The preference of coblation-assisted over cold dissection tonsillectomy

ABSTRACT

Tonsillectomy is one of the most commonly performed surgical procedures in otolaryngology. There are several operative methods currently in use, but the superiority of one over another has not been clearly demonstrated. Objective: To compare intraoperative efficiency and postoperative recovery between dissection and coblation tonsillectomy. Patients and Methods: This prospective clinical study was conducted at Rizgary teaching hospital/ Erbil, and Baghdad private hospitals from 29th November 2011 to 17th July 2012. The study included 100 patients who underwent tonsillectomy, half of them by coblation and the other half by cold dissection technique. Both techniques performed under general anaesthesia. Each tonsillectomy technique was assessed intraoperatively for amount of blood loss, and duration of operation. Postoperatively they were assessed for pain, hemorrhage, and day of return to normal activity and normal diet. Results: Duration of operations was significantly shorter for the coblation group versus the dissection group [17.7 min vs 22.3 min, P= 0.000]. Intraoperative blood loss was statically lower for the coblation versus the dissection group [45.3 ml vs. 74.7 ml, P= 0.003]. There was statically significant differences in daily pain scores and return to normal diet and activity between two groups [mean 5.7 day for coblation vs. 7.32 day for the dissection, P= 0.001]. And only two patients [4%] in coblation group developed secondary bleeding.Conclusion: Coblation tonsillectomy offers better operative speed, intraoperative hemostasis, less postoperative pain scores and faster recoveries than dissection tonsillectomy especially in pediatric age group