Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2021, Vol. 35 ›› Issue (5): 62-66.doi: 10.6040/j.issn.1673-3770.0.2020.430

Previous Articles     Next Articles

Application of the ultrasonic scalpel in tonsillectomy for biopsy of patients with suspected tonsillar tumor

SHEN Nimei, QIAN Maohua, JIN Jiaxin, QIN Yang, WANG Jun, WU Ying, GAO Gang   

  1. Department of Otorhinolaryngology & Head and Neck Surgery, Second Affiliated Hospital of Nantong University, Nantong First People's Hospital, Nantong 226001, Jiangsu, China
  • Published:2021-09-29

PDF (PC)

69

Abstract: Objective We aimed to explore the application of the ultrasonic scalpel in tonsillar tumor resection. Methods Seventy cases of adult patients with abnormally shaped unilateral tonsils suspected of being tumors were divided into ultrasonic scalpel(35 cases)and electric scalpel(35 cases)groups. The general clinical data, operation time, intraoperative blood loss, postoperative pharyngeal pain and complications of the patients were recorded, and the data of the two groups were compared. Results The postoperative pathologies of the two groups were revealed to be mostly benign lesions, with the most chronic inflammation, followed by papilloma and cysts. Most malignant lesions were lymphoma. The ultrasonic scalpel group was superior to the electrosurgical group in terms of operative time and intraoperative blood loss(P<0.001), although it exhibited no obvious advantages in terms of postoperative secondary bleeding, postoperative infection, and duration of hospitalization. No postoperative primary hemorrhage was observed in the ultrasonic scalpel group and 5 patients in the electrosurgical group; however, the difference between the two groups was not statistically significant(P=0.054). The pain visual analogue scale(VAS)score of the ultrasonic scalpel group on the first day after surgery was superior to that of the electrosurgical group(P=0.009), and the difference was not statistically significant at 2, 5, and 10 days after surgery. Conclusion The ultrasonic scalpel is an ideal surgical instrument for tonsillectomy in patients with suspected tonsillar tumors.

Key words: Tonsil, Tumor, Ultrasonic scalpel, Electric scalpel, Tonsillectomy

CLC Number: 

