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Guillotine tonsillectomy: a neglected technique

  • V S Sunkaraneni (a1), H Ismail-Koch (a2), R J Salib (a2) and P K Jain (a3)

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.

Copyright

Corresponding author

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: parmod.jain@virgin.net

Footnotes

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

Footnotes

References

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

Keywords

Guillotine tonsillectomy: a neglected technique

  • V S Sunkaraneni (a1), H Ismail-Koch (a2), R J Salib (a2) and P K Jain (a3)

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