Post-tonsillectomy morbidities: randomised, prospective controlled clinical trial of cold dissection versus thermal welding tonsillectomy

Background: New surgical techniques and devices have been described that decrease post-tonsillectomy morbidities. This study aimed to compare the two most popular tonsillectomy techniques. Method: Forty children underwent tonsillectomies using both the thermal welding and cold dissection techniques. In each patient, one side was removed with thermal welding and the other was removed with cold dissection. Results: There was a significant decrease in intra-operative blood loss, and the mean operation time was significantly lower on the thermal welding side compared with the cold dissection side. On the cold dissection side, tissue healing (i.e. the rate of complete tissue healing) was better and less pain was reported compared with the thermal welding side. However, there were no significant differences between the two techniques in terms of throat pain scores on the 1st, 3rd or 14th day post-operatively, or tissue healing scores on any of the post-operative days assessed. Conclusion: Cold dissection resulted in better tissue healing and lower pain scores than thermal welding, but thermal welding was associated with less intra-operative blood loss and lower mean operation time than cold dissection.