DIATHERMY TONSILLECTOMY - COMPARISONS OF MORBIDITY FOLLOWING BIPOLAR AND MONOPOLAR MICRODISSECTION NEEDLE EXCISION

Tonsillectomy is frequently associated with a considerable post-operat ive morbidity. In some cases reactionary or secondary haemorrhage occu rs and all patients suffer a degree of post-operative pain. The use of bipolar diathermy excision has become popular because it reduces intr a-operative blood loss, but all diathermy inevitably produces a degree of damage to adjacent normal soft tissues. In turn this inadvertent i njury must act to increase the post-operative pain. Monopolar dissecti on using a fine tungsten diathermy needle (the Colorado needle) allows sharp dissection at low power levels and in previous studies has been shown to produce a reduction in collateral tissue damage. In this pro spective study the morbidity associated with tonsillectomy using this needle was compared to that following a standard bipolar dissection. U sing the monopolar needle produced no enhanced risk of reactionary or secondary haemorrhage while causing significantly less post-operative pain and a reduction in eschar. We believe that excision using this ne edle preserves the advantages associated with bipolar dissection while reducing local soft tissue damage.