title: Six years of evidence-based adult dissection tonsillectomy with ultrasonic scalpel, bipolar electrocautery, bipolar radiofrequency or 'cold steel' dissection.
abstract: OBJECTIVE
  To conduct an adequately powered, prospective, randomised, controlled trial comparing adult dissection tonsillectomy using either ultrasonic scalpel, bipolar electrocautery, bipolar radiofrequency or 'cold steel' dissection.
  
  
  METHODS
  Three hundred patients were randomised into four tonsillectomy technique groups. The operative time, intra-operative bleeding, post-operative pain, tonsillar fossa healing, return to full diet, return to work and post-operative complications were recorded.
  
  
  RESULTS
  The bipolar radiofrequency group had a shorter mean operative time. The mean intra-operative blood loss during bipolar radiofrequency tonsillectomy was significantly less compared with cold dissection and ultrasonic scalpel tonsillectomy. Pain scores were significantly higher after bipolar electrocautery tonsillectomy. Patients undergoing bipolar electrocautery tonsillectomy required significantly more days to return to full diet and work. The bipolar electrocautery group showed significantly reduced tonsillar fossa healing during the first and second post-operative weeks.
  
  
  CONCLUSIONS
  In this adult series, bipolar radiofrequency tonsillectomy was superior to ultrasonic, bipolar electrocautery and cold dissection tonsillectomies. This method combines the advantages of 'hot' and 'cold' tonsillectomy.
authors.affiliation: Department of Otolaryngology, Tanta University Hospital, Tanta, Gharbia, Egypt. sragab@doctors.org.uk
authors.forename: S M
authors.initials: SM
authors.lastname: Ragab
mesh_terms: D000293:Adolescent; D000328:Adult; D016063:Blood Loss, Surgical; D017115:Catheter Ablation / Q000295:instrumentation; D004564:Electrocoagulation / Q000295:instrumentation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010149:Postoperative Pain; D013525:Surgical Instruments; D014068:Tonsillectomy / Q000295:instrumentation*; D059708:Ultrasonic Surgical Procedures / Q000295:instrumentation; D014945:Wound Healing; D055815:Young Adult