COMPARATIVE STUDY BETWEEN HISTOACRYL AND SUTURE FOR TONSILLAR BLEEDING

SUMMARYThis work was planed to evaluate using the N-butyl cyanoacrylate adhesive (Histoacryl) in experimental tonsillectomy through macroscopic and histological assays, compared to the common used ligation method.Fifteen dogs were used in this experiment. Dogs were divided into three separate groups.(1) The first group includes 6 dogs. Blunt dissection tonsillectomies were performed with the use of general anesthesia. Hemostasis was achieved by suture ligation.(2) The second group includes 6 dogs. Blunt dissection tonsillectomies were performed with the use of general anesthesia. Hemostasis was achieved by histoacryl application.(3) The third group 3 dogs were kept as control.The following measures were collected daily:(1) Daily observation of all dogs for any clinical manifestation was applied and tonsillar fossae and other structures in the oral cavity were examined.(2) Assessment of subjective pain during eating and drinking.(3) Return to normal diet. Normal diet was defined as consumption of the types and amount of food such that control animals. Dietary progression from liquid to soft and solid food was also documented.(4) Return to normal activity. Normal activity was defined as carrying out the same types and amounts of daily activity as before surgery, even if still associated with fatigue.The results revealed that:A) Results of clinical examination:(a) The most observed clinical signs of dogs post-tonsillectomy, in which hemostasis was achieved by suture ligation (first group) were: moderate morbidity (delay onset of eating solid food, less amount of food ingested per day and delay onset of normal activity) dyspnoea due to edema in the peripheral tissue after 12 to 24hrs of tonsillectomy High degree of weight loss. All dogs were not as active as normal. Appetite returned gradually to normal by the third days post-tonsillectomy. Five out of six dogs in the first group were reluctant to eat because of the pain associated with swallowing especially on the first day after operation. There were significantly increase in both the pulse and the respiratory rates during the period of 12-24 hours pos-tonsillectomy.(b) Whereas the most observed clinical signs of dogs that had histoacryl application to the operative sites in tonsillectomy (second group) were: Slight anorexia after 12 hrs of tonsillectomy. Most dogs were returned to normal appetite after 24 hours post-tonsillectomy. There were non-significant change of body temperature, pulse rate and the respiratory rate. The operation time was on average longer with suture 22.8 min vs. histoacryl 15.5 min. Our results suggest that histoacryl offers minimal duration of operation.B) Pathological findings:(a) The gross examination of dogs revealed: In the first group moderate oedema, congested oral mucosa and severe sore throat were significantly higher in the first three days post-tonsillectomy. Whereas in the second group mild oedema, slight congested mucosa and mild sore throat were observed during the first 24- 48 hrs post-tonsillectomy.(b) The microscopical picture revealed: In the first group, there were revitalization of the epithelium, thrombosis, and fibrosis as well as dilated and regenerated capillary vessels were apparent at 7th day with more leucocytes infiltration in submucosa. On the 3rd week collagen fibrosis up to the level of the epithelium was observed. Whereas the microscopic picture in the second group revealed very mild inflammatory reaction (leucocytes infiltration) were apparent at 7th days post-tonsillectomy and collagen fibrosis at the level of epithelium was observed at 14th day post-tonsillectomy. At the end of 6 weeks, histopathological examination showed complete absence of tonsillar tissue with normal mucosa in both the suture ligation (1st group) and histoacryl application (2nd group).