REDEFINING INDICATIONS AND EVALUATION OF DISSECTION VERSUS DIATHERMY METHOD OF TONSILLECTOMY

The current availability of randomized clinical trials have assessed the efficacy of the most common presumed indications for tonsillectomy, but the controversery still exists So, the present study was conducted to assess (1) Whether tonsillectomy leads to any significant benefits as compared to watchful waiting (2)evaluating the two most commonly used techniques for tonsillectomy i.e; cold dissection & diathermy. 170 patients were included,104 were assigned to the surgical group(Group A) & 66 patients acted as control(Group B).The surgical group underwent tonsillectomy.The efficacy of tonsillectomy viz-a-viz chronic tonsillitis related morbidity, school absenteeism, & work absenteeism, Group A beta hemolytic streptococcal pharyngitis, otitis media, Rhinosinusitis, obstructive sleep apnea & psoriasis was studied.The results of our study were as; Majority among children ( 7-15 years) & the mean age of adult population was 23.02 years.Tonsillectomy definitely provided benefit in case of chronic tonsillitis , mild to moderate obstructive sleep apnea on polysomnographic findings where as the Patients who had been included in this study to redefine otitis media & rhinosinusitis as an indication for tonsillectomy did not benefit much when compared to the watchful waiting group The three most commonly used techniques of tonsillectomy i.e; cold steel using ties & packs, cold steel using monopolar diathermy for hemostasis & using monopolar diathermy exclusively were evaluated.The operating time was least for the diathermy alone method .The intraoperative blood loss was minimal for the monopolar diathermy method .The primary hemorrhage rate was maximum in technique of cold steel with ties & packs as hemostasis.The secondary hemorrhage rate was maximum in monopolar diathermy method . The postoperative pain measured by using the verbal rating scale was considerable after using monopolar diathermy alone with 33% complaining of severe pain & 67% complaining of moderate pain.