MONOPOLAR CAUTERY VERSUS COLD STEEL DISSECTION FOR TONSILLECTOMY IN CHILDREN. A RANDOMIZED CLINICAL TRIAL

ABSTRACT Objective: To compare monopolar cautery with cold steel dissection for tonsillectomy in pediatric age group. First described by Celsius in the 1st century BC many new techniques have evolved since then. In Pakistan cold steel dissection is thre most commonly employed technique for tonsil because of the ease of availability and the fact that most young surgeons are initially trained in performing this surgery switching to other methods as they gain more experience5. All patients above 4 years regardless of gender presenting with complaints of recurrent tonsillitis, Obstructive sleep apnea, history of peritonsillar abscess and suspected malignancy were included in the study. Patients having bleeding disorders, recent history of respiratory tract infection and any systemic illness or congenital condition were excluded from the study. Cold steel dissection was done using blunt and sharp dissectors and snares for dissection and suture ligation for hemorrhage control. Intraoperative blood loss was measured by weighing 1x1cm round cotton swabs before and after tonsillectomy and adding the amount in suction bottle as well. Around 60000 surgeries are performed annually in United States alone1,6. as each method is with its pros and cons however ENT unit in our hospital favors monopolar diathermy because of its significantly less intraoperative blood loss at the cost of slightly increased operative time. Electrocautery Tonsillectomy: A Prospective Randomized Study Comparing Clinical Outcomes in Adolescents and Adults.