title: Bipolar tonsillotomy: A novel and effective tonsillotomy technique.
abstract: OBJECTIVE
  To present, for the first time, tonsil size reduction using reusable bipolar forceps electrocautery (RBFE), as a treatment for pediatric OSAS and to assess the safety and efficacy of the procedure.
  
  
  METHODS
  A prospective interventional design study was performed. Thirty children aged 2-15 years with OSAS (AHI>5) diagnosed by means of polysomnography were included. All children were treated with adenoidectomy and RBFE tonsillotomy without dissection. Re-polysomnography was performed after 1 year. The size of the tonsils was blindly assessed by two ENT specialists and the parents were asked to fill out 'Pediatric Sleep Questionnaires' (PSQ), before surgery, and one month and one year after surgery.
  
  
  RESULTS
  There were no complications during or after surgery. There were no events involving postoperative bleeding or dehydration. The surgery mean time, including adenoidectomy, was 20.6min. The AHI was 10.9 before surgery and decreased to 1.8 after surgery (p<0.001), minimum saturation (SaO2 min) increased from 86.1% to 93.2% (p<0.001). The size of the tonsils decreased from a mean of +3.3 before surgery to +1.3 and +1.4 one month and one year after surgery, respectively. The mean of the PSQ scores went down from 23.6 to 5.5 and to 6.2 one month and one year after surgery, respectively.
  
  
  CONCLUSIONS
  We demonstrated that simple cauterization of the tonsils using a RBFE device with an adenoidectomy is a safe and effective treatment to decrease tonsil size in OSAS. In addition, the method is inexpensive, rapid and does not cause bleeding, which may be particularly interesting in the presence of coagulation problems.
authors.affiliation: Department of Otolaryngology and Head and Neck Surgery, Shaare-Zedek Medical Center, Affiliated with the Hebrew University Medical School, Jerusalem, Israel. Electronic address: hananshaul@gmail.com.
authors.forename: Chanan
authors.initials: C
authors.lastname: Shaul
authors.affiliation: Department of Otolaryngology and Head and Neck Surgery, Shaare-Zedek Medical Center, Affiliated with the Hebrew University Medical School, Jerusalem, Israel.
authors.forename: Pierre D
authors.initials: PD
authors.lastname: Attal
authors.affiliation: Department of Otolaryngology and Head and Neck Surgery, Shaare-Zedek Medical Center, Affiliated with the Hebrew University Medical School, Jerusalem, Israel.
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Schwarz
authors.affiliation: Department of Otolaryngology and Head and Neck Surgery, Shaare-Zedek Medical Center, Affiliated with the Hebrew University Medical School, Jerusalem, Israel.
authors.forename: Nidal
authors.initials: N
authors.lastname: Muhanna
authors.affiliation: Statistic Service, School of Pharmacy, The Hebrew University Medical School, Jerusalem, Israel.
authors.forename: Dvora
authors.initials: D
authors.lastname: Izgelov
authors.affiliation: Department of Otolaryngology and Head and Neck Surgery, Shaare-Zedek Medical Center, Affiliated with the Hebrew University Medical School, Jerusalem, Israel.
authors.forename: Uri
authors.initials: U
authors.lastname: Peleg
authors.affiliation: Department of Otolaryngology and Head and Neck Surgery, Shaare-Zedek Medical Center, Affiliated with the Hebrew University Medical School, Jerusalem, Israel.
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Sichel
mesh_terms: D000233:Adenoidectomy; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004564:Electrocoagulation / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D020181:Sleep Apnea, Obstructive / Q000601:surgery*; D014068:Tonsillectomy / Q000379:methods*; D016896:Treatment Outcome