Coblation Tonsillectomy Research Articles

Coblation Reduced Post-operative Pain Over Bipolar Diathermy in Tonsillectomy Operation

Background: Tonsillectomy is a common surgical procedure performed for conditions like chronic tonsillitis and obstructive sleep apnea. Coblation and Bipolar Diathermy are advanced techniques that offer potential benefits over traditional methods; however, comparative studies evaluating these techniques in Bangladesh are scarce. Methods: A prospective analysis of 750 tonsillectomy cases (420 Coblation, 330 Bipolar Diathermy) was conducted at the Department of ENT, Rajshahi Medical College Hospital and Metropolitan Hospital, Rajshahi, Bangladesh, from January 2021 to June 2024. Data were collected on primary outcomes (pain duration, post-operative bleeding rates, healing time) and secondary outcomes (operation time, analgesic use, intra-operative bleeding, diet, and healing degree). Statistical analysis included chi-square and t-tests. Results: Coblation tonsillectomy significantly reduced post-operative pain duration compared to Bipolar Diathermy. In the pediatric group (ages 3-15 years), 85% of Coblation patients reported pain resolution within 5-7 days, while only 60% in the Bipolar group achieved resolution within 8-12 days. In adults (>15 years), 70% experienced pain resolution within 8-10 days with Coblation versus 55% with Bipolar Diathermy. Coblation was associated with lower reactionary hemorrhage rates (pediatric: 0.24% vs. 1.21%; adult: 0.1% vs. 0.61%) and secondary hemorrhage rates (pediatric: 1.67% vs. 3.33%; adult: 2.17% vs. 3.57%). Healing times were shorter with Coblation, with reduced analgesic use, lower intra-operative bleeding (average 1.5 ml vs. 3.5 ml), earlier return to a normal diet, and faster healing in the tonsillar fossa. Conclusion: Coblation tonsillectomy provides superior outcomes in terms of pain management, bleeding complications, and healing time compared to Bipolar Diathermy. These findings support Coblation as a preferred tonsillectomy technique for both pediatric and adult patients in a tertiary care setting in Bangladesh.

Surgical arrest of post-tonsillectomy haemorrhage: hospital episode statistics 2016-2022.

Return to theatre for arrest of post-tonsillectomy haemorrhage represents a significant complication of a commonly performed Ear, Nose and Throat procedure. We used Hospital Episode Statistics data to quantify this risk. This method has been used previously for data from 2002-2004 and again for 2010-2016. In this article, coblation tonsillectomy was considered separately as it had not been analysed in previous studies. We used Hospital Episode Statistics data provided by the Department of Health to determine the risk of return to theatre for patients undergoing tonsillectomy between 2016 and 2022. Adults and children were analysed separately. Between 1 April 2016 and 30 April 2022, 179,172 tonsillectomies were performed (not including coblation tonsillectomy), 4,311 (2.41%) of which returned to theatre for control of postoperative bleeding. In children, 1.16% returned to theatre, whereas in adults, 3.80% returned (p<0.05). When including coblation tonsillectomy, the return to theatre rate was 0.82% in children, 3.46% in adults and 1.92% overall. This study shows that adults remain more than three times more likely than children to require a return to theatre for arrest of haemorrhage following tonsillectomy. The rates of post-tonsillectomy haemorrhage decrease when coblation tonsillectomies are added to the analysis. The rate of return to theatre for post-tonsillectomy haemorrhage seems to have stabilised compared with previous work carried out. The authors recommend further work to assess the complication rate of tonsillectomy in the UK and to compare coblation tonsillectomy with other techniques.

Recurrence of sleep apnea in children after intracapsular coblation tonsillectomy: A comprehensive exploration of tonsil regrowth

