Tonsillectomy | Purpose, Contraindications, Procedure, Recovery and Complications

Tonsillectomy operations techniques

There are multiple techniques in performing tonsillectomy. In the operation room, the patient is placed in the rose position with a shoulder roll. A mouth prop is inserted to open the mouth and keep it open. Then Allison clamp is used to clasp the tonsils. The next step is dissection of the tonsil capsule, which have variable methods such as:

    • Using of cold steel and known as cold tonsillectomy
    • Monopolar cautery
    • Bipolar cautery
    • Radiofrequency ablation
    • Harmonic scalpel with vibrating titanium blades
    • Microdebrider for an intracapsular dissection

There are a lot of debate about the optimum surgical technique to use. The choice of one technique over the others depends on the technique cost, postoperative risks, intraoperative bleeding, and time.

Tonsillectomy using cold tonsillectomy technique is suggested to cause less postoperative pain, on the other hand, hot tonsillectomy may be associated with less intraoperative time and complications as intraoperative bleeding.

A study conducted by Chan et al. to determine how cold tonsillectomy technique can affect postoperative recovery time. The authors founded that, the complications that are usually associated with the traditional methods were decreased significantly after using cold tonsillectomy technique, and the residual tonsillar tissue that is usually associated with this technique have no major consequences.

The final decision of the technique of tonsillectomy return to the surgeon experience, and what is useful for every case.

A study by Leinbach et al. to study hot versus cold tonsillectomy. They founded that bleeding postoperatively is similar in both techniques, with no significant difference between hot and cold tonsillectomy.

Another study by Kay W Chang to compare the recovery of patients undergoing coblation assisted intracapsular tonsillectomy in comparison to patients undergoing traditional subcapsular electrocautery tonsillectomy. The authors founded that, patient undergoing coblation assisted intracapsular tonsillectomy have a significantly better postoperative recovery. Those patients had less pain and returned to their normal activity faster than patients with the traditional tonsillectomy.