Comparison of Use of Ligasure Versus a Standard Technique for Tonsillectomy in Brachycephalic Obstructive Airway Syndrome

Introduction:
The principal aim of this study was to document the effectiveness of tonsillectomy in BOAS patients using a LigaSureTM device compared to a standard technique with tonsillectomy forceps. A secondary aim of the study was to document histopathological changes of the excised tonsillar tissue.

Material and methods:
All brachycephalic dogs presenting with BOAS with enlarged, everted tonsils underwent tonsillectomy using a standard technique with a tonsillectomy clamp and using a 5mm short LigaSureTM or either the left or right tonsil.

Results:
14 dogs were studied The time taken to remove a tonsil using the LigaSureTM was a mean of 49 seconds (SD 15s, 95% CI 40-57s) and with the standard technique a mean of 311 seconds (SD 67s, 95% CI 272s-349s). The difference in time between the two methods was statistically significant p <0.0001. There was a significant median difference of 2 cotton-tipped applicator swabs used between techniques (p<0.0001). Histopathology of the tonsils was characterized by multifocal neutrophilic and lymphocytic inflammation and 1-2mm of heat-induced coagulation necrosis at the cut edge of the LigaSureTM tonsils.

Conclusion:
Our study shows that LigaSureTM is significantly faster and resulted in less bleeding than the standard technique. Quick surgery with less tissue handling is likely to decrease swelling and oedema. We have also demonstrated that histopathology of tonsillar enlargement in dogs with BOAS compares similarly to those changes previously documented in soft palates of these patients.