Tonsillectomy (Tonsillotomy and Coblation)

Most tonsillectomies are carried out by dissection. Only a small minority of otolaryngologistsstill routinely perform guillotine tonsillectomy. We carried out a prospective study on 86children undergoing tonsillectomy utilising a standard anaesthetic and analgesic regimen tocompare post-operative pain after dissection tonsillectomy and guillotine tonsillectomy using aPopper's hemostatic guillotine. Guillotine tonsillectomy was significantly less painful(P<0.001) than dissection tonsillectomy. The relative risk of experiencing moderately severeto severe pain was 0.36 (95% CI, 0.18-0.72) in the guillotine group. A significant proportion ofchildren experience moderately severe to severe pain despite a comprehensive analgesicregimen confirming that post operative pain remains an important issue after this operation.On the basis of our findings we advocate tonsillectomy by guillotine in children. The less painthat arises within the first 24 h may be particularly important if performing tonsillectomy as aday-case procedure.PMID: 10699236 [PubMed indexed for MEDLINE] Clin Otolaryngol Allied Sci. 1997 Dec;22(6):532-5. Streptococcal tonsillitis and its association withpsoriasis: a review.England RJ1, Strachan DR, Knight LC.Author information AbstractLancefield group A streptococcal upper respiratory tract infections are well known to beprecursors of a number of disease processes. That they frequently herald a first attack ofguttate psoriasis or a reactivation of chronic plaque psoriasis is well recognized, though this isperhaps more true among dermatologists than otolaryngologists. This paper brieflysummarizes the historical background, recent research into, and current understanding of theconnection between the two pathological phenomena.Lancefield group A streptococcal upper respiratory tract infections are well known to beprecursors of a number of disease processes. That they frequently herald a first attack ofguttate psoriasis or a reactivation of chronic plaque psoriasis is well recognized, though this isperhaps more true among dermatologists than otolaryngologists. This paper brieflysummarizes the historical background, recent research into, and current understanding of theconnection between the two pathological phenomena. BMJ Case Reports 2012; doi:10.1136/bcr-2012-007059