ObjectivesSleep apnea is a prevalent issue in children, associated with significant morbidities such as cardiovascular and neurocognitive disorders. There is increasing interest in intra-capsular tonsillectomy by coblation (ICTC) as a method to address obstructive sleep apnea (OSA) in children. However, the literature remains controversial regarding the most effective intra-capsular tonsillectomy (ICT) technique with the least morbidity. Our current research extends a previous study that established the effectiveness and safety of ICTC, demonstrating rapid post-surgical recovery with minimal analgesic needs. This new investigation specifically focuses on long-term follow-up. Our aim is to assess tonsil regrowth and the risk of recurrence of OSA symptoms at a mean follow-up of 6.1 years post-surgery. By presenting the results of this extended study, our goal is to gain a better understanding of the long-term effectiveness of this surgical intervention in treating OSA in children. Thus, considering the initial benefits, we will also explore potential long-term implications. Materials and methodsThis research follows up on children from our previous study who underwent ICTC, with or without adenoidectomy, for OSA resulting from tonsillar hypertrophy at a tertiary-level university hospital between March 2016 and March 2018. They were followed up for an average of 6.1 years postoperatively. Symptom recurrence is assessed by comparing preoperative OSA-18 questionnaire results with those obtained at the 6.1-year mark. Tonsil regrowth is evaluated by comparing preoperative Brodsky scores with those obtained at 6.1 years. ResultsThe mean total score of OSA-18 significantly decreased from 79.41 (SD = 14.95) before ICTC to 25.47 (SD = 8.92) at 6.1 years postoperatively (p < 0.001, mean difference = 53.94, 95 % CI [50.32, 57.56]). Similarly, the mean Brodsky score dropped from 2.95 (SD = 0.51) before ICTC to 1.04 (SD = 0.24) 6.1 years postoperatively (p < 0.001, mean difference = 1.92, 95 % CI [1.80, 2.04]). The overall regrowth rate was 2.35 % (n = 2), with a revision surgery rate of 1.18 % (n = 1). ConclusionICTC exhibits minimal risk of tonsil regrowth and maintains long-term efficacy in preventing the recurrence of OSA symptoms. Therefore, it justifies broader utilization in addressing OSA symptoms arising from tonsillar hypertrophy in children.

Postoperative Morbidity of Different Tonsillectomy Techniques: A Systematic Review and Network Meta-Analysis.

To compare different tonsillectomy techniques in terms of postoperative bleeding incidence and postoperative pain. An arm-based network analysis was conducted using a Bayesian hierarchical model. The primary and secondary outcomes were postoperative bleeding incidence and mean postoperative pain score. A total of 6464 patients were included for five different interventions (cold dissection tonsillectomy; extracapsular coblation tonsillectomy; intracapsular coblation tonsillectomy [ICT]; bipolar diathermy tonsillectomy [BDT]; monopolar diathermy tonsillectomy). ICT showed the lowest absolute risk (4.44%) of postoperative bleeding incidence (73.31% chance of ranking first) and the lowest mean postoperative pain score (1.74 ± 0.68) with a 94.0% chance of ranking first, whereas BDT showed both the highest absolute risk of bleeding incidence (10.75%) and the highest mean postoperative pain score (5.67 ± 1.43). ICT seems to offer better postoperative outcomes, in terms of reduced risk of bleeding and reduced pain. Further prospective studies are advised to confirm these findings. NA Laryngoscope, 134:1696-1704, 2024.

Comparison between Tonsillectomy by Coblation, Bipolar and Surgical Dissection

Abstract Background Tonsillectomy is one of the most common paediatric surgical procedures performed worldwide. Although it is one of the most widely performed procedures in otorhinolaryngology, none of the commonly used techniques for tonsillectomy is considered optimal till now. Objective To compare coblation, bipolar diathermy, and surgical dissection approaches for tonsillectomy in terms of operative time, surgical blood loss, postoperative pain and the incidence of postoperative complications. Methods A systematic review and meta-analysis in accordance to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and Meta-analysis Of Observational Studies in Epidemiology (MOOSE) statement. Guidelines and an electronic search of information was conducted to identify studies that compare between coblation, cold dissection and bipolar diathermy techniques. Results This study showed that bipolar diathermy tonsillectomy was the lowest risk of primary bleeding followed by coblation then cold dissection tonsillectomy but with insignificant difference. Coblation technique was the highest secondary bleeding risk followed by cold dissection and the lowest risk was figured in bipolar diathermy procedure also the difference did not reach statistical significance. Coblation tonsillectomy was the best technique regarding blood loss and operative time with significant difference in the comparison with cold dissection and insignificant in the comparison with bipolar diathermy. Because of using a different postoperative pain measures in the studies we could not pool its data, but the majority of studies showed that coblation technique was better as regard postoperative pain than cold dissection and bipolar diathermy. While there was no significant difference between cold dissection and bipolar diathermy in the most studies Conclusion Overall, bipolar diathermy procedure for tonsillectomy was considered the best technique regarding primary and secondary bleeding outcomes, but the difference did not reach statistical significance. Coblation procedure for tonsillectomy was considered the best technique regarding intraoperative blood loss with significant difference except in comparison between bipolar diathermy and coblation the difference was not significant. Coblation technique also considered the best one regarding operative time with significant difference in direct comparison between coblation and cold, and insignificant in other comparisons. By systematic review on 21 studies coblation technique shows less postoperative pain than cold dissection and bipolar diathermy in the majority of studies comparing coblation with every technique. And there was no significant difference between studies compared cold dissection with bipolar diathermy regarding postoperative pain.

