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Histological analysis of tonsillectomies: relationship with surgical technique, post-operative pain and haemorrhage

Published online by Cambridge University Press:  10 November 2016

ML Magdalena*
Affiliation:
Department of Ambulatory Surgery, Hospital Universitario Central de Asturias, University of Oviedo, Spain
A Solé
Affiliation:
Department of Ambulatory Surgery, Hospital Universitario Central de Asturias, University of Oviedo, Spain
V Blanco
Affiliation:
Department of Pathology, Hospital Universitario Central de Asturias, University of Oviedo, Spain
JP Rodrigo
Affiliation:
Department of Otolaryngology, Hospital Universitario Central de Asturias, University of Oviedo, Spain
*
Address for correspondence: Dr M L Magdalena, Roces de Colloto, 53, 33010, Oviedo, Asturias, Spain E-mail: luzcolloto@gmail.com

Abstract

Objectives:

There is no consensus on the optimal technique to decrease post-tonsillectomy morbidity. Histopathological analysis can estimate collateral tissue damage. This study compared histological findings for tonsils removed by cold or electrocautery dissection and their relationship with post-operative complications.

Methods:

Two adult out-patient groups were included in the study: 37 who underwent cold dissection and 37 who underwent electrocautery dissection. Histological analysis was used to assess tissue damage.

Results:

Tissue damage was significantly higher in the electrocautery dissection group (p = 0.002), as were the number of emergency department visits (p = 0.01) and the need for supplemental analgesia (p = 0.013). Patients in the cold dissection group experienced less pain (p = 0.001) and fewer secondary haemorrhage episodes.

Conclusion:

Cold dissection produces less tissue damage, which is associated with lower incidence of complications. This study suggests that cold dissection is the technique of choice for tonsillectomy.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2016 

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References

1 Rakesh, S, Anand, TS, Payal, G, Pranjal, K. A prospective, randomized, double–blind study of coblation versus dissection tonsillectomy in adult patients. Indian J Otolaryngol Head Neck Surg 2012;64:290–4CrossRefGoogle ScholarPubMed
2 Elwany, S, A Nour, Y, Magdy, EA. Does laringopharyngeal reflux affect healing and recovery after tonsillectomy? J Laryngol Otol 2008;122:603–8CrossRefGoogle Scholar
3 Magdy, EA, Elwany, S, el-Daly, AS, Abdel-Hadi, M, Morshedy, MA. Coblation tonsillectomy: a prospective, double-blind, randomised, clinical and histopathological comparison with dissection–ligation, monopolar electrocautery and laser tonsillectomies. J Laryngol Otol 2008;122:282–90CrossRefGoogle ScholarPubMed
4 Aksoy, F, Ozturan, O, Veyseller, B, Yildirim, YS, Demirhan, H. Comparison of radiofrequency and monopolar electrocautery tonsillectomy. J Laryngol Otol 2010;124:180–4CrossRefGoogle ScholarPubMed
5 Hahn, CH, Rungby, JA, Overgaard, T, MØller, H, Schultz, P, Tos, M. Effect of diathermy on pain and healing in tonsillectomy, compared with other methods of haemostasis: a randomised study. J Laryngol Otol 2009;123:648–55CrossRefGoogle ScholarPubMed
6 Echevarría, M. Information and education about postoperative pain in ambulatory surgery [in Spanish]. Cir May Amb 2011;16(suppl 1):2830 Google Scholar
7 Cervera Escario, J, Del Castillo Martín, F, Gómez Campderá, JA, Gras Albert, JR, Perez Piñero, B, Villafruela Sanz, MA. Indications for tonsillectomy and adenoidectomy: consensus document by the Spanish Society of ORL and the Spanish Society of Pediatrics [in Spanish]. Acta Otorrinolaringol Esp 2006;57:5965 CrossRefGoogle ScholarPubMed
8Major ambulatory surgery. Standards and recommendations [in Spanish]. 2008 Ministry of Health and Consumer Affairs, Madrid, SpainGoogle Scholar
9 International Association for Ambulatory Surgery. Definitions in major ambulatory surgery [in Spanish]. Cir May Amb 2000;5:1315 Google Scholar
10 Aydin, S, Taskin, U, Altas, B, Erdil, M, Senturk, T, Celebi, S et al. Post-tonsillectomy morbidities: randomised, prospective controlled clinical trial of cold dissection versus thermal welding tonsillectomy. J Laryngol Otol 2014;128:163–5CrossRefGoogle ScholarPubMed
11 Bhattacharyya, N, Kepnes, LJ. Revisits and postoperative hemorrhage after adult tonsillectomy. Laryngoscope 2014;124:1554–6CrossRefGoogle ScholarPubMed
12 Tomkinson, A, Harrison, W, Owens, D, Harris, S, McClure, V, Temple, M. Risk factors for postoperative hemorrhage following tonsillectomy. Laryngoscope 2011;121:279–88CrossRefGoogle ScholarPubMed
13 Sarny, S, Habermann, W, Ossimitz, G, Stammberger, H. Significant post-tonsillectomy pain is associated with increased risk of hemorrhage. Ann Otol Rhinol Laryngol 2012;121:776–81CrossRefGoogle ScholarPubMed
14 Shah, UK, Galinkin, J, Chiavacci, R, Briggs, M. Tonsillectomy by means of plasma-mediated ablation: prospective, randomized, blinded comparison with monopolar electrosurgery. Arch Otolaryngol Head Neck Surg 2002;128:672–6CrossRefGoogle ScholarPubMed