Coblation vs. Electrocautery Tonsillectomy: A Prospective Randomized Study Comparing Clinical Outcomes in Adolescents and Adults

Abstract

Objectives: Coblation is operated in low temperature, so it is proposed that tonsillectomy with coblation involves less postoperative pain and allows accelerated healing of the tonsillar fossae compared with other methods involving heat driven processes. However, the results of the previous studies showed that the effect of coblation tonsillectomy has been equivocal in terms of postoperative pain and hemorrhage. Though, most of the previous studies which evaluated coblation tonsillectomy were performed in children. Recently, electrocautery tonsillectomy has been used most widely because of the reduced intraoperative blood loss and shorter operative time compared to other techniques. This prospective study compared intraoperative records and postoperative clinical outcomes in adolescents and adults following coblation and electrocautery tonsillectomies.

Methods: Eighty patients over 16 years of age with histories of recurrent tonsillitis were enrolled. The patients were randomly allocated into coblation (n=40) and electrocautery tonsillectomy groups (n=40). All operations were performed by one surgeon who was skilled in both surgical techniques. Intraoperative parameters and postoperative outcomes were checked.

Results: Postoperative pain and otalgia were not significantly different between the two groups; however, there was a tendency towards reduced pain and otalgia in the coblation group. More cotton balls for swabbing the operative field were used introoperatively in the electrocautery group (P=0.00). There was no significant difference in postoperative hemorrhage, wound healing, commencement of a regular diet, and foreign body sensation between the groups.

Conclusion: Only cotton use, which represented the amount of blood loss, was less in the coblation tonsillectomy group. Coblation tonsillectomy warrants further study with respect to the decreased postoperative pain and otalgia.

Keywords: Coblation; Electrocautery; Tonsillectomy.

Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1

Postoperative visual analoge scale (VAS) pain scores. No significant difference was evident between the coblator and electrocautery groups; however, there was a tendency towards less pain in the coblation group. P-values at postoperative day (POD) 0, 1, 2, 7, and 14 are 0.31, 0.99, 0.59, 0.19, and 0.41 each.

Fig. 2

Postoperative number of patients with otalgia. A tendency towards less otalgia was evident in the coblation group. P-values at postoperative day (POD) 0, 1, 2, 7, and 14 are 0.42, 1.00, 0.79, 0.81, and 0.46 each.