Many different methods for tonsillectomy have emerged but whether they provide an improvement over the traditional cold steel tonsillectomy is another matter. Thermal welding is a recent method of tonsillectomy in which the tissues are simultaneously coagulated and divided. In this study the authors have made a direct comparison between the two methods of tonsillectomy in the same patient. The study comprises 40 children ranging from four to 14 years. Postoperative morbidity was measured in terms of a visual analogue scale for pain, the presence or absence and sidedness of otalgia during swallowing, drinking and speaking, bleeding and comparison of postoperative healing on the two sides. Patients were assessed on the first, third, seventh and fourteenth postoperative days. It was noted that it took less time to do the thermal welding tonsillectomy, which also had less bleeding. However in cases undergoing cold dissection, tissue healing proved to be better and the throat pain scores were significantly lower on the seventh postoperative day. There was no primary or secondary bleeding in any of the cases. The authors are aware of the pain scores being confused because of the highly subjective nature of pain. The study has its merits in that the two different methods were used on the same subject by the same surgeon and statistical analysis has been applied. The study is in agreement with many comparative studies between cold dissection tonsillectomy and newer methods and rightly makes one conscious of introducing more expensive methods in a cost effective scenario.

Post tonsillectomy morbidities: randomised, prospective controlled clinical trial of cold dissection versus thermal welding tonsillectomy.
Aydin S, Taskin U, Altas B, et al.
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Madhup K Chaurasia

United Lincolnshire Hospitals NHS Trust; University of Leicester, UK.

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