EVALUATION OF SAFETY OF BIPOLAR DIATHERMY TONSILLECTOMY

Authors

  • Shahid Ali Shah
  • Rehman Ghani

Abstract

Background: Tonsillectomy is a common operation in both children as well as adults, performedby a variety of techniques that have evolved over the years to ensure the safety of the procedure.Cold dissection and electrodissection are the two mostly used techniques. Bipolar diathermytonsillectomy was evaluated for its safety and postoperative morbidity. Methods: This study wasconducted over a period of two years, in the Department of Ear, Nose Throat and Head & NeckSurgery at Ayub Teaching Hospital, Abbottabad, Pakistan. Two hundred and forty-six wereenrolled; however, 238 patients completed the full evaluation as the technique had to be modifiedin 8 patients. All the procedures were performed by the first author thereby ensuring the sameexpertise level. Operating time, intraoperative blood loss, postoperative algesia, feeding status andtime taken getting back to school/work and episodes of secondary bleeding were recorded.Results: Time taken by the procedure ranged from 10 to 20 minutes. Intraoperative blood lossranged between 2 to 5 ml. Postoperative pain averaged around 3–5 on a 1–10 point scale in 75%of patients. 80% of patients were back to normal diet by day 3 postoperative. Nine (3.6%) patientshad a secondary haemorrhage that was managed conservatively and did not need surgicalintervention. Conclusion: Bipolar diathermy tonsillectomy is an effective and safe technique,especially in children population. Adequate experience with the technique is mandatory to achievethe desired goals.Keywords: Tonsillectomy; Electro dissection; Bipolar diathermy; Morbidity

References

Pang YT. Paediatric tonsillectomy: bipolar electrodissection

and dissection/snare compared. J Laryngol Otol.

;109(8):733–6.

Burton MJ, Doree C. Coblation versus other surgical

techniques for tonsillectomy. Cochrane Database Syst Rev.

;(3):CD004619. Comment in: Otolaryngol Head Neck

Surg. 2008;138(1):4–7.

Gendy S, O'Leary M, Colreavy M, Rowley H, O'Dwyer T,

Blayney A. Tonsillectomy--cold dissection vs. hot dissection:

a prospective study. Ir Med J. 2005;98(10):243–4.

Sargi Z, Younis RT. Tonsillectomy and adenoidectomy

techniques: past, present and future. ORL J Otorhinolaryngol

Relat 2007;69(6):331–5.

Bukhari MA, Al-Ammar AY. Monopolar electrodissection

versus cold dissection tonsillectomy among children. Saudi

Med J. 2007;28(10):1525–8.

Silveira H, Soares JS, Lima HA. Tonsillectomy: cold

dissection versus bipolar electrodissection. Int J Pediatr

Otorhinolaryngol. 2003;67(4):345–51.

Atallah N, Kumar M, Hilali A, Hickey S. Post-operative pain

in tonsillectomy: bipolar electrodissection technique vs

dissection ligation technique. A double-blind randomized

prospective trial.J Laryngol Otol. 2000;114(9):667–70.

Kirazli T, Bilgen C, Midilli R, Ogüt F, Uyar M, Kedek A.

Bipolar electrodissection tonsillectomy in children. Eur Arch

Otorhinolaryngol. 2005;262(9):716–8.

Cardozo AA, Hallikeri C, Lawrence H, Sankar V, Hargreaves

S. Teenage and adult tonsillectomy: dose-response relationship

between diathermy energy used and morbidity. Clin

Otolaryngol. 2007;32(5):366–71.

Shah SA, Ghani R. Frequency of post-tonsillectomy

haemorrhage following tonsillectomy with bipolar

diathermy--an experience at Ayub Teaching Hospital,

Abbottabad. J Ayub Med Coll Abbottabad. 2004;16(4):38–9.

Lowe D, van der Meulen J, Cromwell D, Lewsey J, Copley

L, Browne J, et al. Key messages from the National

Prospective Tonsillectomy Audit. Laryngoscope.

;117(4):717–24.

Most read articles by the same author(s)

1 2 > >>