  • R766
[1] Qin Y, Lu LJ, Lu YW, et al. Hodgkin lymphoma involving the tonsil misdiagnosed as tonsillar carcinoma: a case report and review of the literature[J]. Medicine(Baltimore), 2018, 97(7): e9761. doi:10.1097/MD.0000000000009761.
[2] Iyengar P, Mazloom A, Shihadeh F, et al. Hodgkin lymphoma involving extranodal and nodal head and neck sites: characteristics and outcomes[J]. Cancer, 2010, 116(16): 3825-3829. doi:10.1002/cncr.25138.
[3] 张立庆, 宋圣花, 王愿, 等. 低温等离子刀、超声刀及传统方式行扁桃体切除术的术后两年随访比较[J]. 山东大学耳鼻喉眼学报, 2017,31(5): 67-71. doi: 10.6040/j.issn.1673-3770.0.2017.181. ZHANG Liqing, SONG Shenghua, WANG Yuan, et al. Comparison of the efficacy of coblation, ultrasonic knife operation, and conventional tonsillectomy in a 2-year postoperative follow-up[J]. J Otolaryngol Ophthalmol Shandong Univ, 2017,31(5): 67-71. doi: 10.6040/j.issn.1673-3770.0.2017.181.
[4] Brkic F, Mujic M, Umihanic S, et al. Haemorrhage rates after two commonly used tonsillectomy methods: a multicenter study[J]. Med Arch, 2017, 71(2): 119-121. doi:10.5455/medarh.2017.71.119-121.
[5] Arbin L, Enlund M, Knutsson J. Post-tonsillectomy pain after using bipolar diathermy scissors or the harmonic scalpel: a randomised blinded study[J]. Eur Arch Otorhinolaryngol, 2017, 274(5): 2281-2285. doi:10.1007/s00405-017-4451-9.
[6] 张杰, 陈雪梅, 许安廷. 超声刀扁桃体切除术与低温等离子扁桃体切除术的对比研究[J]. 山东大学耳鼻喉眼学报, 2017,31(5): 95-100. doi: 10.6040/j.issn.1673-3770.0.2017.278. ZHANG Jie, CHEN Xuemei, XU Anting. A comparative analysis of harmonic scalpel tonsillectomy and coblation tonsillectomy[J]. J Otolaryngol Ophthalmol Shandong Univ, 2017,31(5): 95-100. doi: 10.6040/j.issn.1673-3770.0.2017.278.
[7] Kwek WMJ, Chua SMCA, Xu SH, et al. Randomized controlled study comparing tonsillectomy safety and patient satisfaction outcomes between HARMONIC ACE®+shears and monopolar diathermy in an adult population-A pilot study[J]. Am J Otolaryngol, 2020, 41(5): 102568. doi:10.1016/j.amjoto.2020.102568.
[8] Karimi E, Safaee A, Bastaninejad S, et al. A comparison between cold dissection tonsillectomy and harmonic scalpel tonsillectomy[J]. Iran J Otorhinolaryngol, 2017, 29(95): 313-317.
[9] Subasi B, Oghan F, Tasli H, et al. Comparison of three tonsillectomy techniques in children[J]. Eur Arch Otorhinolaryngol, 2021,(278): 2011-2015. doi: 10.1007/s00405-020-06299-8.
[10] Basu S, Sengupta A, Dubey AB, et al. Harmonic scalpel versus coblation tonsillectomy A comparative study[J]. Indian J Otolaryngol Head Neck Surg, 2019, 71(4): 498-503. doi:10.1007/s12070-019-01679-x.
[11] Sarny S, Ossimitz G, Habermann W, et al. Hemorrhage following tonsil surgery: a multicenter prospective study[J]. Laryngoscope, 2011, 121(12): 2553-2560. doi:10.1002/lary.22347.
[12] O'Leary S, Vorrath J. Postoperative bleeding after diathermy and dissection tonsillectomy[J]. Laryngoscope, 2005, 115(4): 591-594. doi:10.1097/01.mlg.0000161361.66191.60.
[13] 张华, 冯永, 蒋璐. 以单侧扁桃体肿大为首发症状的非霍奇金淋巴瘤[J]. 临床耳鼻咽喉头颈外科杂志, 2010, 24(19): 903-904. doi:10.3969/j.issn.1001-1781.2010.19.012.
[14] 戚建伟, 樊贤超, 王长宽, 等. 单侧扁桃体肿大与非霍奇金淋巴瘤[J]. 临床耳鼻咽喉科杂志, 2002,16(9): 469-470. doi: 10.3969/j.issn.1001-1781.2002.09.008. QI Jianwei, FAN Xianchao, WANG Changkuan, et al. Unilateral tonsillar enlargement and malignant tonsillar lymphoma[J]. J Clin Otorhinolaryngol, 2002,16(9): 469-470. doi: 10.3969/j.issn.1001-1781.2002.09.008.
[15] Waltonen JD, Ozer E, Schuller DE, et al. Tonsillectomy vs. deep tonsil biopsies in detecting occult tonsil tumors[J]. Laryngoscope, 2009, 119(1): 102-106. doi:10.1002/lary.20017.
[16] Koch WM, Bhatti N, Williams MF, et al. Oncologic rationale for bilateral tonsillectomy in head and neck squamous cell carcinoma of unknown primary source[J]. Otolaryngol - Head Neck Surg, 2001, 124(3): 331-333. doi:10.1067/mhn.2001.114309.
[17] Chernock RD, Lewis JS. Approach to metastatic carcinoma of unknown primary in the head and neck: squamous cell carcinoma and beyond[J]. Head Neck Pathol, 2015, 9(1): 6-15. doi:10.1007/s12105-015-0616-2.
[18] Kennel T, Garrel R, Costes V, et al. Head and neck carcinoma of unknown primary[J]. Eur Ann Otorhinolaryngol Head Neck Dis, 2019, 136(3): 185-192. doi:10.1016/j.anorl.2019.04.002.
[19] Cianchetti M, Mancuso AA, Amdur RJ, et al. Diagnostic evaluation of squamous cell carcinoma metastatic to cervical lymph nodes from an unknown head and neck primary site[J]. Laryngoscope, 2009, 119(12): 2348-2354. doi:10.1002/lary.20638.
[20] 刘丁丁, 钱晓云, 刘永泽, 等. 84例原发头颈部淋巴瘤临床及病理特征分析[J]. 山东大学耳鼻喉眼学报, 2018,32(6): 48-51. doi: 10.6040/j.issn.1673-3770.0.2018.274. LIU Dingding, QIAN Xiaoyun, LIU Yongze, et al. Analysis of clinical and pathological features of 84 patients with primary head and neck lymphoma[J]. J Otolaryngol Ophthalmol Shandong Univ, 2018,32(6): 48-51. doi: 10.6040/j.issn.1673-3770.0.2018.274.
[21] Pynnonen M, Brinkmeier JV, Thorne MC, et al. Coblation versus other surgical techniques for tonsillectomy[J]. Cochrane Database Syst Rev, 2017, 8: CD004619. doi:10.1002/14651858.cd004619.pub3.
