Abstract

Coblation tonsillectomy is a new technique that was started in 1975, it involves passing a radiofrequency bipolar electrical current through a medium of normal saline, resulting in a plasma field of highly ionized particles which in turn break down intercellular bonds and thus melt tissue at around 40º to 70ºC (in comparison with electrocautery which cuts tissues at 400ºC)The aim of this study is to evaluate the benefit of coblation tonsillectomy over conventional (cold steel) tonsillectomy, comparing tonsillectomy duration, blood loss during the surgery, and the postoperative pain. This prospective randomised single-blinded clinical trial was done on 90 patients. Patients were divided into 2 equal groups; Group A: Underwent coblation tonsillectomy, and Group B who underwent cold steel tonsillectomy. The study was performed in Al-Musawy Private Hospital, Basrah Teaching Hospital, and Al-shifaa hospital, Basrah, Iraq. All surgeries were done by the three authors in the period between February 2018 to August 2020. The intraoperative bleeding, duration of surgery, and postoperative pain were evaluated and compared for both groups. The age range of the studied patients was 4–32 years, 52 were males and 38 were females. The average duration of tonsillectomy procedure was 31.8 minutes in coblation tonsillectomy (Group A), while the average duration in the cold steel tonsillectomy (Group B) was 25.8 minutes. The average operative blood loss in cold steel tonsillectomy was 31.5 ml while that incoblation was 3.2 ml. Average postoperative pain in coblation group was (20.7± 6.15), while in cold steel group was (27.5±7.27).In conclusion, coblation tonsillectomy is effective and beneficial in decreasing the volume of intraoperative blood loss but not for postoperative pain in comparison with conventional method, in addition that it take more time to be completed.Key words: coblation, cold steel, tonsillectomy.

Highlights

  • Celsus was the first person to recognize tonsillar disease and its relationship to infection performing the first tonsillectomy in 40 A.D1

  • After enucleating the secure all bleeding in time. tonsil with his fingernail, he suggested Izny Hafiz Zainon et al[8] showed in his the fossae should be washed with vinegar study that coblation tonsillectomy is and painted with a medication to reduce superior in improving intraoperative bleeding

  • One of randomized double blind study was 31.5 ml and for coblation method performed in 2012, described the duration was 3.2 ml. which is statistically of surgery of both coblation and cold significant. steel methods, it found less duration of Paramasivam et al[9], concluded that coblation compared to conventional method[6]

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Summary

Introduction

Celsus was the first person to recognize tonsillar disease and its relationship to infection performing the first tonsillectomy in 40 A.D1. Tonsillectomy is one of the most frequently performed surgical procedure[3]. Improvements in the procedure of tonsillectomy which are many should have the advantage of decreasing the operating time, reduction in the intraoperative and postoperative blood loss, and reduction in postoperative morbidity namely pain. Coblation is a new technique that was started in 1975 It involves passing a radiofrequency bipolar electrical current through a medium of normal saline resulting in a plasma field of highly ionized particles, which in turn break down intercellular bonds and melt tissue at around 40o to 70oC (in comparison with electrocautery which cuts tissues at 400o C)[4]. This study was carried out to evaluate the benefit of coblation tonsillectomy over conventional (cold steel) tonsillectomy, comparing tonsillectomy duration, blood loss during surgery, and the postoperative pain

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