Influence of the Results of the Morphofunctional Investigation of the Pulmonary Tools on the Choice of the Technique of Electrowelding Technology of Tonsilectomy

Abstract

Introduction. Tonsillectomy is still one of the most frequently performed operations in the paediatric population worldwide. During surgery under local anaesthesia, an aesthetic solution is traditionally injected into the peritonsillar tissue before tonsillectomy. With tonsillectomy under general anaesthesia, some doctors additionally perform local anaesthesia, while others perform surgical intervention without local injection of aesthetic. Therefore, it is logical to study the morphological changes in the tonsils with the introduction of the solution into the peritonsillar tissue and without its introduction, both when using traditional techniques, and when using electric welding technology. Purpose. Morphofunctional substantiation of the choice of tonsillectomy technique. Materials and methods. The study of the features of morphological changes in the tissues of the palatine tonsils after the introduction of saline into the peritonsillar tissue during tonsillectomy by various methods was carried out on 44 palatine tonsils removed from 22 patients with chronic tonsillitis at the age from 6 to 17 years. The method of electric welding during tonsillectomy was used in the "overlap" mode ("manual welding") using a bipolar scalpel and an EK-300M1 high-frequency electrocoagulator. Results. When performing tonsillectomy with the help of cold cutting instruments, after additional injection of saline into the peritonsillar tissue, the central zone of damage increases 1.6 times, and the peripheral zone of damage - 6.5 times. When performing tonsillectomy using a bipolar scalpel and high-frequency current, after additional injection of saline into the peritonsillar tissue, the central zone of damage increases by 1.8 times, and the peripheral zone of damage - 9.3 times. The additional action of high-frequency current during tonsillectomy after preliminary injection of saline into the peritonsillar tissue does not statistically significantly affect the increase in the damaged area compared to tonsillectomy after preliminary administration of saline solution into the peritonsillar tissue without the action of high-frequency current. Conclusions. The introduction of physiological saline into the peritonsillar tissue before tonsillectomy contributes to a significant increase in the area of damage to the tissues surrounding the palatine tonsils during surgery using both the traditional technique and the technology of electric welding.