The use of the harmonic scalpel is popular with some head and neck surgeons. This study looked at selective neck dissections for 40 patients with oral cavity carcinoma. They were randomised into harmonic scalpel (HS) use and monopolar electrocautery. The HS group had statistically less bleeding although ultimately this amounted to a mean difference of just 12 mls. All other outcome measures such as operating time and postoperative stay were similar. Apparently the quality of the operative field looked a bit better using electro cautery although the authors suggested that the p value of 0.407 was “not statistically non-significant.” So some support for the harmonic scalpel and encouragement for enthusiasts but perhaps not enough to convince surgeons experienced with electrocautery.