT) groups. Patients underwent tonsillectomy where intraoperative blood loss and time were evaluated. Patients where then followed for pain analysis.

Results: Operative time varied from 6 to 31 minutes, and mean operative time was 13.76 ± 5.28 minutes. Operative time in the HST group was significantly shorter than in the CDT and TWT groups (p = 0.001). Highest intraoperative bleeding was observed in the CDT group (68.6 ± 35.3 ml) and was significantly higher than in the HST (9.4 ± 3.1ml) and BPT groups (13.4 ± 3.8 ml) (P = .001, resp P = .022). Pain scores in the HST group were much lower than in the CDT and BPT groups (P = .022, resp P = .001). Pain scores between other groups did not show any statistically significant difference (P > .05).

Conclusion: The 4 techniques compared all show different attributes useful during surgery, but considering long learning curves and high prices we believe that cold dissection tonsillectomy still has the upper hand.