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

  • A. Akkielah (a1), A. Kalan (a1) and G. S. Kenyon (a1)

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.

Copyright

COPYRIGHT: © JLO (1984) Limited 1997

Corresponding author

Address for correspondence: Mr G. S. Kenyon, Department of Otolaryngology, The Royal Hospitals Trust, St Bartholomew's Hospital, West Smithfield, London EC1A 7BE.

References

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Bluestone, C. D. (1977) Status of tonsillectomy and adenoidectomy. Laryngoscope 87: 1235–1243.
Choy, A. T. K., Su, A. P. (1992) Bipolar diathermy or ligation for haemostasis in tonsillectomy? A prospective study on post-operative pain. Journal of Laryngology and Otology 106: 21–22.
Farnworth, T. K., Beals, S. P., Manwaring, K. H., Trepeta, R. W. (1993) Comparison of skin necrosis in rats using a new microdissection electrocautery, standard size needle electrocautery and the Shaw hemostatic scalpel. Annals of Plastic Surgery 31 (2): 164–167.
Goycoolea, M. V., Cubillos, P. M., Martinez, G. C. (1982) Tonsillectomy with a suction coagulator. Laryngoscope 92: 818–819.
Handler, S. D., Miller, L., Richmond, K. H., Corso Baranak, C. (1986) Post-tonsillectomy haemorrhage: incidence, prevention and management. Laryngoscopy 96: 1243–1247.
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Kristensen, S., Tveteras, K. (1984) Post-tonsillectomy haemorrhage: a retrospective study of 1,150 operations. Clinical Otolaryngology 9: 347–350.
Mann, D. G., St George, C., Granoff, D., Scheiner, E., Imber, P., Mlynarczyk, F. A. (1984) Tonsillectomy – some like it hot. Laryngoscope 94: 677–679.
McAuliffe, C. J. (1987) The history of tonsil and adenoid surgery. Otolaryngologic Clinics of North America 20: 415–419.
Weimert, T. A., Babyak, J. W., Bichter, H. J. (1990) Electrodissection tonsillectomy. Archives of Otolaryngology – Head and Neck Surgery 116: 186–188.

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  • Cited by 22

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

  • A. Akkielah (a1), A. Kalan (a1) and G. S. Kenyon (a1)

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