Effect of diathermy on pain and healing in tonsillectomy, compared with other methods of haemostasis: a randomised study

OBJECTIVE: To compare three methods of haemostasis used for 'cold steel' tonsillectomy, in terms of pain scores and morbidity. METHOD AND MATERIAL: Prospective, randomised, single-blinded, controlled clinical study. Three haemostasis methods were compared: compression of the tonsillar fossae with gauze packs; bipolar diathermy; and local anaesthesia then pack compression. The outcome measures were pain scores (derived from a visual analogue scale), peri-operative bleeding, and post-operative episodes of blood-stained saliva, consultation rate, tonsillar bed healing and days before return to regular diet. One hundred and five patients were included. RESULTS: Peri-operative bleeding was significantly reduced in the local anaesthesia group compared with the other two groups. Delayed post-operative tonsillar bed healing was noted in the diathermy group. No other significant differences were found between the three haemostasis groups, for any other outcome measures. The presence of blood-stained saliva was associated with higher pain scores. CONCLUSION: Diathermy and compression were associated with similar post-tonsillectomy morbidity.