scholarly journals Comparison of Bipolar Diathermy Tonsillectomy Versus Cold Steel Dissection Tonsillectomy

2020 ◽  
Vol 14 (2) ◽  
2012 ◽  
Vol 18 (1) ◽  
pp. 55-58
Author(s):  
Mohammad Shah Kamal ◽  
Rubina Farzana ◽  
Abu Hena Mohammad Parvez Humayun ◽  
AHM Zahurul Huq ◽  
Md Mostafizur Rahman

Tonsillectomy is probably the most common operation performed by an Otolaryngologist. One of the most significant complications is post-operative haemorrhage. Episodes of post tonsillectomy haemorrhage are unpredictable and sometimes life threatening. The aim of the present study was to find out the incidence of reactionary haemorrhage after tonsillectomy. A prospective study was conducted at Shaheed Shamsuddin Ahmed Hospital, Sylhet from April 2010 to March 2011. We had selected 112 cases undergoing tonsillectomy. Tonsillectomy was done by cold steel dissection technique and bipolar diathermy haemostasis. Post operatively every patient was treated with pain killer (diclofenac sodium and paracetamol), antibiotics (amoxicillin and cloxacillin) and hydrogen peroxide mouth wash. Postoperative follow-up was done till the tonsillar fossa healed. The incidence of reactionary haemorrhage was 2.68%, primary and secondary haemorrhage was 0%. In our series haemorrhage (2.68%) was higher than that reported in most publications and may be due to inadequate per-operative haemostasis. DOI: http://dx.doi.org/10.3329/bjo.v18i1.10415  Bangladesh J Otorhinolaryngol 2012; 18(1): 55-58


2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Hussein Walijee ◽  
Ali Al-Hussaini ◽  
Andrew Harris ◽  
David Owens

There are a multitude of techniques to undertake tonsillectomy, with hot techniques such as diathermy and coblation being associated with a higher risk of secondary haemorrhage. The UK National Prospective Tonsillectomy Audit (2004) advocated cold steel dissection and ties to be the gold standard. This prospective observational study investigates the trends in tonsillectomy techniques across Wales in the last decade to establish if surgeons have adhered to this national guidance. Data relating to tonsillectomy were extracted over a 10-year period from 1 January 2003 to 31 December 2012 from the Wales Surgical Instrument Surveillance Programme database. A total of 19,195 patients were included. Time-series analysis using linear regression showed there was an increase in the number of bipolar diathermy tonsillectomies by 84% (Pearson’sr=0.762,p=0.010) and coblation tonsillectomies by 120% (r=0.825,p=0.003). In contrast, there was a fall in the number of cold steel dissection tonsillectomies with ties by 60% (r=-0.939,p<0.001). This observational study suggests that the use of bipolar and coblation techniques for tonsillectomy has increased. This deviation from national guidance may be due to these techniques being faster with less intraoperative bleeding. Further study for the underlying reasons for the increase in these techniques is warranted.


2008 ◽  
Vol 123 (5) ◽  
pp. 545-549 ◽  
Author(s):  
A Smithard ◽  
C Cullen ◽  
A S Thirlwall ◽  
C Aldren

AbstractObjectives:To determine the frequency of altered tongue sensation following tonsillectomy, and its relationship to different surgical techniques.Design:Case–control study.Setting:District general hospital.Participants:One hundred and four consecutive adults undergoing tonsillectomy, and 43 control patients.Main outcome measures:Altered tongue sensation.Results:Twenty-eight of 100 patients described altered tongue sensation post-tonsillectomy. No patients in the control group experienced altered tongue sensation. There was a difference in rates of altered sensation between tonsillectomy patient groups undergoing bipolar diathermy and ‘cold steel’ techniques (p < 0.019). Three months after surgery, 22/23 contactable patients reported complete recovery of tongue sensation. One patient experienced tongue paraesthesia persisting until one year post-tonsillectomy.Conclusion:Tonsillectomy resulted in altered tongue sensation in 28 per cent of our study group. Bipolar diathermy dissection was significantly more likely to cause altered sensation than cold steel dissection. Ninety-six per cent of these disturbances resolved by three months, all by one year. Possible alteration of tongue sensation should be discussed whilst obtaining consent for tonsillectomy.


2007 ◽  
Vol 121 (10) ◽  
pp. 968-972 ◽  
Author(s):  
Y M Takwoingi ◽  
M Shykhon ◽  
M Wake

Objectives: To determine whether the introduction of a 14-day post-tonsillectomy analgesic regime would be associated with a statistically significant decrease in readmission rate.Method: A comparative study of tonsillectomy patients over two study periods. A retrospective review was undertaken of 342 patients (group one, five-day analgesic regime) who had undergone tonsillectomy. A prospective study was undertaken of 228 patients (group two, 14-day analgesic regime). The readmission rates for the two study periods were compared.Results: The median age of group one patients was 8.1 years (range, zero to 43 years). In this group, ‘cold steel’ dissection was performed in 177 patients (52 per cent) and bipolar dissection in 165 patients (48 per cent); seven patients suffered reactionary haemorrhage, all from the cold steel dissection group. The median age of group two patients was 8.0 years (range, one to 47 years). In this group, cold steel dissection was performed in 103 patients (45 per cent) and bipolar dissection in 125 patients (55 per cent); there were no cases of reactionary haemorrhage. The readmission rate for group one was 9.9 per cent (34 patients), with 2.1 per cent (seven patients) returning to the operating theatre for control of haemorrhage. In group two, 8.8 per cent (20 patients) were readmitted and 1.3 per cent (three patients) returned to the operating theatre. The main reason for readmission was secondary haemorrhage: 9.1 per cent from group one and 8.3 per cent from group two. No significant difference in readmission was found between the 5-day analgesia and the 14-day analgesia groups (p=0.443). However, there was a significant difference between the diathermy and cold steel dissection groups (p<0.001). Patients undergoing bipolar diathermy were almost six times more likely to be readmitted than those undergoing cold steel dissection (odds ratio 5.78). The average time to readmission after tonsillectomy did not significantly differ between the two groups.Conclusion: The post-tonsillectomy readmission rate was not affected by the duration of post-operative analgesia; however, operating technique did have an effect.


1987 ◽  
Vol 137 (6) ◽  
Author(s):  
Thomas E.D. McDermott ◽  
John M. Fitzpatrick ◽  
Domingo Suatengco ◽  
H. Barton Grossman
Keyword(s):  

1987 ◽  
Vol 18 (12) ◽  
pp. 904-905
Author(s):  
Relja Zivojnovic ◽  
Ger Vijfvinkel
Keyword(s):  

1990 ◽  
Vol 22 (5) ◽  
pp. 493-497 ◽  
Author(s):  
F. Aragona ◽  
P. Ferrarese ◽  
G. Passerini Glazel

1990 ◽  
Vol 33 (1) ◽  
pp. 32-34 ◽  
Author(s):  
A. Dennison ◽  
R. J. Whiston ◽  
S. Rooney ◽  
R. D. Chadderton ◽  
D. C. Wherry ◽  
...  

1985 ◽  
Vol 62 (6) ◽  
pp. 933-934 ◽  
Author(s):  
Tomio Ohta ◽  
Noboru Funatsu ◽  
Toshihiko Kuroiwa ◽  
Takayoshi Matsui

✓ A method for providing a saline drip during bipolar diathermy is described. Stainless steel tubing is incorporated in both blades of standard bipolar forceps and connected to the irrigating line. Irrigation is started when the forceps are closed and is stopped when they are open.


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