Post-operative Outcomes and Recovery Differences Between Electrocautery and Cold Dissection Tonsillectomy Techniques: A Comparative Study

Open Access

Abstract

Background: Tonsillectomy is one of the most common surgical procedures performed in otolaryngology. The choice of surgical technique, particularly electrocautery versus cold dissection, can influence operative time, intraoperative blood loss, post-operative pain, and recovery time. Objective: To compare post-operative outcomes, complications and recovery parameters in patients undergoing tonsillectomy using electrocautery versus cold dissection techniques. Methods & Materials: This prospective study included 70 patients aged 5-40 years undergoing elective tonsillectomy at National Institute of ENT, Tejgaon, Dhaka, Bangladesh from January to December 2024. Patients were randomly assigned to either Electrocautery Group (n=35) or Cold Dissection Group (n=35). Key outcome measures included operative time, intraoperative blood loss, post-operative pain (assessed using Visual Analog Scale, VAS), time to resume oral intake and incidence of post-operative hemorrhage and other complications. Data were analyzed using SPSS v25, and p-values <0.05 were considered statistically significant. Results: The mean operative time was significantly shorter in the electrocautery group (28.3 ± 4.6 min) compared to the cold dissection group (37.5 ± 5.2 min, p<0.001). Intraoperative blood loss was lower in the electrocautery group (35.7 ± 10.4 mL) versus cold dissection (72.5 ± 15.2 mL, p<0.001). Post-operative pain scores at 24 hours were higher in the electrocautery group (VAS 6.2 ± 1.1) compared to cold dissection (VAS 4.8 ± 1.2, p<0.001). Time to resume normal diet was shorter in cold dissection (3.2 ± 1.0 days) compared to electrocautery (4.5 ± 1.2 days, p=0.002). Minor post-operative hemorrhage occurred in 2 patients in each group, with no major complications reported. Conclusion: Electrocautery tonsillectomy offers the advantage of reduced operative time and blood loss, while cold dissection provides less post-operative pain and faster recovery. Choice of technique should be individualized based on patient characteristics surgeon preference, and clinical priorities.