Freer Tonsil Knife — Peritonsillar Dissection

Freer Tonsil Knife — Peritonsillar Plane Dissection

The Freer tonsil knife is the cold-dissection knife for the tonsillar plane — between the tonsillar capsule and the superior constrictor muscle. In an era of bipolar diathermy and coblation many surgeons no longer use cold knives for tonsillectomy, but the Freer remains the safety-net instrument for the bleed in a difficult dissection where the diathermy field cannot be cleared and the operator needs a sharp blade to find and divide a tissue band by feel.

Peritonsillar abscess drainage

The other indication is peritonsillar abscess drainage in the conscious patient: after a topical lignocaine spray and a single injection of local infiltration the Freer’s short blade incises the soft palate just superior to the upper tonsillar pole, deep enough to enter the abscess cavity but no deeper. The blade is then withdrawn and pus is drained with suction. Length and depth of the cut are controlled by the operator’s grip on the shaft, marked at the tip with a millimetre scale.

Sterilisation

Steam-autoclave 134°C 18 min standard; the edge holds through repeat cycles when the blade is rinsed before drying.