Volume 25 , Issue 2 , December 2023 , Pages 362-369
Soran Mohammed Ali Fatah 1 ; Yousif Ibrahim Chalabi 1
1 Department of Surgery, College of Medicine, University of Sulaimani, Sulaimani,Kurdistan region, Iraq
Background: Tonsillectomy is one of the most commonly practised surgeries in general
and otolaryngology. Bleeding tonsillar lower pole, primarily pain and tonsillar remnant
are common complications of this operation. Objectives: To assess and compare the
effectiveness of wired snare removal of the inferior tonsillar pole with negus artery
ligaturisation technique regarding bleeding, pain, operative time, and the tonsillar
remnant in cold dissection tonsillectomy. Patients and Methods: This hospital-based,
prospective, comparative study was conducted on 200 patients (400 tonsils) that
underwent a tonsillectomy in Sulaimani Teaching Hospital and Shorsh Teaching
Hospital from April 2021 to February 2022. On one side, the tonsil's inferior pole was
removed by silk using negus artery ligaturisation, while the other lower pole tonsil of the
same patient was crushed by wired eves snare. Patients followed up on the 4
th, 7th day,
and 8th weeks postoperative for bleeding, pain, fever, and tonsillar remnant. Results:
Most patients were aged 5-10 years (48.5%) and males (56%). The mean±SD of surgical
time for wired snaring was significantly (p=0.000) shorter (6.04±0.47 minutes) than that
of artery ligation (7.0±1.55 minutes). The tonsillar remnant occurred mainly with
ligation, while bleeding more commonly occurred on the snare side (p=0.048).
Conclusions: Lower tonsillar pole negus ligation removal was associated with less
bleeding and pain. However, it is more time-consuming operatively, with more tonsillar
remnant occurrence than wired snare removal of the lower pole.