Comparison of Intraoperative and Postoperative Morbidity between Carbondioxide Laser Tonsillectomy and Dissection Tonsillectomy: A Randomised Clinical Trial
Journal Title: Journal of Clinical and Diagnostic Research - Year 2018, Vol 12, Issue 12
Abstract
ABSTRACT Introduction: Tonsillectomy is one of the most common procedures done in Ear, Nose and Throat department. Various methods of tonsillectomy have come into practice starting from dissection and snare to the recent coblation methods. Dissection and Snaring causes endothelial injury and release of tissue thromboplastin that results in aggregation of platelets and platelet plug formation and controls bleeding. It causes open wound that results in the exposure of nerves. On the other hand, CO2 LASER produces a characteristic wound that results in very minimal thermal effects on nearby non-targeted tissues. Postoperative morbidity is determined by the degree of thermal injury to the oropharyngeal mucosa that is less with dissection method. Reduced intraoperative time reduces unnecessary hospital stay and also increases patients turnover. Aim: To compare CO2 LASER tonsillectomy and dissection tonsillectomy in terms of intraoperative time, intraoperative bleeding and postoperative pain. Materials and Methods: This was a randomised study done on 126 consenting patients; randomised into two groups. Inclusion criteria were; children and young adults of age group 7-18 years with chronic tonsillitis and fulfilling diagnostic Scottish Intercollegiate Guidelines Network (SIGN) criteria. Results: The mean operative time for CO2 LASER group was 31.2 minutes (range 20 to 45 minutes) and 53.89 minutes (range 20 to 90 minutes) for dissection group with p<0.001. The mean intraoperative bleeding for CO2 LASER group was 40.8 mL (range 20.5 to 84.9 mL) compared with 80.2 mL for dissection group (range 44.4 to 117.2 mL) with p-value <0.001. The mean pain scores Visual Analog Scale (VAS) on postoperative day 1 in CO2 LASER group was 5.52 (range 3 to 8) and 4.87 (range 2 to 8) for dissection group with p=0.007. The mean pain score on postoperative day 7 in CO2 LASER group was 2.65 (range 2 to 6) and 2.00 (range 1 to 4) for dissection group with p-value <0.001. Conclusion: To conclude, tonsillectomy with CO2 LASER method is associated with less intraoperative time, less intraoperative bleeding but with more postoperative pain. Though laser tonsillectomy is proven for its efficacy and proven benefits, we suggest that the advantages of Laser tonsillectomy over conventional techniques have to be outweighed with respect to availability of resources and patient preferences.
Authors and Affiliations
Saranya Thangavel, Sunil Kumar Saxena, Arun Alexander
Keywords
Related Articles
- EP ID EP526040
- DOI 10.7860/JCDR/2018/38178.12333
- Views 37
- Downloads 0
Ultrasound Guided Oblique Subcostal Transverse Abdominis Plane Block using Local Anaesthetic Versus Saline for Laparoscopic Cholecystectomies: A Randomised Controlled Trial
ABSTRACT Introduction: Laparoscopic cholecystectomy surgery causes patients to have postoperative discomfort due to pain caused by incisions on the anterior abdominal wall. With the introduction of peripheral nerve block...
Application of Curved MPR Algorithm to High Resolution 3 Dimensional T2 Weighted CISS Images for Virtual Uncoiling of Membranous Cochlea as an Aid for Cochlear Morphometry
Introduction: With the use of various surgical techniques, types of implants, the preoperative assessment of cochlear dimensions is becoming increasingly relevant prior to cochlear implantation. High resolution CISS prot...
Prognostic Significance of Epidermal Growth Factor Receptor in Patients of Glioblastoma Multiforme
Introduction: Glioblastoma Multiforme (GBM) is the most aggressive glial tumour with hallmark characteristics of rampant proliferation of glial cells along with high pleomorphism, necrosis, endothelial proliferation and...
Evaluation of C-Reactive Protein and Fibrinogen in Patients with Chronic and Aggressive Periodontitis: A Clinico-Biochemical Study
Introduction: Periodontal disease is characterised by chronic infection and inflammation in periodontal tissues leading to destruction of alveolar bone with subsequent tooth loss. Periodontal infections are the result of...
Brain Derived Neurotrophic Factor as a Treatment Modality: The Future of Clinical Neurosciences
ABSTRACT Brain Derived Neurotrophic Factor (BDNF) is one of the Neurotrophic factors responsible for the survival, growth, differentiation and maturation of neurons. BDNF has been reported to have multiple physiological...