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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)


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.


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.


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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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