Cold dissection versus bipolar electrocautery tonsillectomy

Abstract

BACKGROUND: Tonsillectomy is one of the most common methods in Head and Neck operations and in ENT all over the world. Children are the most affected group. There are different methods of tonsillectomy including: the common method of using sharp instruments or a newer method the electrocautery, the monopolar or the bipolar, method. This study was conducted to compare cold dissection with bipolar electrocautery tonsillectomy.
METHODS: In a clinical trial carried on 60 patients between the ages of 6 to 15 at Amir-al-momenin Hospital in Rasht,
one tonsil underwent the bipolar electrocautery tonsillectomy and the other underwent the cold dissection tonsillectomy.
The amount of bleeding, duration of operation, throat pain and referral otalgia during hospitalization and after discharge
were evaluated.
RESULTS: The average amount of bleeding related to electrocautery tonsillectomy was 41.2 ± 2.46 ml and in cold dissection, tonsillectomy was 73.13 ± 3.37ml (P<0.001). The mean time of operation was 9.1 ± 0.39 minutes and 15.11 ±
0.65 respectively (P<0.001). On the second day after operation, 21.67% of the patients had more pain on the cauterized
side and 31.67% experience pain on the other side. 46.66 of the patients had equal pain on the two sides.15% of the
patients had referral otalgia in the cauterized side and 16.67% in the other side. There was no pain in 68.37% of the patients.
CONCLUSIONS: The bipolar electrocautery appears to cause less bleeding and postoperative pain and it seems to be less
time consuming in compare with the cold dissection tonsillectomy.
KEYWORDS: Tonsillectomy, cold dissection, bipolar electrocautery, postoperative complications.