A prospective study on pros and cons of electrodissection tonsillectomy.

OBJECTIVE: Hemorrhages are main complications after tonsillectomy, whatever technique is used. This prospective study aimed at revealing pros and cons associated with monopolar electrodissection tonsillectomy. STUDY DESIGN: A prospective study. METHODS: A prospective study on all patients undergoing tonsillectomy or adenotonsillectomy in Central Hospital of Central Finland in 1997. Operation time and bleeding, as well as perioperative and postoperative complications, were recorded. RESULTS: Inpatient tonsillectomy was performed in 440 patients (mean age, 17.9 y). Primary post-tonsillectomy hemorrhage (within 24 h) occurred in 2.3%. A total of 15.9% of patients searched for medical help because of secondary post-tonsillectomy hemorrhage, 7.7% receiving active treatment and 8.2% not. Post-tonsillectomy hemorrhages proved to be most common in older patients and when peritonsillar abscess was in patient history. CONCLUSIONS: Monopolar electrodissection tonsillectomy was fast and resulted in little intraoperative bleeding. However, postoperative hemorrhages were common, and the mean use of analgesics was for more than 10 days. Preoperative counseling must be thorough and realistic. Our results indicate that better methods for tonsillectomy still need to be developed.

Consequences of adenoidectomy in conjunction with tonsillectomy in children.

OBJECTIVE: The purpose of this prospective study was to investigate the role of adenoidectomy in children undergoing elective adenotonsillectomy. PATIENTS AND METHODS: All consecutive children less than 15 years of age operated on over a 12-month period were included. Adenoidectomy was done with curettes and forceps under mirror visualization and tonsillectomy with a unipolar electrodissection technique. Duration of the operation, intra-operative blood loss, and post-operative complications were recorded. RESULTS: Adenotonsillectomy was done in 98 children with a mean age of 7.8 years. The mean duration of adenoidectomy was 10.3 min (S.E. 0.7), 51.8% of the time used for adenotonsillectomy and 25. 9% of the total operating room time. The blood loss was 43.6 ml (S.E. 5.4) and 7.8 ml (S.E. 2.5) for adenoidectomy and tonsillectomy, respectively. Both the duration (P=0.04) and blood loss (P=0.0005) of adenoidectomy increased significantly with the increasing age of children. Post-adenoidectomy complications did not occur. CONCLUSION: Even though adenoidectomy prolonged the operating time and increased the intra-operative blood loss, especially in older children the procedure in general remained relatively short and safe. However, adding adenoidectomy to tonsillectomy should always be carefully considered, particularly in children 10 years or older operated on principally because of palatine tonsil disease.