A-1b.

LT and HST have shown comparable results regarding intraoperative blood loss, postoperative hemorrhage, and pain. Compared with CKT, both were associated with less intraoperative blood loss and pain.

Objective: To evaluate and introduce a new method of tonsillectomy using the Thermal Welding System (TWS). Method: The TWS is a new surgical instrument which uses direct heat and pressure to seal and divide tissues. Fifty consecutive patients underwent tonsillectomy with the use of the TWS. Inclusion criteria were chronic tonsillitis, peritonsilar abscess history and obstructive sleep apnea syndrome. Patients undergoing adenoidectomy or any other procedure together with tonsillectomy and patients with bleeding disorders were excluded. Intraoperative bleeding, operative time, complication rates and return to normal diet were evaluated. Results: There was no measurable bleeding during surgery in any case. No postoperative hemorrhage or other complication occurred. Mean operative time was 23 min. Mean time for return to normal diet was 8.7 days. Conclusions: The TWS was found quite effective and safe, providing sufficient hemostasis and minimal intraoperative blood loss.

Merocel packing rehydration with tetracaine 0.25% solution is an easy, safe, inexpensive, and effective analgesia method for nasal packing removal in septoplasty.

The aim of this study was to determine clinical features that could predict the presence of tonsillar malignancy in children and adults. A retrospective review of the histopathologic reports of the children, who underwent tonsillectomy (753 cases) during the past 16 years (January 1991-December 2006) in a busy district general hospital, was undertaken. We compared the results to the pre-operative data of the patients, for risk factors of malignancy. Such proposed risk factors were tonsillar asymmetry, palpable firmness, visible lesions, neck adenopathy, history of malignancy, and systemic symptoms. The same data (history, risk factors and histopathologic results) were reviewed for an adult group (>16 years old, 1,027 cases) who underwent tonsillectomy during that period, and the results of the two groups were compared. In the pediatric group only one case was diagnosed as lymphoma (0.13%) and the rest as chronic inflammation (47%), reactive tonsil tissue (26%), lymphoid hyperplasia (19%) and actinomycosis (8%). In the lymphoma case, the diagnosis was suspected preoperatively by history and clinical manifestations. In the adult group, there were 21 cases of malignancy out of 1,027 cases (2.04%), again with one or more positive risk factors in the pre-surgery history. Based on our review, it is concluded that histopathology of tonsillectomy is not necessary in children unless there is clinical suspicion based on preoperative findings. A protocol based on proposed risk factors which may be predictive of possible malignancy can be used as a guide to intraoperative histology.