Surgical Treatment of Chronic Tonsillitis

Abstract

The use of diathermy or coblation for both tissue dissection and hemostasis reduced primary bleeding but increased the risk of secondary bleeding compared with traditional tonsillectomy.

The objective: was to increase the effectiveness of surgical treatment of children with chronic tonsillitis.

Materials and methods. We observed 75 children with chronic tonsillitis between the ages of 6 and 17 under our observation. There were52 in the main group,23 in the comparison group. During tonsillectomy, bipolar instruments and the mode of operation of the high frequency current generator «manual welding» («overlap») with a current frequency of 66 kHz or 440 kHz were used in the main group.

Results. With tonsillectomy using high-frequency current, intraoperative blood loss was 6,0±0,440 ml, while during tonsillectomy by the traditional method, intraoperative blood loss was 32,48±1,781 ml (p<0,001) (blood loss when using high-frequency current was 5,4 times lower). The time of tonsillectomy is reduced by 2,1 times. The manifestations of local tissue reaction after tonsillectomy with and without the use of electrothermal adhesion are not significantly different, except for sore throat.

Conclusions. The use of high-frequency bipolar welding of biological tissues with the use of developed bipolar power tools for tonsillectomy significantly improves the quality of operations, namely, blood loss during tonsillectomy is reduced by 5,3 times (p<0,001), the duration of surgery is reduced by 2,1 times. Secondary bleeding was not observed in patients using the proposed procedure. The manifestations of local tissue reaction after tonsillectomy with and without the use of electrothermal adhesion are not significantly different.