Health Science ISM
By Jacqueline Meier
Mrs. Click
Spring 2014
• Mentor: Dr. Deborah Miller
• Career: Ear, Nose, and throat specialist
• Mentorship site: 250 Blossom St.
• Project Topic: Comparing different
removal options and procedures for
tonsillectomy
Dr. Miller’s Background
 Current education level: Doctorate (M.D) total of 8 years of school
 Typical schedule: Seeing patients in office Monday, Wednesday, and
Friday.
 Tuesday and Thursday are surgery days
 Decided to become an ENT after doing rotations in med school
 Studied at Virginia Tech for 4 years & later finished up school at University of
Texas for another 4 years
What is an ENT Specialist?
 “Otolaryngologists diagnose and manage diseases of
the ears, nose, sinuses, larynx (voice box), mouth, and
throat, as well as structures of the neck and face.”
Ears• Earing loss and earing disorders
• Middle ear infection
Nose• Chronic sinusitis
• Nasal polys
Throat• Swollen tonsils
• Tonsillectomy
What does it take to be an ENT?
 Educational requirements- Undergraduate degree- 4 years Medical
Degree- 4 years Residency- 3- 8 years
 According to globalpost.com “ear, nose and throat doctors must
complete a 5-year residency when studying at Loyola University in
Chicago.”
 Total of at least 11 years at least and a maximum of 16
 Salary- Average annual income 411,689
Project topic
Comparing different
procedures and techniques
that can be utilize in order to
perform tonsillectomy
Product: Tri-fold board
Tonsillectomy
 What is tonsillectomy? Surgical removal of tonsils, glands in the
throat that help fight infection.
 Why should you get them removed? Constantly getting strep throat
or other infections of the mouth, blocking breathing passage way,
foul order or taste in mouth.
Brief animation of tonsillectomy
procedure
 http://www.youtube.com/watch?v=zzXzr-zDLX8
Main ways to perform tonsillectomy
Electrocauterization
• - Burns tonsils and surrounding tissue
Harmonic Scalpel
• Also knows as Ultrasonography this uses energy from an
ultrasound to vibrate the blade
Bipolar Radiofrequency Ablation
• Disrupts the molecular bonds of tonsil tissue.
Electrocauterization
• A device that burns tonsils
and surrounding tissue in
order to remove tonsils and
cause less bleeding
Use During Surgery
This technique may be used in surgery to cut
through soft tissue and completely remove
the tonsils this is done so that the surgeon can
gain access to the site and seal off blood
vessels that are bleeding during surgery.
Harmonic Scalpel
• Uses hot ultrasonic energy to vibrate a
special blade. The blade cuts tonsil
tissues and stops bleeding.
Used during surgery:
This action cuts tissue with a fraction of the heat and
trauma as compared to electrical cutting currents. The
intense vibration also causes the blood in the immediate
area to coagulate, so there is virtually no blood loss
during the operation.
Bipolar Radiofrequency Ablation
• Uses radiofrequency energy to
destroy tonsil tissue
Used during surgery:
As the energy is transferred to the tissue, ionic dissociation occurs.
This mechanism can be used to remove all or only part of the tonsil.
This causes removal of tissue with a thermal effect of 45-85 C°. The
advantages of this technique are less pain, faster healing, and less
post operative care.
Data:
Blood Loss
17%
70
50%
60
33%
50
40
Electrocauterization
30
Harmonic Scalpel
Bipolar Radiofrequency Ablation
20
10
0
over all
return to normal
complaction
diet
Electrocauterization
Bipolar Radiofrequency Ablation
Harmonic Scalpel
Conclusion:
 Coblation tonsillectomy results in decreased postoperative pain compared
to electrocautery and Harmonic tonsillectomy. This is based on pain scores
analysis and on faster return to normal diet.
 patients undergoing cold steel tonsillectomy have less pain than patients
undergoing electrocautery. However, intraoperative blood loss and
operative time are decreased cautery tonsillectomy.
 The Harmonic Scalpel tonsillectomy offers advantages of early return to diet
and activity over standard electrocautery tonsillectomies.
 Dr.Miller
 Mrs.Click
 Mrs.Randall
 Kelsi Smith
 My mom
Citations
 Ahmed, A., I. Aliyu, and E. Kolo. "Indications for Tonsillectomy and
Adenoidectomy: Our Experience." Nigerian Journal of Clinical Practice 17.1
(2014): 90. Academic OneFile. Web. 10 Apr. 2014.
http://go.galegroup.com/ps/i.do?id=GALE|A354977565&v=2.1&u=leag775
73&it=r&p=AONE&sw=w&asid=77b916f5648722a546d8467390aa3663
 Fallon, L. Fleming. "Tonsillectomy." The Gale Encyclopedia of Surgery. Ed.
Anthony J. Senagore. Vol. 3. Detroit: Gale, 2004. 1423-425. Gale Virtual
Reference Library. Web. 10 Apr. 2014.
<http://go.galegroup.com/ps/i.do?id=GALE|CX3406200448&v=2.1&u=leag
77573&it=r&p=GVRL&sw=w&asid=751d1777e8a99015105e082f3317e3d9>.
 Ibekwe, Titus, Godwin Obasikene, and Ekeng Offiong. "Tonsillectomy:
Vasoconstrictive Hydrolytic Cold Dissection Method." African Journal of
Paediatric Surgery 10.2 (2013): 150. Academic OneFile. Web. 4 Apr. 2014.
<http://go.galegroup.com/ps/i.do?id=GALE|A340351123&v=2.1&u=leag77
573&it=r&p=AONE&sw=w&asid=38b7a665eda08d43338f3d63aca6e0e7>.
Citations Continued
 Skolnik, Neil, and Jennifer Thuener. "Tonsillectomy in Children." Family Practice
News 1 Aug. 2011: 98. Academic OneFile. Web. 6 Apr. 2014.
<http://go.galegroup.com/ps/i.do?id=GALE|A266941036&v=2.1&u=leag77573
&it=r&p=AONE&sw=w&asid=2c0631a9e4b68b8a306b77d70279e5e3>.
 Chang, Christopher Y., and Richard Thrasher. "Coblation Cryptolysis to Treat
Tonsil Stones: A Retrospective Case Series." Ear, Nose and Throat Journal June
2012: 238. Academic OneFile. Web. 10 Apr. 2014.
<http://go.galegroup.com/ps/i.do?id=GALE|A294894492&v=2.1&u=leag77573
&it=r&p=AONE&sw=w&asid=f04a5e3d28b33588dd4930e29d46d876>.
 Ali, Naeem Sultan, Dr, and Mubasher Ikram, Dr. "Harmonic Scalpel versus
Electrocautery Tonsillectomy: A Comparative Study in Adult Patients."
Harmonic Scalpel versus Electrocautery Tonsillectomy: A Comparative Study in
Adult Patients. N.p., n.d. Web. 04 May 2014.