Comparison of efficacy and post-operative complications of adenotonsillectomy using coblation versus adenotonsillectomy using microdebrider and bipolar diathermy
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20220803Keywords:
Adenoids, Adenoidectomy, Diathermy, Tonsils, TonsillectomyAbstract
Background: Adenotonsillectomy is one of the widely performed surgical procedures in children worldwide, but there continues to be no universally accepted “ideal” method of tonsillectomy. This study is aimed to compare the outcome of coblation adenotonsillectomy versus microdebrider adenoidectomy with bipolar tonsillectomy in terms of efficacy and complication rate.
Methods: In this analytical observational study, 40 patients who underwent adenotonsillectomy were divided into two groups according to the technique of surgery adopted. Group A were the children who underwent coblation adenotonsillectomy and group B underwent microdebrider adenoidectomy with bipolar tonsillectomy. Comparison was made between intraoperative bleeding, the method of haemostasis, ease of haemostasis during surgery, post operative pain and comfort levels of the patient and also recurrence of symptoms after 3 months.
Results: Results of this study show that microdebrider adenoidectomy was found to have significantly higher intraoperative bleeding. The surgeons found it easier to attain hemostasis in the group who underwent coblation adenotonsillectomy. Postoperative pain, pain while feeding, difficulty in talking, higher rates of residual adenoid tissue were observed more in adenotonsillectomy using microdebrider and bipolar diathermy while ear pain, edema of the uvula were found to be slightly higher with coblation adenotonsillectomy.
Conclusions: Results of our study conclude that ‘coblation adenotonsillectomy’ has an advantage over ‘adenotonsillectomy using microdebrider and bipolar diathermy’ and was found to be more efficacious and safer with less morbidity and rapid recovery.
References
Pynnonen M, Brinkmeier JV, Thorne MC, Chong LY, Burton MJ. Coblation versus other surgical techniques for tonsillectomy. Cochrane Database Syst Rev. 2017; 8:CD004619.
Berlucchi M, Salsi D, Valetti L, Parrinello G, Nicolai P. The role of mometasone furoate aqueous nasal spray in the treatment of adenoidal hypertrophy in the pediatric age group: preliminary results of a prospective, randomized study. Pediatrics. 2007; 119(6):e1392-7.
Cassano P, Gelardi M, Cassano M, Fiorella ML, Fiorella R. Adenoid tissue rhinopharyngeal obstruction grading based on fiberendoscopic findings: a novel approach to therapeutic management. Int J Pediatr Otorhinolaryngol. 2003;67(12):1303-9.
Wong DL, Baker CM. Pain in children: comparison of assessment scales. Pediatr Nurs. 1988;14(1):9-17.
Leach J, Manning S, Schaefer S. Comparison of two methods of tonsillectomy. The Laryngoscope. 1993; 103(6):619-22.
Özkiriş M, Karaçavuş S, Kapusuz Z, Saydam L. Comparison of two different adenoidectomy techniques with special emphasize on postoperative nasal mucociliary clearance rates: coblation technique vs. cold curettage. Int J Pediatr Otorhinolaryngol. 2013;77(3):389-93.
Al-Mazrou KA, Al-Qahtani A, Al-Fayez AI. Effectiveness of transnasal endoscopic powered adenoidectomy in patients with choanal adenoids. Int J
Pediatr Otorhinolaryngol. 2009;73(12):1650-2.
Koltai PJ, Chan J, Younes A. Power-assisted adenoidectomy: total and partial resection. Laryngoscope. 2002;112(8):29-31.
Pagella F, Matti E, Colombo A, Giourgos G, Mira E. How we do it: a combined method of traditional curette and power-assisted endoscopic adenoidectomy. Acta Otolaryngol (Stockh). 2009;129(5):556-9.
Lowe D, van der Meulen J, Cromwell D, Lewsey J, Copley L, Browne J, et al. Key messages from the National prospective tonsillectomy audit. Laryngoscope. 2007;117(4):717-24.
Zhong Z, Xiao S, Wang C, Wang H, Wang G. Coblation tonsillectomy versus blunt dissection tonsillectomy. Lin Chuang Er Bi Yan Hou Ke Za Zhi. 2006;20(9):391-2.
Glade RS, Pearson SE, Zalzal GH, Choi SS. Coblation Adenotonsillectomy: An Improvement Over Electrocautery Technique?. Otolaryngol-Head Neck Surg. 2006;134(5):852-5.
Chang KW. Randomized controlled trial of Coblation versus electrocautery tonsillectomy. J Am Acad Otolaryngol Head Neck Surg. 2005;132(2):273-80.
Timms MS, Temple RH. Coblation tonsillectomy: a double blind randomized controlled study. J Laryngol Otol. 2002;116(6):450-2.
Philpott CM, Wild DC, Mehta D, Daniel M, Banerjee AR. A double-blinded randomized controlled trial of coblation versus conventional dissection tonsillectomy on post-operative symptoms. Clin Otolaryngol Facial Surg. 2005;30(2):143-8.
Stoker KE, Don DM, Kang DR, Haupert MS, Magit A, Madgy DN. Pediatric total tonsillectomy using coblation compared to conventional electrosurgery: a prospective, controlled single-blind study. Otolaryngol Neck Surg. 2004;130(6):666-75.
Shah UK, Galinkin J, Chiavacci R, Briggs M. Tonsillectomy by means of plasma mediated ablation: prospective, randomized, blinded comparison with monopolar electrosurgery. Arch Otolaryngol Neck Surg. 2002;128(6):672-6.
Belloso A, Chidambaram A, Morar P, Timms MS. Coblation tonsillectomy versus dissection tonsillectomy: Postoperative hemorrhage. Laryngoscope. 2003;113(11):2010-3.
Noon AP, Hargreaves S. Increased post-operative haemorrhage seen in adultcoblation tonsillectomy. J Laryngol Otol. 2003;117(9):704-6.
Gallagher TQ, Wilcox L, McGuire E, Derkay CS. Analyzing factors associated with major complications after adenotonsillectomy in 4776 patients: Comparing three tonsillectomy techniques. Otolaryngol-Head Neck Surg. 2010;142(6):886-92.
Chinpairoj S, Feldman MD, Saunders JC, Thaler ER. A comparison of monopolar electrosurgery to a new multipolar electrosurgical system in a Rat Model. The Laryngoscope. 2001;111(2):213-7.
Divi V, Benninger M. Postoperative Tonsillectomy Bleed: Coblation Versus Noncoblation. Laryngoscope. 2005;115(1):31-3.
Hill FT. Observations following adenoidectomy. Arch Otolaryngol. 1931;14(6):775-83.
Lundgren N. The recurrence rate of adenoids. Acta Otolaryngol (Stockh). 1949;37(1):50-6.
