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CO2-Lasertonsillotomy Under Local Anesthesia in Adults

CO₂-Lasertonsillotomy Under Local Anesthesia in Adults

Published on: November 6, 2019

Hemorrhage after tonsillectomy: does the surgical technique really matter?

Claudine Gysin¹, Pavel Dulguerov

¹Division of Pediatric Otolaryngology, University Children's Hospital, Zurich, Switzerland. claudine.gysin@kispi.uzh.ch

ORL; Journal for Oto-Rhino-Laryngology and Its Related Specialties

|August 28, 2013

Summary

Comparing tonsillectomy techniques, bipolar cautery shows less early bleeding, while cold dissection has less delayed bleeding. Further research is needed to determine the optimal surgical method for tonsillectomy.

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Area of Science:

Otolaryngology
Surgical Oncology

Background:

Post-tonsillectomy bleeding (PTB) is a significant complication.
Accurate categorization of PTB and associated risk factors is crucial for assessment.

Purpose of the Study:

To review and analyze surgical techniques for tonsillectomy.
To evaluate factors influencing post-tonsillectomy bleeding (PTB) rates.

Main Methods:

Comprehensive review of publications on tonsillectomy surgical techniques.
Emphasis on randomized controlled trials and meta-analyses.
Analysis of reported PTB rates and influencing factors.

Main Results:

Reported PTB rates: 1% early, 2.5% delayed, 10% anamnestic, 2% objective, 2% re-operation.
Bipolar technique associated with lowest early PTB; cold technique with lowest delayed PTB.
Current evidence insufficient to declare a superior technique; some methods may need abandonment.

Conclusions:

Optimal tonsillectomy technique remains unclear due to limited high-quality trials.
Electrocautery power should be minimized; monopolar, Coblation, lasers, and harmonic scalpel may be suboptimal.
Vessel-sealing systems warrant further investigation; tonsillotomy's bleeding advantage needs more study.