Although traditional tonsil surgery is a common procedure, it is “easy to perform and difficult to perform”. It is easy to bleed during and after surgery, slow recovery of trauma, scar formation, and significant postoperative sore throat in patients. Therefore, how to avoid excessive damage to the peri-tonsil tissue, reduce intraoperative and postoperative bleeding, fast trauma recovery, and less scar formation has always been a concern of ENT surgeons. In hundreds of cases of tonsil removal by curved vascular forceps, the authors observed that there was very little intraoperative bleeding, often only 1-2 cotton balls were wet (2-4 ml of blood leakage), and there was almost no postoperative bleeding. Less scar formation.
Anatomically speaking, the tonsils are located in the triangular tonsillar fossa between the two palatal arches, which is bounded by the lingual-palatal arch in front and the pharyngeal-palatal arch in the back, and the lateral wall is bounded by the peritonsillar space and the superior pharyngeal constrictor muscle, except for the inner side, which is mostly surrounded by a connective tissue peritoneum. To separate the tonsils, it is often necessary to use tonsil clamp to pull the tonsils forward in the lower direction, while using tonsil stripper to press the tonsils in the same direction to separate them from the tonsillar fossa. This is especially true for tonsils with heavy adhesions to the tonsillar fossa and for smaller tonsils. The use of curved vascular forceps to separate the tonsils can accurately and gently tear the filamentous fibrous connective tissue between the tonsillar fossa and the fascial surface of the tonsillar fossa in a clear field, which will not tear the fascial surface of the tonsillar fossa and will not easily tear the tonsils.
The placement of dry cotton balls during the operation not only absorbs the blood and exposes the surgical field, but also completes the whole procedure under the pressure of cotton balls to stop the bleeding. The smooth fascial surface can often be seen to have only a little blood leakage, and often only 1-2 cotton balls are wet (2-4 ml of blood leakage), and sometimes larger vessels can be seen to be exposed or avoided during separation, or first tied and then separated, so that hemostasis and peeling are synchronized, and often no more epinephrine is needed during infiltration anesthesia, so the surgical field of this method is The surgical field is clear, the surgical steps are well defined, bleeding is low, and hemostasis is complete. It is worthwhile to promote the clinical application of this method because it is easy to master for a first-time ENT clinician.