OUTCOME OF TONSILLECTOMY BY DISSECTION METHOD VS BIPOLAR DIATHERMY

Abstract

Background: Tonsillectomy remains one of the most frequently performed surgical procedures among children and adolescents worldwide, typically indicated for recurrent tonsillitis or obstructive sleep-disordered breathing. Two commonly practiced surgical approaches include the conventional cold dissection method and bipolar diathermy technique. Postoperative throat pain is a key concern influencing recovery, quality of life, and return to normal function. Despite existing studies, comparative evidence from local populations remains limited.

Objective: To compare the postoperative pain outcomes of tonsillectomy performed via dissection method versus bipolar diathermy in patients aged 4 to 18 years.

Methods: This randomized controlled trial was conducted at the Department of ENT – Head and Neck Surgery, Lady Reading Hospital, Peshawar, from July 12, 2024, to January 12, 2025. A total of 84 patients aged 4–18 years undergoing tonsillectomy were equally divided into Group A (dissection method) and Group B (bipolar diathermy) through blocked randomization. Pain was assessed 24 hours postoperatively using the Visual Analogue Scale (VAS; 0 = no pain, 10 = worst pain). Demographic characteristics, socioeconomic status, residence, and speech outcomes were also recorded. Data were analyzed using SPSS version 22, with p ≤ 0.05 considered statistically significant.

Results: The mean age was 11.36 ± 4.11 years in Group A and 10.26 ± 4.79 years in Group B. The mean VAS pain score at 24 hours was significantly lower in Group A (1.21 ± 1.22) compared to Group B (1.88 ± 1.13), with a p-value of 0.01. Pain incidence was 59.5% in Group A versus 81.0% in Group B (p = 0.03), while absence of pain was more frequent in Group A (40.5%) than Group B (19.0%).

Conclusion: Tonsillectomy using the dissection method demonstrated significantly lower postoperative pain compared to bipolar diathermy, highlighting its potential benefit in patient comfort and recovery.