A Parallel Group Analysis of Tonsillectomy Using the Harmonic Scalpel vs Electrocautery | Otolaryngology | JAMA Otolaryngology–Head & Neck Surgery | JAMA Network
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1.
Younis  RTLazar  RH History and current practice of tonsillectomy.  Laryngoscope 2002;1123- 5PubMedGoogle ScholarCrossref
2.
Johnson  LBElluru  RGMyer  CM  III Complications of adenotonsillectomy.  Laryngoscope 2002;11235- 36PubMedGoogle ScholarCrossref
3.
Wexler  DB Recovery after tonsillectomy: electrodissection vs sharp dissection techniques.  Otolaryngol Head Neck Surg 1996;114576- 581PubMedGoogle ScholarCrossref
4.
Willging  JPWiatrak  BJ Harmonic scalpel tonsillectomy in children: a randomized prospective study.  Otolaryngol Head Neck Surg 2003;128318- 325PubMedGoogle ScholarCrossref
5.
Walker  RASyed  ZA Harmonic scalpel tonsillectomy versus electrocautery tonsillectomy: a comparative pilot study.  Otolaryngol Head Neck Surg 2001;125449- 455PubMedGoogle Scholar
6.
Wiatrak  BJWillging  JP Harmonic scalpel for tonsillectomy.  Laryngoscope 2002;11214- 16PubMedGoogle ScholarCrossref
7.
Morgenstein  SAJacobs  HKBrusca  PA  et al.  A comparison of tonsillectomy with the harmonic scalpel versus electrocautery.  Otolaryngol Head Neck Surg 2002;127333- 338PubMedGoogle ScholarCrossref
8.
Lavy  JA Posttonsillectomy pain: the difference between younger and older patients.  Int J Pediatr Otorhinolaryngol 1997;4211- 15PubMedGoogle ScholarCrossref
Original Article
January 2005

A Parallel Group Analysis of Tonsillectomy Using the Harmonic Scalpel vs Electrocautery

Arch Otolaryngol Head Neck Surg. 2005;131(1):49-51. doi:10.1001/archotol.131.1.49
Abstract

Objective  To evaluate efficiency and postoperative morbidity in tonsillectomy using the harmonic scalpel (HS) vs conventional electrocautery (EC).

Design  A retrospective medical chart review of all patients who underwent tonsillectomy at a single children’s hospital during a 32-month period from January 2001 to August 2003.

Patients  The charts of 605 patients who underwent tonsillectomy or adenotonsillectomy were reviewed. The patients were stratified into 2 groups based on the dissecting instrument used (HS vs EC). Each group consisted of 2 subcategories based on age (≤7 years and >7 years). Data collected included age, sex, operative indication, operative time, postanesthetic recovery room time, pain scale scores, postoperative admissions, and postoperative morbidities.

Results  There were significant differences in mean age (P<.001), mean weight (P<.001), and indication for surgery (P<.001) between the 2 methods: HS patients were younger, weighed less, and more often had obstructive symptoms as their primary operative indication compared with the EC group. Average operative times were not significantly different between methods. No differences were noted with respect to recovery time (HS group, P = .10; EC group, P = .30), postoperative oxygen requirements (HS group, P = .07; EC group, P = .09), and postoperative pain scores (HS group, P = .31; EC group, P = .58). There was a significant difference in postoperative admissions between the 2 methods in patients 7 years or younger (P = .005). Finally, we noted a significant difference in postoperative bleeding between the HS (2/292) and EC (13/313) methods when the data were compared per age group (P = .006), but the overall bleeding rate was not statistically significant owing to the small number of total bleeding instances (15/605).

Conclusions  Recent prospective studies indicate that the HS provides advantages over conventional EC with respect to postoperative pain and return to normal activity. This study shows that HS tonsillectomy was as efficient as the conventional EC method. In addition, there was evidence that the rate of postoperative bleeding was significantly reduced by using the HS vs conventional EC.

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