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Diathermy tonsillectomy: comparisons of morbidity following bipolar and monopolar microdissection needle excision

Published online by Cambridge University Press:  29 June 2007

A. Akkielah ,
A. Kalan  and
G. S. Kenyon
A. Akkielah
Affiliation:
Department of Otolaryngology, The Royal Hospitals Trust, St Bartholomew's Hospital, London, UK.
A. Kalan
Affiliation:
Department of Otolaryngology, The Royal Hospitals Trust, St Bartholomew's Hospital, London, UK.
G. S. Kenyon*
Affiliation:
Department of Otolaryngology, The Royal Hospitals Trust, St Bartholomew's Hospital, London, UK.
*
Address for correspondence: Mr G. S. Kenyon, Department of Otolaryngology, The Royal Hospitals Trust, St Bartholomew's Hospital, West Smithfield, London EC1A 7BE.
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Abstract

Tonsillectomy is frequently associated with a considerable post-operative morbidity. In some cases reactionary or secondary haemorrhage occurs and all patients suffer a degree of post-operative pain. The use of bipolar diathermy excision has become popular because it reduces intra-operative blood loss, but all diathermy inevitably produces a degree of damage to adjacent normal soft tissues. In turn this inadvertent injury must act to increase the post-operative pain.

Monopolar dissection using a fine tungsten diathermy needle (the Colorado needle) allows sharp dissection at low power levels and in previous studies has been shown to produce a reduction in collateral tissue damage. In this prospective study the morbidity associated with tonsillectomy using this needle was compared to that following a standard bipolar dissection.

Using the monopolar needle produced no enhanced risk of reactionary or secondary haemorrhage while causing significantly less post-operative pain and a reduction in eschar. We believe that excision using this needle preserves the advantages associated with bipolar dissection while reducing local soft tissue damage.

Keywords

TonsillectomyElectrocoagulationPain, post-operativeSoft tissue injuries
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 111 , Issue 8 , August 1997 , pp. 735 - 738
Copyright
Copyright © JLO (1984) Limited 1997

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