Objective: To evaluate the effectiveness of a new device "plasma knife" for tonsillectomy by comparing to two well-established tonsillectomy techniques: cold dissection, and bipolar electrocautery.
Methods: A prospective, randomized study conducted on 110 patients undergoing tonsillectomy. Subjects were randomized to plasma knife (PKT), cold dissection (CDT) and bipolar electrocautery (BET) groups. Operative time, intraoperative blood loss and postoperative complications were recorded. Pain/discomfort level of patients and healing time of the tonsillar fossae were assessed postoperatively. Data were recorded and statistically analyzed.
Results: Operative time with plasma knife and bipolar electrocautery were associated with a significant decrease in operative time compared to cold dissection (p<0.05). Intraoperative blood loss was significantly decreased with plasma knife, compared to cold dissection and bipolar electrocautery (p<0.05). Less postoperative pain was observed with plasma knife compared to bipolar electrocautery but more postoperative pain was observed with both compared to CDT (p<0.05). Postoperative healing time was longer with plasma knife and bipolar electrocautery, compared to cold dissection (p<0.05).
Conclusion: Plasma knife is a useful and safe device in tonsillectomy. Its use reduces intraoperative blood loss and provides a fast tonsillectomy with acceptable morbidity.