J Appl Biomed 14:35-40, 2016 | DOI: 10.1016/j.jab.2015.08.002

Can we improve clinical results of tonsillectomy using lasers?

David Slouka^a,*, Pavel Polenik^b, Ondrej Hes^c, David Smid^d, Karel Slama^a, Petr Hosek^e, Ludmila Boudova^c

^a Ear, Nose and Throat Clinic, Charles University in Prague, Faculty of Medicine Pilsen, Edvarda Benese 13, 305 99 Pilsen, Czech Republic

^b Stomatological Clinic, Charles University in Prague, Faculty of Medicine Pilsen, Alej Svobody 80, 304 60 Pilsen, Czech Republic

^c Department of Pathology, Charles University in Prague, Faculty of Medicine Pilsen, Edvarda Benese 13, 305 99 Pilsen, Czech Republic

^d Department of Surgery, Charles University in Prague, Faculty of Medicine Pilsen, Edvarda Benese 13, 305 99 Pilsen, Czech Republic

^e Biomedical Centre, Faculty of Medicine in Plzen, Charles University in Prague, Alej Svobody 1655/76, 323 00 Pilsen, Czech Republic

Current medicine uses a variety of high-tech devices to obtain maximum results with minimally invasive procedures. Our goal was to determine the benefits of laser medicine in tonsillectomy in comparison with traditional tonsillectomy, harmonic scalpel and radio frequency scalpel. Forty adult patients with chronic tonsillitis, scheduled for bilateral tonsillectomy, were divided into four groups in a prospective study. The left side tonsillectomy was performed using a traditional technique. The right side tonsillectomy was performed using four different methods: Ho:YAG laser, Er,Cr:YSGG laser, radiofrequency scalpel and harmonic scalpel. Peroperative bleeding and operation time were evaluated by the surgeon, development of pain during the healing period was evaluated by the patients and also histological examination of the resecates was performed. The results showed a significant increase of postoperative pain after the Ho:YAG and Er,Cr:YSGG laser procedure in comparison to traditional tonsillectomy. No significant differences in postoperative pain were found after the use of radiofrequency scalpel and harmonic scalpel. Average operation time and peroperative bleeding differed partially in all methods. In conclusion, all the tested methods offer a safe, uncomplicated alternative to traditional tonsillectomy; however, they do not bring any substantial benefit for the patient in reduction of pain during the postoperative period.

Keywords: Surgical procedures; Minimally invasive tonsillectomy; Laser therapy; Pulsed radiofrequency treatment; Ultrasonic surgical procedures

Received: July 15, 2015; Revised: August 17, 2015; Accepted: August 18, 2015; Published: February 1, 2016  Show citation