KBB-Forum 2011 , Cilt 10, Sayı 4


Dr. Ercan AKBAY, Dr. Yaşar ÇOKKESER, Dr. Şerif Şamil KAHRAMAN
Mustafa Kemal Üniversitesi Tıp Fakültesi, Kulak Burun Boğaz Anabilim Dalı, Hatay, Türkiye Purpose: The purpose of this study is to make clearer and more objective comparisons between Bipolar Electrodissection Tonsillectomy (BET) and Traditional Cold Dissection Tonsillectomy (TCT) by comparing the results of both tecniques performed on the same patient.

Patients and Methods: One hundred and four patients with a ratio of 54 females and 50 males aged from 6 to 32 (with a mean of 10.2 ± 4.2 years) with either a tonsillectomy or an adenotonsillectomy have participated to the study. TCT was applied to the right-side of each of the participants, while BET was performed to the left-side. The results were compared in terms of time spent in operations, postoperative pain and postoperative bleeding.

Resuts: The avarage time spent on the left-side tonsillectomy was found as 5.6 ± 1.3 minutes ranging from 4-10 minutes; on the other hand the average of the time spent on the right-side tonsillectomy was 4.9 ± 1.3 minutes ranging from 3-9 minutes (p<0.05). Observed postoperative bleeding for right-side was 2 (1.9%); meanwhile 3 (2.9%) postoperative bleeding was seen on the left-sided tonsillectomies. By the end of postoperative 2nd hour, 17 (16.3%) patients had complained that they had more pain on the right side; however, 36 (34.6%) of them felt more pain on the left-side. Further, remaining 51 (49%) patients reported the same amount of pain on both-sides. The following day, the number of patients experiencing relatively more pain on the left-side has droped down to 14(13.5%); on the contrary, the number of patients having relatively more pain on the right-side has increased up to 26(25%).

Conclusion: Both operation techniques were compared with regards to time spent on operations, postoperative bleeding and pain. First of all, with respect to the operations examined in this study, average surgery time on BET is found significantly longer than the avarage time spent on TCT. Secondly, considering the postoperative pain, BET is more painful than CTC for shorter-terms; however as time passes, such as the next day, experienced postoperative pain for BET is significantly less than the pain for CTC (p<0.05). However, the number of observed post operative hemorrhage for both BET and TCT was close to one another; therefore mentioned techniques, in terms of hemorrhage, did not significantly differ from one another. Keywords : Tonsillectomy; electrosurgery; bipolar surgery; cold dissection