Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-25T21:28:10.387Z Has data issue: false hasContentIssue false

Guillotine tonsillectomy: a neglected technique

Published online by Cambridge University Press:  08 March 2017

V S Sunkaraneni
Affiliation:
Department of Otolaryngology, the Queen Alexandra Hospital, Cosham, UK
H Ismail-Koch
Affiliation:
Department of Otolaryngology, Southampton General Hospital, UK
R J Salib
Affiliation:
Department of Otolaryngology, Southampton General Hospital, UK
P K Jain*
Affiliation:
Poole Hospital NHS Foundation Trust, UK
*
Address for correspondence: Mr Parmod K Jain, ENT Department, Poole Hospital NHS Foundation Trust, Poole BH15 2JB, UK. Fax: +44 (0)1202 448410 E-mail: [email protected]

Abstract

Background:

Increased post-operative tonsillectomy haemorrhage rates have been observed following ‘hot’ tonsillectomy techniques, compared with ‘cold steel’ dissection. Post-tonsillectomy haemorrhage rates and the degree of blood loss during guillotine tonsillectomy have not been reported in the recent literature.

Methods:

This retrospective case note review assessed the degree of blood loss during guillotine tonsillectomy, as measured by the number of tonsil swabs used, and the post-tonsillectomy haemorrhage rate.

Results:

In a group of 168 patients, no tonsil swabs were used in 13.1 per cent of cases, and less than two tonsil swabs were used in 41.1 per cent of cases.

Conclusion:

Guillotine tonsillectomy, when performed by the method described in this article, resulted in minimal intra-operative blood loss in 54 per cent of cases, and appeared to have comparable post-tonsillectomy haemorrhage rates to cold steel dissection techniques.

Type
Short Communications
Copyright
Copyright © JLO (1984) Limited 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

VS Sunkaraneni & H Ismail-Koch are the joint first authors.

References

1 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 2007;117:717–24Google Scholar
2 Lowe, D, van der Meulen, J. National Prospective Tonsillectomy Audit. Tonsillectomy technique as a risk factor for postoperative haemorrhage. Lancet 2004;364:697702Google Scholar
3 Mathews, J, Lancaster, J, Sherman, I, Sullivan, GO. Guillotine tonsillectomy: a glimpse into its history and current status in the United Kingdom. J Laryngol Otol 2002;116:988–91Google Scholar
4 Friedberg, SA. The evolution of the tonsillotome. Ann Otol Rhinol Laryngol 1914;23:293303Google Scholar
5 Jain, PK. How we do it: Jain Tonsil ‘A’ Frame – a solution to slipping rods. Clin Otolaryngol 2005;30:266–86CrossRefGoogle Scholar
6 McGuire, NG. A new method of guillotine tonsillectomy with an historical review. J Laryngol Otol 1967;81:187–95Google Scholar
7 Roberts, C, Jayaramachandran, S, Raine, CH. A prospective study of factors which may predispose to post-operative tonsillar fossa haemorrhage. Clin Otolaryngol 1992;17:1317Google Scholar