title: Thermal welding versus cold dissection tonsillectomy: a prospective, randomized, single-blind study in adult patients.
abstract: OBJECTIVE
  We performed a single-blind, prospective, randomized, controlled clinical study to compare the rates of postoperative morbidity in adults undergoing thermal welding tonsillectomy versus cold dissection tonsillectomy.
  
  
  METHODS
  Thirty-two adults with recurrent tonsillitis who were scheduled for elective tonsillectomy were randomized to either thermal welding or cold dissection tonsillectomy groups. The main outcome measures included intraoperative blood loss, intensity of postoperative pain expressed on a 10-cm visual analog scale (with 0 representing no pain and 10 representing the worst possible pain), day of cessation of significant pain (ie, a pain score of at least 7), and presence of postoperative hemorrhage estimated on a 3-point scale (with 0 representing no bleeding, 1 representing minor bleeding, and 2 representing major bleeding). Additional outcome measures included total analgesic requirements, last day of receipt of analgesics, presence of nausea and/or vomiting, and wound healing after 10 days of surgery.
  
  
  RESULTS
  The rate of intraoperative blood loss was significantly lower in the thermal welding group (p < .0001). Patients who had thermal welding tonsillectomy also showed a general trend toward lower pain scores, and this difference was statistically significant from the first to the fourth postoperative days (p < .05). Cessation of significant pain also occurred 3 days earlier in this group (p < .05). No significant difference was observed regarding pain medication, nausea and/or vomiting, postoperative hemorrhage, or wound healing.
  
  
  CONCLUSIONS
  Thermal welding tonsillectomy is a relatively safe and reliable method with significantly less postoperative morbidity than cold dissection tonsillectomy.
authors.affiliation: Department of Otorhinolaryngology, General Hospital of Volos, Volos, Greece.
authors.forename: Pelagia
authors.initials: P
authors.lastname: Stavroulaki
authors.forename: Charalampos
authors.initials: C
authors.lastname: Skoulakis
authors.forename: Evangelos
authors.initials: E
authors.lastname: Theos
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Kokalis
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Valagianis
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical / Q000503:physiopathology; D003452:Cryosurgery / Q000379:methods*; D004564:Electrocoagulation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology*; D019106:Postoperative Hemorrhage / Q000209:etiology; D020250:Postoperative Nausea and Vomiting / Q000209:etiology; D016037:Single-Blind Method; D014068:Tonsillectomy / Q000379:methods*; D014069:Tonsillitis / Q000601:surgery*; D014945:Wound Healing / Q000502:physiology