IS THE COLD STEEL DISSECTION METHOD STILL THE MOST EFFECTIVE METHOD OF TONSILLECTOMY?
Cold Steel Dissection For Tonsillectomy
Objective: To compare post operative the efficacy of tonsillectomy performed by cold steel dissection and bipolar diathermy method.
Study Design: Randomized controlled trial.
Place and Duration of Study: ENT department POF Hospital Wah from Jan 2013 to Jan 2015.
Material and Methods: All the patients presenting with recurrent acute tonsillitis and fulfilling the criterion were included. Two groups of 40 patients each were constituted randomly irrespective of age and sex. Cold steel dissection tonsillectomy was carried out on group A patients while group B was operated by bipolar diathermy method. Patients were examined on 2nd, 10th and 14th post-operative days by the surgeon who was blind about the procedures on these patients. Patients were evaluated for per operative hemorrhage, post-operative hemorrhage and amount of pain experienced by the patients post operatively.
Results: Mean age in group A was 25.5 years while it was 24.5 years in group B. There was no significant difference between the operative times of both groups; it was 15.90 minutes for cold steel tonsillectomy and 12.50 minutes for bipolar diathermy group. There was statistically significant difference between the blood losses in both groups. In cold steel it was 90.20 ml while in bipolar diathermy group it was 20.50 ml. Bipolar diathermy tonsillectomy groups experienced more pain at all post-operative visits. Healing was less in bipolar diathermy group as compared to cold steel tonsillectomy at 14th day.
Conclusion: This study shows that the both procedures have advantages and disadvantages. Cold steel dissection tonsillectomy was found superior in healing and less amount of pain while the bipolar diathermy method caused less per operative blood loss and more pain.