EVALUATION OF SAFETY OF BIPOLAR DIATHERMY TONSILLECTOMY
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; MorbidityReferences
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.
