COMPARATIVE STUDY OF VARIOUS TECHNIQUES TONSILLECTOMY

Abstract

Objective: The purpose of the study was to compare intraoperative factors and postoperative outcomes between the image-guided acute dissection technique and the endoscopic image-guided acute dissection technique. Material and methods: The study was conducted in 153 patients (81 men and 72 women, average age 26.4 years) who underwent tonsillectomy (2018-2023). Patients were randomly assigned 2 group 52% percent of patients(group1) underwent tonsillectomy with acute dissection technique under visual control, and 48% of patients (group 2) underwent tonsillectomy with acute dissection technique under endoscopic visualization using a 4.0 mm 0° endoscope (Karl Storz, Tuttlingen, Germany). Indications for tonsillectomy were hypertrophy of the tonsils in 82 patients, recurrent tonsillitis in 23 patients and focal infection of the tonsils in 48 patients. Tonsillectomy was performed under general anesthesia using an oral speculum specifically designed for tonsillectomy. All patients were assessed and compared for postoperative pain, bleeding, recurrence, or tonsil tissue growth in the immediate and late postoperative period. The removed adenoid is sent for histology. Clinical diagnosis: Chronic decompensated tonsillitis. Pathohistological diagnosis: Within the limits of the examined material, the histological picture corresponds to chronic tonsillitis, hypertrophy of nasopharyngeal adenoid tissue. Results: There were no serious intra- or postoperative complications. Bleeding points were identified in 47 patients (31 patients group1 and 16 patients group 2). The source of bleeding was observed in the central deep part of the adenoids - in 18 patients, in the lateral parts of the adenoids - in 16 patients, adenoids on both sides in 13. Remnants of adenoid tissue were found in 23 patients, (17 patients group 1 and 6 patients group 2). Remnants of adenoid tissue were removed using bipolar diathermy under image guidance. The operation time for endoscopic tonsillectomy is shorter than for traditional procedures. Conclusions: The visibility provided Tonsillectomy by endoscopic techniques improves the ease and precision of surgery. Clinical significance determines the need for further testing of already proposed means and methods.