A comparison of the results of harmonic scalpel and cold knife tonsillectomy in pediatric patients

OBJECTIVE: We sought to compare LigaSure Vessel Sealing System tonsillectomy (LT), Harmonic Scalpel tonsillectomy (HST), and cold knife tonsillectomy (CKT). STUDY DESIGN: We conducted a prospective study on 161 adult patients undergoing tonsillectomy. Subjects were randomized to LT, HST, or CKT groups, and intraoperative bleeding, operative time, postoperative pain, and complication rates were assessed. RESULTS: The LT, HST, and CKT groups consisted of 50, 43, and 37 individuals, respectively. Intraoperative bleeding was significantly lower in the LT group, whereas bleeding in the HST group was significantly lower than that in the CKT group. Operative time and postoperative pain were significantly lower in the LT and HST groups. One primary hemorrhage occurred in the HST group, and one occurred in he CKT group. Secondary hemorrhage occurred in one, two, and one patients in the LT, HST, and CKT groups, respectively. CONCLUSION: LT and HST have shown comparable results regarding intraoperative blood loss, postoperative hemorrhage, and pain. Compared with CKT, both were associated with less intra-operative blood loss and pain.

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Harmonic Scalpel vs “cold knife” dissection in uvulopalatopharyngoplasty

American Journal of Otolaryngology ◽

10.1016/j.amjoto.2009.08.009 ◽

2010 ◽

Vol 31 (6) ◽

pp. 442-447 ◽

Cited By ~ 4

Author(s):

Angelo Salami ◽

Massimo Dellepiane ◽

Maurizio Bavazzano ◽

Barbara Crippa ◽

Luca Guastini ◽

...

Keyword(s):

Harmonic Scalpel ◽

Cold Knife

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A comparison of the harmonic scalpel, coblation, bipolar, and cold knife tonsillectomy methods in adult patients

Journal of Surgery and Medicine ◽

10.28982/josam.957229 ◽

2021 ◽

Vol 5 (12) ◽

pp. 1198-1201

Author(s):

Buğra SUBAŞI ◽

Fatih OĞHAN ◽

Hamdi TAŞLI ◽

Nesibe Esra KARAMAN ◽

Seçkin AKBAL

Keyword(s):

Harmonic Scalpel ◽

Adult Patients ◽

Cold Knife

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Clinical Profile of Post-Tonsillectomy Bleeding: A 30-Month Institutional Review

Philippine Journal of Otolaryngology Head and Neck Surgery ◽

10.32412/pjohns.v25i2.621 ◽

2010 ◽

Vol 25 (2) ◽

pp. 14-17

Author(s):

Sarah D. Moral ◽

Ann Kathleen C. Barlin ◽

Jose M. Acuin

Keyword(s):

Medical Records ◽

Private Hospital ◽

Harmonic Scalpel ◽

Surgical Techniques ◽

Length Of Hospital Stay ◽

Institutional Review ◽

Trade Offs ◽

Cold Knife ◽

Clinically Significant ◽

Observational Descriptive Study

Objective: To determine the prevalence of post-tonsillectomy bleeding in our institution and to describe the clinical characteristics, tonsillectomy techniques and post-tonsillectomy bleeding intervention in these patients. Methods: Study Design: Observational descriptive study Setting: Tertiary private hospital Population: All patients who were treated for post-tonsillectomy bleeding were retrospectively reviewed from medical records of all patients who had undergone tonsillectomy between January 1, 2007 and June 30, 2009. Age and sex, indication for surgery, tonsil grade, Body Mass Index (BMI), surgical technique, post-operative medications, length of hospital stay, interval between tonsillectomy and onset of bleeding and interventions to address post-operative bleeding were noted. Results: Of the 662 patients who underwent tonsillectomy, 37 (5.6%) were managed for post-operative hemorrhage. Most had grade 2 or 3 tonsils (18 or 48.6% and 16 or 43.2% respectively) and were obese (25 or 67.5%). The highest proportion of post-operative bleeding was 9.2% for bipolar cauterization technique (18 of 196 patients) followed by 7.4% with cold knife, monopolar cauterization and suturing (11 of 148 patients); 6.9% with harmonic scalpel (2 of 29 patients); 6.5% with monopolar and bipolar cauterization (3 of 46 patients), and 2.8% for cold knife or Fischer knife (3 of 109 patients). Seven patients (18.9%) required blood transfusion. Onset of bleeding occurred between 4-12 days following surgery (mean: 8 days). Possible causes of bleeding included heavy physical activity and cough but most had no identifiable cause. Majority of the patients (29 out of 37) required surgical exploration under general anesthesia. Conclusion: Post tonsillectomy bleeding is still a clinically significant complication despite advances in surgical techniques. Surgeons must always consider trade-offs between benefits and risks of the procedure and be continually vigilant of this potentially serious complication. Key Words: Post-tonsillectomy bleeding, tonsillectomy techniques

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Inflammatory cytokine expression following the use of bipolar electrocoagulation, ultracision harmonic scalpel and cold knife biopsy

Molecular Medicine Reports ◽

10.3892/mmr.2015.3677 ◽

2015 ◽

Vol 12 (2) ◽

pp. 2985-2990 ◽

Cited By ~ 7

Author(s):

PIETRO LITTA ◽

CARLO SACCARDI ◽

SALVATORE GIZZO ◽

LORENA CONTE ◽

GIULIA AMBROSI ◽

...

Keyword(s):

Inflammatory Cytokine ◽

Harmonic Scalpel ◽

Cytokine Expression ◽

Bipolar Electrocoagulation ◽

Cold Knife

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Harmonic Scalpel versus Cold Knife Dissection in Superficial Parotidectomy

Otolaryngology ◽

10.1016/j.otohns.2004.03.043 ◽

2004 ◽

Vol 131 (4) ◽

pp. 397-400 ◽

Cited By ~ 32

Author(s):

D. Russ Blankenship ◽

Christine G. Gourin ◽

Edward A. Porubsky ◽

Edward S. Porubsky ◽

Frederick N. Klippert ◽

...

Keyword(s):

Harmonic Scalpel ◽

Superficial Parotidectomy ◽

Cold Knife

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Audiology Service Models in a Family Physician Practice Setting

Perspectives on Audiology ◽

10.1044/poa6.1.24 ◽

2010 ◽

Vol 6 (1) ◽

pp. 24-32 ◽

Cited By ~ 2

Author(s):

Sridhar Krishnamurti

Keyword(s):

Pediatric Patients ◽

Practice Patterns ◽

Healthcare Delivery ◽

Direct Consequence ◽

Direct Access ◽

Practice Setting ◽

Pediatric Populations ◽

Family Practice Physicians ◽

Primary Focus ◽

Balance Problems

This article illustrates the potential of placing audiology services in a family physician’s practice setting to increase referrals of geriatric and pediatric patients to audiologists. The primary focus of family practice physicians is the diagnosis/intervention of critical systemic disorders (e.g., cardiovascular disease, diabetes, cancer). Hence concurrent hearing/balance disorders are likely to be overshadowed in such patients. If audiologists get referrals from these physicians and have direct access to diagnose and manage concurrent hearing/balance problems in these patients, successful audiology practice patterns will emerge, and there will be increased visibility and profitability of audiological services. As a direct consequence, audiological services will move into the mainstream of healthcare delivery, and the profession of audiology will move further towards its goals of early detection and intervention for hearing and balance problems in geriatric and pediatric populations.

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