Abstract

Tonsillectomy is the most commonly performed surgery. Cold dissection tonsillectomy remains as the gold standard for tonsil removal, although it may increase risk for complication. Coblation tonsillectomy is a new technique .There are studies comparing these two method of surgery and have shown coblation technique to cause less postoperative pain, less intra operative time along with less intra and postoperative blood loss. In contrary few studies have shown it to be ineffective in reducing postoperative bleeding. Hence more studies are still required. Thus the objective of the present study was to compare coblation and cold dissection techniques outcome among tonsillectomy patients at Birat Medical College and Teaching Hospital. The study intended to determine and compare the intraoperative time, intra operative blood loss and postoperative pain in coblation and cold dissection tonsillectomy. This is a hospital based cross sectional comparative study. Eighty six patients underwent tonsillectomy during the study period of one year (15th Feb 2020 to 14th Feb 2021) in the department of ENT HNS, Birat Medical College and Teaching Hospital. Among 86 patients, 43 underwent cold dissection and 43 coblation tonsillectomy. Method of surgery was based on odd and even serial number of the patients during presentation. This study showed that intra operative time, intraoperative blood loss and post operative pain score was 16.77±2.7mins, 36.51±128ml and 6.28 respectively in coblation method and 37.84±3.1 mins, 101.4±12.7ml and 7.88 respectively in cold dissection method. Hence coblation method is a safer and effective method of tonsillectomy compared to cold dissection which ultimately leads to less post operative analgesics demands and early recovery.

Highlights

  • Palatine tonsils are situated in oropharynx within tonsillar fossa

  • Patient with odd serial number were included in group 1 who underwent cold dissection method and even serial number were included in group 2 who underwent coblation tonsillectomy method

  • Eighty six patients between 10-55 years of age presented during the period of one year out of which 43 underwent cold dissection tonsillectomy and 43 underwent coblation tonsillectomy

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Summary

Introduction

Palatine tonsils are situated in oropharynx within tonsillar fossa. They are collection of lymphoid tissue and play important role in immunology and defense mechanism by antibody secretion, especially secretory IgA. This protective mechanism sometimes fails and become a seat of infection causing recurrent sore throat, fever and other complications which requires the removal of diseased tonsils.[1] Tonsillectomies are very commonly performed surgeries worldwide. The most common indication for tonsillectomy is recurrent tonsillitis.[2] There are many different techniques of performing this surgery. Available techniques are cold knife dissection, coblation method, electrocautery, cryosurgery, harmonic scalpel, laser tonsillectomy, radiofrequency coblation method etc.[3] There have been lots of controversies about tonsillectomy techniques that provide fewer complications.[4]

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