Can we improve clinical results of tonsillectomy using lasers?

• Ho:YAG laser and harmonic scalpel significantly reduce bleeding during tonsillectomy.
• Er,Cr:YSGG laser and radiofrequency scalpel extend the duration of tonsillectomy.
• Ho:YAG laser tonsillectomy is faster than traditional tonsillectomy.
• Use of Ho:YAG or Er,Cr:YSGG laser in tonsillectomy increases postoperative pain.
• Radiofrequency and harmonic scalpel bring no relevant decrease of postoperative pain.

Current medicine uses a variety of high-tech devices to obtain maximum results with minimally invasive procedures. Our goal was to determine the benefits of laser medicine in tonsillectomy in comparison with traditional tonsillectomy, harmonic scalpel and radio frequency scalpel. Forty adult patients with chronic tonsillitis, scheduled for bilateral tonsillectomy, were divided into four groups in a prospective study. The left side tonsillectomy was performed using a traditional technique. The right side tonsillectomy was performed using four different methods: Ho:YAG laser, Er,Cr:YSGG laser, radiofrequency scalpel and harmonic scalpel. Peroperative bleeding and operation time were evaluated by the surgeon, development of pain during the healing period was evaluated by the patients and also histological examination of the resecates was performed. The results showed a significant increase of postoperative pain after the Ho:YAG and Er,Cr:YSGG laser procedure in comparison to traditional tonsillectomy. No significant differences in postoperative pain were found after the use of radiofrequency scalpel and harmonic scalpel. Average operation time and peroperative bleeding differed partially in all methods. In conclusion, all the tested methods offer a safe, uncomplicated alternative to traditional tonsillectomy; however, they do not bring any substantial benefit for the patient in reduction of pain during the postoperative period.

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