Comparative Study between Cold Dissection Technique and Bipolar Diathermy in Tonsillectomy in the Same Patient

Abstract

Background: Tonsillectomy is one of the most frequent and oldest operations performed by otolaryngologists. Tonsillectomy postsurgical complications are uncommon, with post-tonsillectomy bleeding being one of the most significant complications. Aim of the work: To compare the effects of cold dissection technique and hot bipolar diathermy for tonsillectomy on intraoperative blood loss, surgical time, postsurgical pain, hemorrhage, infection, and wound healing in the same patient.Patients and methods: This randomized prospective trial was performed in the Department of Otorhinolaryngology [Faculty of Medicine, Al-Azhar University] from June 2021 to January 2022. The study enrolled 100 cases who had tonsillectomy with or without adenoidectomy to treat chronic tonsillitis. All of the participants signed their informed consent to take part in the study. Randomly, on one side of the same patient, cold dissection tonsillectomy was performed, while bipolar diathermy was performed on the other. We compared the two techniques regarding intraoperative blood loss, surgical time, postsurgical pain, postsurgical hemorrhage, postsurgical infection, and wound healing.Results: As regard age and sex of the studied group, it was founded that the age group ranged between 3 to 19 years with mean age of 10.22 years. These patients were represented by 62 male [62%] and 38 females [38%] of the total number of patients [100]. According to age group distribution, there have been significant differences [p-value < 0.05] with the most frequent percentage in the 5–10-year group [55%]. Regarding the intraoperative data, bipolar dissection had a high significant low operative time [12.02±1.27 min] and blood loss [10.89±1.58 ml] than cold steel dissection with operative time [22.37±2.12 min] and blood loss [20.41±0.78 ml] with p-value < 0.001.Conclusion: Between two tonsillectomy surgical approaches, the bipolar diathermy dissection approach took much less time and produced significantly less intra-operative blood loss than the cold dissection method

Keywords

• tonsillectomy
• bipolar diathermy
• cold dissection technique