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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 ,
A Solé ,
V Blanco  and
JP Rodrigo
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: [email protected]
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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.

Keywords

TonsillectomyPainAnalgesiaHemorrhageDissectionElectrocoagulation
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 12 , December 2016 , pp. 1142 - 1146
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):28–30 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;57:59–65 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;5:13–15 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