Safety of Cold Tonsillectomy Techniques: Comparison between Wired Snare and Inferior Tonsillar Pole Ligation Methods

Objective: The aim of this study was to assess the safety of wired snare method compared with inferior tonsillar pole ligation method as techniques used in cold dissection tonsillectomy. Study design: Prospective, case series study with six months follow up. Setting: Al-Fallujah Teaching Hospital, Al-Anbar, Iraq. Subjects and methods: This was a hospital based prospective study performed in the Department of Ear, Nose and Throat, from July 2012 to June 2013, during this period 210 patients underwent tonsillectomy by same surgeon. Tonsillectomy done by cold dissection technique, one side the inferior tonsillar pole ligated by silk, the other side in the same patient, the inferior pole had been taken with cold wire snare, the selection done randomly. Bipolar diathermy forceps were used for tonsillar bed homeostasis adenoidectomy done by curettage if indicated. Follow up continued for the next six months. Results: The indication for tonsillectomy was mainly due to recurrent acute or chronic tonsillitis (75.2%). Early complications as primary bleeding happened more with wired snare method (four times) as well as the reactionary hemorrhage, on the other hand the anesthetic complications (four times), trauma to base of tongue and tonsillar remnant happened more with inferior tonsillar pole ligation method. Late complications were very limited after both procedures. Conclusion: From this study we concluded that wired snare method carried more risk of bleeding, while inferior tonsillar pole ligation method associated with more anesthetic, traumatic and tonsillar remnant complications.