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VOLUME 15 , ISSUE 3 ( September-December, 2023 ) > List of Articles

Original Article

A Comparative Study between Lower Pole Silk Ligation and Pillar Suturing Technique of Hemostasis in Tonsillectomy

Balaji Shankarrao Mane, Rushali Madhukar Gavali

Keywords : Cold dissection, Hemostasis, Lower pole, Pillar suturing, Post-tonsillectomy bleed, Silk ligation

Citation Information : Mane BS, Gavali RM. A Comparative Study between Lower Pole Silk Ligation and Pillar Suturing Technique of Hemostasis in Tonsillectomy. Int J Otorhinolaryngol Clin 2023; 15 (3):103-106.

DOI: 10.5005/jp-journals-10003-1453

License: CC BY-NC 4.0

Published Online: 09-01-2024

Copyright Statement:  Copyright © 2023; The Author(s).


Introduction: Tonsillectomy operation was first described in the literature in 1000 BC by Celsus and Paul of Aegine. Various attempts have been made till now in the literature to control bleeding, including injection of medicines into peritonsillar area, fibrin glue application to the surgical site, suturing together the pillars, lower pole silk ligation. The aim of this study was to compare the morbidity associated with tonsillectomy using two different methods of hemostasis. Materials and methods: The study design was duration-based prospective observational study which was conducted at the ENT Department of our Institute from August 2021 to August 2022. Total of 200 patients who have undergone tonsillectomy during this 1-year duration were selected for the study. In half number of patients, pillar suturing technique was performed, and in the remaining half number of patients, lower pole silk ligation was used to control bleeding during operation to compare the morbidity associated with each technique. Results: Pillar suturing technique shown statistically significant reduction in primary and secondary post-tonsillectomy hemorrhage as compared to lower pole silk ligation. Conclusion: Tonsillectomy procedure with pillar suturing technique of hemostasis has shown earlier pain relief and significantly faster wound healing than lower pole silk ligation technique. Pillar suturing technique of hemostasis has shown significantly increased pillar edema without significant increase in palatal discomfort sensation, palatal hematoma, suture site infection as compared with lower pole silk ligation technique of hemostasis. However, pillar suturing technique of hemostasis has shown similar results as that of lower pole silk ligation technique in terms of velopharyngeal insufficiency.

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