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Being dissatisfied with the available instruments for removing fibrosed tonsils, I designed the instrument shown in the figure.
The design of the saw-knife is based on that of the Pierce tonsil knife. The lateral edges are flattened and blunted, and numerous fine serrations are made in the cutting blade, which is then honed to as sharp an edge as the thickness of the blade permits.
The tonsil is grasped with a tenaculum at the midportion and is pulled medially. With a sharp instrument an incision is made into the reflection of mucous membrane behind the anterior pillar. The reflections over both pillars are split with a Tyding knife, and the superior pole is freed with the same instrument. The tenaculum is reapplied to the superior pole, and the tonsil is rotated medially and downward to expose the tonsillar bed. The saw-knife is slipped down over the superior pole of
PALMER MP. A SAW-KNIFE FOR TONSILLECTOMY. Arch Otolaryngol. 1936;23(3):349–350. doi:10.1001/archotol.1936.00640040357008
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