[1] GONG Xiaoyang, LI Wang, CHEN Xi. Retrospective analysis of 67 cases of primary parapharyngeal space tumors [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(4): 60-65.
[2] ZHANG Fengzhen, WANG Guixiang, WEI Yunyun, ZHANG Yamei, ZHAO Jing, WANG Hua, LI Hongbin, LI Xiaodan, ZHANG Jie. Perioperative management of children with mild bleeding disorders undergoing adenotonsillectomy procedures [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(4): 66-72.
[3] ZHANG Lijun, XU Ran, LUO Jifang, LIU Guoqi, HE Qian, LI Wei, JIANG Zhenhua. Factors affecting flap neurosis and other postoperative flap-related complications after free-flap reconstruction of head and neck tumors [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(4): 86-90.
[4] WANG MeiOverview,LI ZhihaiGuidance. Laryngeal cancer stem cells: potential therapeutic targets for overcoming multidrug resistance [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(4): 120-128.
[5] CHEN Jiahong, WANG Lin, JIANG Yan, YU Longgang, ZHANG Jisheng, ZHANG Zhiyong, KONG Jingwen. Primary extraskeletal Ewing sarcoma/peripheral primitive neuroectodermal tumor in the nasal cavity and paranasal sinus: a case report and literature review [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(3): 290-296.
[6] ZHAO Xiaobing,ZHANG Dawei, CHEN Renjie. A case of middle-ear anaplastic large T- cell lymphoma and literature review [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(2): 7-14.
[7] JIN Xiaoxue, HAN Yingying, GUO Ruixiang, NI Shoujie, ZOU Juanjuan, WANG Yan, LI Yanzhong. Correlation between allergy factors and maxillofacial malformation in children with tonsil and adenoid hypertrophy in denture replacement period [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(2): 45-50.
[8] CHEN Kun, LU Hui, HUANG Qi, LI Lei, MENG Guozhen, YANG Jun, HOU Dongming. Clinical diagnosis and treatment of congenital nasal sinus mass in children [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 81-85.
[9] SHI Xiaoli, MU Hong. Multidisciplinary diagnosis and treatment of a child with severe obstructive sleep apnea syndrome complicated by pulmonary hypertension [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 116-119.
[10] ZHAO Xinghe, FAN Mingyue, DOU Xunwu, JIA Guangbiao. Primary large B-cell lymphoma of tonsil in children: a case report and document review [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 120-124.
[11] YUAN Chenyang, LIU Yan, FANG Zhensheng. Advances on the effect of OSAHS on pulmonary function in children [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 143-148.
[12] WANG JunxinOverview,SUN YanGuidance. Research progress of miRNA-29b involved in EMT-related signaling pathway regulation [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(6): 132-137.
[13] ZHANG Xiaoyan, HAO XiaofengOverview,XIE LikeGuidance. The application and progress of optical coherence topography in choroidal osteoma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(6): 138-141.
[14] JIN Xin, SHI Lei, JIN Mengyuan. Application of decellularized dermal matrix after benign tumor resection in the nasal sinus [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(5): 17-22.
[15] FENG Shiqiang, JIANG Xian. Adjunctive treatment of refractory by adjustable laryngoscope Hemorrhage after tonsillectomy [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(5): 67-69.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(2): 116 -118 .
[2] ZHOU Zi-ning,JIN Guo-wei . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(5): 462 -465 .
[3] ZHOU Bin,LI Bin . Endoscopic sinus surgery for 75 patients with chronic sinusitis and nasal polyps[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(1): 24 -26 .
[4] XU Sainan,YANG Lei . Apoptosis of epithelial cells in nasal polyps promoted by erythromycin[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(1): 27 -29 .
[5] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(1): 94 -95 .
[6] LIU Lian-he . Treatment of deep neck abscess in 37 cases[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(2): 180 -181 .
[7] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 200 -203 .
[8] QIAO Yi,NI Guan-sen,CHEN Wen-wen . Effect of H-UPPP and nasal operations on obstructive sleep apnea syndrome in 38 cases
[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 206 -208 .
[9] WANG Xiao-feng,LIN Chang,CHENG Jin-mei . Expression of ABAD in inner ears and its clinical significance in different age mice[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 207 -211 .
[10] FAN Qi-jun,HUANG Zhi-wu,MEI Ling,XIAO Bo-kui . Expression of the heat shock protein 27 in rat cochlea induced by sodium salicylate injection by the FQ-PCR technique[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 212 -214 .
Website Copyright: Editorial Office of Journal of Otolaryngology and Ophthalmology of Shandong University
Address: No.27 Shanda South Road, Jinan, Shandong, China. Post code: 250100 Tel: +86-0531-88366912 Email: ebhxb@sdu.edu.cn Supported by Beijing Magtech Co.Ltd