Zanco Journal of Medical Sciences
 
Skip Navigation Links
Home
Available Issues
Search
Editorial Board
Information for Authors
Review Process
Copyright
Links and Contacts
  Zanko J Med Sci:  Apr. 2018; 22 (1): 25-31

Coblation versus dissection tonsillectomy in children

Sermed Ebdollatif Tahyr *, Moyaser Abdul-Rahman Yaseen *

 
* Department of Surgery, College of Medicine, Hawler Medical University, Erbil, Iraq.
 


Abstract

Background and objective: Tonsillectomy is the surgical procedure of removing the tonsils. Various methods of tonsillectomy have been practiced aimed at decreasing or eliminating intraoperative and postoperative morbidity. This study was conducted to determine the different outcomes of tonsillectomy surgery in both coblation and dissection techniques. 

Methods: A prospective control study was conducted with a total sample size of 66 patients. Each patient underwent tonsillectomy by using ArthroCare Coblator on the right side and dissection method on the left side. Children between the age of 3-12 years old were selected with indications of recurrent tonsillitis and/or kissing tonsil causing snoring and/or sleep apnea. Children with peritonsillar abscess, malignancy, bleeding disorder were excluded. Operative time and blood loss, postoperative pain, bleeding and healing process were compared between two methods. Operations performed by the same surgeon.

Results: The intraoperative time was significantly shorter (P <0.001) and intraoperative blood loss was significantly lesser (P <00.01) in coblation as compared to dissection tonsillectomy, while there were no significant differences in the postoperative pain scores on 1st, 2nd, 7th and 14th postoperative days. There was a significant healing process in tonsillar fossa in favor of coblation rather than dissection. No primary or secondary postoperative bleeding was reported.

Conclusion: Coblation tonsillectomy is a safe procedure with significantly less intraoperative time and less blood loss and better surgical wound healing with similar postoperative pain in comparison with dissection tonsillectomy.

Keywords: Tonsillectomy; Coblation; Dissection; Radiofrequency.


Reference

1. Anniko M, Bernal SM, Bonkowsky V, Bradley P, Iurato S. Otorhinolaryngology Head and Neck Surgery. Munich: Springer; 2010. P. 426.

2. Özler GS, Tatar EC. Comparing Traditional Cold Knife Tonsillectomy with a New Technique Plasma Knife Tonsillectomy. Turk Arch Otolaryngol 2013; 51:114-7.

3. Businco LDR, Tirelli GC. Pediatric Tonsillectomy: Radiofrequency- Based Plasma Dissection Compared to Cold Dissection with sutures. {www.businco.it}. [citedat Jan.19th -2016]. Available from [http://www.businco.it/studio].

4. Belloso A, Chidambaram A, Morar P, Timms MS. Coblation Tonsillectomy Versus Dissection Tonsillectomy: Postoperative Hemorrhage. The Laryngoscope 2003; 113(11):2010-3.

5. Back L, Paloheimo M, Ylikoski J. Traditional Tonsillectomy Compared With Bipolar Radiofrequency Thermal Ablation Tonsillectomy in Adults. Arch Otolaryngol Head Neck Surg 2001; (127):1106-10.

6. Jalizada AN, Febohns, Al Rawi M. Comparison of cold tonsillectomy and cobilation tonsillectomy. Int J Tech Res App 2015; 3(1):123-7.

7. Roje Z, Racic G, Dogas Z, Pisac VP, Timms M. Postoperative Morbidity and Histopathologic Characteristics of Tonsillar Tissue Following Coblation Tonsillectomy in Children: A Prospective Randomized Single-Blind Study. Coll Antropol 2009; 33(1):293-8.

8. Chang KW. Randomized controlled trial of coblation versus electrocautery tonsillectomy. Otolaryngol Head Neck Surg 2005; 132: 273-80.

9. Parker D, Howe L, Unsworth V, Hilliam R. A randomised controlled trial to compare postoperative pain in children undergoing tonsillectomy using cold steel dissection with bipolar hemostasis versus coblation technique. Clin Otolaryngol 2009; 34:225-31.

10. Oko MO, Ganly I, Loughran S, Clement W A, Young D, Geddes NK. A Prospective Randomized Single–Blind Trail Comparing Ultrasonic Scalpel Tonsillectomy with Tonsillectomy by Blunt Dissection in a Pediatric Age Group. Glasgow, United Kingdom. Otolaryngol Head Neck Surg 2005; 133(4):579-84.

11. Wong D, Baker C. Pain in children: comparison of assessment scales. Pediatr Nurs 1988; 14:9-17.

12. Zainon IH, Salim R, Daud MK. Coblation tonsillectomy versus dissection tonsillectomy: A comparison of intraoperative time, intraoperative blood loss &postoperative pain. Med J Malaysia 2014; 69(2):74-8.

13. Matin MA. Coblation tonsillectomy versus blunt dissection tonsillectomy. The ORION Med J 2006; 23:330-1.

14. Magdy EA, Elwany S, El-Daly AS, Abdel-Hadi M, Morshedy MA. Coblation tonsillectomy: a prospective, double-blind, randomized, clinical and histopathological comparison with dissection–ligation, monopolar electrocautery and laser tonsillectomies. J Laryngol Otol 2008; 122: 282-90.

15. Shapiro N L, Bhattacharyya N. Cold Dissection Versus Coblation-Assisted Adenotonsillectomy in Children. Laryngoscope 2007; 117:406-10.

16. Timms MS, Temple RH, Paediatric coblation tonsillectomy. Int J Pediatr Otorhinolaryngol 2001; 61(3):195-8.

17. Windfuher JP, Deck JC, Remmert S. Hemorrhage following coblation tonsillectomy. Ann Otol Rhinol Laryngol 2005; 114(10):749-56.

18. Paramavasivan VK, Arumugam SV, Kameswaran M. Randomised comparative study of adenotonsillectomy by conventional and coblation method for children with obstructive sleep apnea. Int J Pediatr Otorhinolaryngol 2012; 76(6):816-21.