ABSTRACT
Introduction: tonsillectomy has been practiced since antiquity. It continues to be one of the most commonly performed surgical procedure. Tonsillectomy produces an open wound that heals by secondary intention. The major postoperative morbidity problems are haemorrhage and pain. Coblation tonsillectomy being a relatively recent introduced technique depends on applying radiofrequency current with lower frequency than bipolar diathermy, allowing for significantly less painful and more rapid healing of tonsillar fossae
Aim of work: is to compare between the traditional dissection tonsillectomy and coblation tonsillectomy. This implies all aspects of surgery including operative time, postoperative course and incidence of complications
Patients and methods: during the period from January to August 2014 a sixty patients [29 males and 3 1 females] were scheduled for tonsillectomy. Their ages ranged from 5 to 16 years with the mean age 8.2 +/- 3.5 years. Patients enrolled in this study were divided into two groups. Group A: [30] underwent surgery using the conventional dissection ligation method, while Group B: [30] underwent Coblation tonsillectomy
Results: the mean score for the operative time was 33.8 minutes in [group A] as compared to 41.5 minutes in [group B] while the mean score for intra-operative blood loss was 104.5 ml in [group A] and 36.4 ml in [group B].Postoperative mean visual analogue scale [VAS] scores of pain for Group A were 7, 7.3, 6.73, 5.8, 5.3,4.87 and 4.5 in the first seven postoperative days respectively, while Mean scores for Group B were 7, 5.97, 5, 4.06, 3.87, 3.13 and 3 in the first seven postoperative days respectively. Regarding as return of normal swallowing [score 4] was achieved on the sixth day [mean 6.16 day] in Group A, and on the fourth day in Group B [mean 3.97 day]. On the seventh postoperative day, the percentage of normal pink mucosal lining was found to be 50% of the tonsillar bed in Group A, as compared to 75% in the coblation group [Group B]. Reactionary haemorrhage occurred in one case in the coblation group in comparison to two cases in the conventional group
Conclusion: coblation tonsillectomy proved to be safe and effective; however, reducing cost and addressing its postoperative complication rate are mandatory before considering it as the modality of choice for this commonly performed procedure