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Abstract Background & aim: Tonsillectomy as one of the most prevalent surgical operations in otolaryngology is followed by great pain and absences from school and work in most patients. The aim of the present study was a comparison of radiofrequency bipolar cautery in tonsillectomy use. Methods: This clinical trial study was conducted on 33 patients older than 10 years-old candidate for tonsillectomy. Radiofrequency and Bipolar techniques were performed on the right and left tonsils of each studied patient, respectively. Data on pain, bleeding, operation duration and hardness was collected and analyzed by SPSS software, version 15. P-value less than 0.05 was considered statistically significant. Results: Bleeding volume did not statistically differ between two techniques while for other studied factors, statistically significant differences were observed in favor of radiofrequency method (P<0.05). The mean pain intensity in the Radiofrequency procedures on different days after surgery was significantly lower than that of bipolar cautery (P<0.05). Conclusion: Due to our results, the mean score of post-tonsillectomy pain was significantly less following radiofrequency technique in compare with bipolar technique. Key words: Tonsillectomy, Radiofrequency, Pain, Bleeding

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Abstract Background & aim: Chronic rhinosinusitis is a common diagnosis in children which affects the lives of patients and their families. The purpose of this study was to compare the effectiveness of adenoidectomy with adenotonsillectomy surgery in symptom’s changes in chronic rhinosinusitis in children less than 14 years of age. Methods: In the present clinical trial, 60 patients less than 14 years of age with a diagnosis of chronic rhinosinusitis resistance to antibiotic were randomly divided into two identical groups. In one group, adenoidectomy, and on the other group, adenotonsillectomy was performed. Prior to surgery and one month after surgery, symptoms of rhinosinusitis were graded based on the visual analogue scale. After surgery the Waters X-ray was taken. Data were analyzed by independent t-test. Results: In both groups, VAS changes in symptoms, headache, cough, postnasal discharge, bad breath, rhinorrhea, and nasal obstruction were significant before and after surgery (p.>0.5 ). Also the mean change in VAS before and after surgery in adenotonsillectomy adenoidectomy was significant (p.>0.5). In this study, reduction of clinical signs and symptoms of rhinosinusitis after adenoidectomy surgery was 100%, but the improvement of Waters X-ray findings was 53%. Reduction of signs and symptoms of rhinosinusitis after adenotonsillectomy surgery was 100%, but recovery process of waters radiographic of rhinosinusitis findings was 80%. Conclusion: Adenotonsillectomy and adenoidectomy surgery were effective in improving of the process of sign and symptoms and radiologic findings in children with chronic rhinosinusitis moreover adenotonsillectomy surgery was more effective in improving symptoms and waters radiological findings. Key words: Adenoidectomy, Adenotonsillectomy, Rhinosinusitis

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Background & aim: Pain is the most important complaint of children after tonsillectomy. Thus, poor relief will lead to complications. Therefore, the aim of the present study was to determine and compare the effect of topical injection of bupivacaine with lidocaine-epinephrine combination on pain after tonsillectomy.
 
Methods: The present paper was a double-blind controlled clinical trial study. The statistical population consisted of 87 children aged 4-10 years who were candidates for tonsillectomy. All patients in all 3 groups underwent general anesthesia in the same way and the knife surgery method was the same in all patients. 5 minutes before the incision, 2 cc in the first group and 2 cc in the second group in the children in the bed and around the tonsils were injected locally and no intervention was performed in the control group. Pain intensity in children 2, 4, 6 and 8 hours after surgery was assessed using the Wang Baker pain scale. The collected data were analyzed using descriptive and analytical statistical tests (95% confidence interval and significance level (p <0.05).The statistical population included 87 children aged 4-10 years who were candidates for tonsillectomy. All subjects which met the inclusion criteria were selected by non-probability and available sampling and randomly assigned to block in 3 groups.
 
Results: The range of postoperative pain intensity in children receiving bupivacaine was 4-8, in the group receiving lidocaine-epinephrine combination was 5-8 and in the control group was 6-10, respectively. There was a statistically significant difference between the pain intensity between the 3 groups of children participating in the study (p=0.001). Although the pain intensity of children in the bupivacaine group at 2, 4, 6, and 8 hours postoperatively was lower than that in children receiving the lidocaine-epinephrine combination, but this difference was statistically only at 2 and 4 hours postoperatively. Significant was reported (p=0.001) and no statistically significant difference was reported at other times (p>0.05). There was a statistically significant difference between the pain intensity range of children in the two intervention groups and children in the control group at all measurement times (2, 4, 6 and 8 hours after surgery) (p=0.001).
 
Conclusion: Topical injection of bupivacaine and lidocaine-epinephrine combination around the tonsils reduced the severity of pain in children after tonsillectomy, however no difference was seen in the effect of topical bupivacaine injection with lidocaine-epinephrine combination on postoperative pain relief after surgery not observed except at 2 and 4 hours after surgery. Topical injection of bupivacaine and lidocaine-epinephrine combination was safe at the injected concentration and no side effects were observed.