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I recently read the article "Perioperative Steroids in Tonsillectomy Using Electrocautery and Sharp Dissection Techniques" published in the August issue of the ARCHIVES,¹ which indicated that the article was based on the largest placebo-controlled, prospective, randomized, double-blind study published to date to examine postoperative morbidity in pediatric patients who received perioperative intravenous steroids.

This study is based on 2 alternating surgical techniques: (1) "hot tonsillectomy" using electrocautery for dissection; and (2) "cold tonsillectomy" using blunt dissection with directed cautery for hemostasis.

On closer examination, this suction cautery applies heat to the tissues, producing necrosis and resulting in prolonged pain, delayed healing, and increased infection as well as raising the incidence of postoperative bleeding. In other words, I do not feel that there is any difference whatsoever between the 2 techniques; one is merely an extension of the other. Applying cautery to multiple bleeding points throughout the tonsil fossa . . . [Full Text of this Article]

AUTHOR INFORMATION
Derek S. Lipman, MD

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Tonsillectomy Techniques—Reply
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Arch Otolaryngol Head Neck Surg. 2005;131(3):279-280.
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