Coagulation is thought to occur through coaptation, where ultrasonic energy disrupts hydrogen bonds and denatures protein, producing a coagulum that coapts small vessels. When applied over a large surface area, tissue coagulation occurs, and when coupled with a sharp edge, tissue cutting is achieved. 3 The HS employs ultrasonic energy through high-frequency vibration (55.5 kHz) over a small amplitude (50 to 80 μm). Fenton and was outlined by this same author in 2000. This technology was first employed in Canada for the removal of tonsils in March 1997 by Dr Ronald S. The harmonic scalpel (HS) was introduced in 1993 and has since gained accepted use in the setting of laparoscopic surgery. In the current study, we set out to specifically compare postoperative pain following monopolar cautery tonsillectomy (MCT), a readily accepted and widely used technique for tonsillectomy, and harmonic scalpel tonsillectomy (HST) (Ethicon Endo-Surgery, Cincinnati, OH). Achieving an optimal balance between intraoperative blood loss and early and delayed hemorrhage while minimizing postoperative pain has been the motivation for ongoing evaluation of varied techniques for tonsillectomy, and to date no single technique has been shown to optimize all considerations. Herein lies the impetus to develop and evaluate additional techniques for tonsillectomy that minimize both pain and postoperative hemorrhage. In addition, tonsillectomy leads to significant postoperative pain for a period of seven to 14 days, with the severity of pain often graded as moderately severe, requiring narcotic analgesia and, at times, readmission to hospital for hydration and intravenous analgesia. Continued evaluation of new techniques and technologies for tonsillectomy is fueled by an accepted postprocedure primary and secondary hemorrhage rate from 0.8 to seven percent, 1, 2 with some instances of hemorrhage being of considerable morbidity, including return to the operating room, blood transfusion, and death. The most relevant outcomes in these evaluations include intraoperative blood loss, postoperative hemorrhage, and pain. Tonsillectomy is one of the most commonly performed surgical procedures in otolaryngology–head and neck surgery, and a growing number of surgical technologies have been applied and evaluated in this setting. All subjects Allied Health Cardiology & Cardiovascular Medicine Dentistry Emergency Medicine & Critical Care Endocrinology & Metabolism Environmental Science General Medicine Geriatrics Infectious Diseases Medico-legal Neurology Nursing Nutrition Obstetrics & Gynecology Oncology Orthopaedics & Sports Medicine Otolaryngology Palliative Medicine & Chronic Care Pediatrics Pharmacology & Toxicology Psychiatry & Psychology Public Health Pulmonary & Respiratory Medicine Radiology Research Methods & Evaluation Rheumatology Surgery Tropical Medicine Veterinary Medicine Cell Biology Clinical Biochemistry Environmental Science Life Sciences Neuroscience Pharmacology & Toxicology Biomedical Engineering Engineering & Computing Environmental Engineering Materials Science Anthropology & Archaeology Communication & Media Studies Criminology & Criminal Justice Cultural Studies Economics & Development Education Environmental Studies Ethnic Studies Family Studies Gender Studies Geography Gerontology & Aging Group Studies History Information Science Interpersonal Violence Language & Linguistics Law Management & Organization Studies Marketing & Hospitality Music Peace Studies & Conflict Resolution Philosophy Politics & International Relations Psychoanalysis Psychology & Counseling Public Administration Regional Studies Religion Research Methods & Evaluation Science & Society Studies Social Work & Social Policy Sociology Special Education Urban Studies & Planning BROWSE JOURNALS
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