Newer technologies designed to improve tonsillectomy outcomes don't necessarily offer significant advantages over conventional methods, according to a report published in the Archives of Otolaryngology—Head and Neck Surgery.
The study's authors say tonsillectomy is largely a safe procedure but often results in significant post-op pain, bleeding and prolonged recoveries for patients. To see if modern tissue-cutting devices help alleviate those drawbacks, the researchers reviewed operative times, intraoperative and post-op bleeding amounts, and post-op patient pain levels in 3,139 tonsillectomy cases involving traditional cold steel and electrocautery dissection, as well as more advanced vessel-sealing systems, sound-wave scalpels and radiofrequency ablation.
According to their findings:
Vessel-sealing systems shaved approximately 4 minutes off case times and resulted in significantly less post-op bleeding and pain compared to cold steel/electrosurgery dissection.
Sound-wave scalpels and traditional methods differed only in post-op bleeding amounts, which were significantly less following surgery with the newer technology.
Radiofrequency ablation and cold steel/electrocautery dissection were comparable with respect to post-op pain, bleeding and case times.
Lead author Vangelis G. Alexiou, MD, MSc, of Northampton General Hospital in England, says a surgeon's tonsillectomy method of choice depends largely on his training, experience and personal preference as well as the cost considerations of the facility where he operates. He points out that vessel-sealing systems appeared to offer advantages over conventional tonsil-removal methods, but he calls for more research to confirm those purported benefits.
Daniel Cook