Coblation tonsillectomy versus conventional tonsillectomy

Objectives: The objective of this study was to compare the effectiveness of conventional tonsillectomy versus coblation tonsillectomy with respect to duration of surgery, amount of intraoperative bleeding, recovery time, and post-surgical pain. Material and Methods: Sixty patients were divided into two groups. One group underwent conventional tonsillectomy while coblation tonsillectomy was performed in the second group. Duration of surgery, amount of intraoperative bleeding, recovery time, and postsurgical pain were measured. All patients were followed for 24 months. Results: Comparing the coblation tonsillectomy group to the cold steel dissection tonsillectomy group, the mean duration of surgery was 6.92 versus 18 min, the amount of intraoperative bleeding was 2.75 versus 39.88 mL, and the difference on the post-operative pain scale between the two groups was statistically significant (P &lt; 0.005). There was no recurrence of tonsillitis episodes in either of the two groups during the 2-year follow-up period. Conclusion: After adequate training, the coblation technique is beneficial to both the surgeon and the patient, including the possibility to excise tissue and coagulate bleeding vessels with the same device. Post-operative morbidity and complications are lower as compared to the conventional cold dissection technique.

Effect of Cold-Water Irrigation on the Coblation Site for Post-Tonsillectomy Pain: A Prospective Randomized Clinical Study.

To explore the effect of cold-water irrigation on post-tonsillectomy pain after coblation. Data from 61 adult patients who underwent coblation tonsillectomy in our hospital from January 2019 to December 2020 were collected, and the patients were randomly divided into the cold-water irrigation group (Group 1) and the room-temperature irrigation group (Group 2). Group 1 was irrigated with ice water mixed saline with the help of a pressure band, and Group 2 was irrigated with room-temperature saline. During the operation, we monitored the temperature of the operating cavity in real time. We recorded the postoperative pain for 11 consecutive days from the day and the 10th day after the operation. The postoperative pain score was significantly lower than that in Group 2, except on the 2nd, 3rd and 7th and 8th days after the operation. The perfusion of cold water during coblation tonsillectomy is helpful to reduce postoperative pain.

Associations Between Post-tonsillectomy Hemorrhage and Anatomical Subsites of the Tonsillar Fossa.

This study presents a novel classification of the anatomical subsites of the tonsillar fossa and discusses their associations with post-tonsillectomy hemorrhage (PTH) after extracapsular tonsillectomy. Coblation tonsillectomy was performed on three adult cadavers and the anatomical subsites of the tonsillar fossa based on the distribution of the tonsillar feeding artery: the upper pole (subsite A), most of the tonsil body (subsite B), the inferior tonsil body (subsite C), and components of the lower pole (subsites D and E). Extracapsular tonsillectomy was prospectively performed using various surgical techniques and PTH was evaluated. A cadaveric study revealed that the intra- and extra-capsular vessel topographies were essentially identical. Although the demarcation lines varied either up or down by a few millimeters, the arterial vascular network was particularly dense at subsites D and E, and the vessel diameter at these subsites was significantly greater than at subsite C and also (especially) at subsite E. Of 680 patients who underwent tonsillectomy, PTH developed early in 13 (31.7%) and late in 28 (68.3%). Surgical interventions were required by 29/41 patients (70.7%). Subsites D and E were the most common subsites of late PTH and PTH that required intervention. Such intervention was rarely necessary when PTH developed at subsite A or B. The new classification of the anatomical subsites of the tonsillar fossa aids inexperienced surgeons and provides an anatomical rationale for variation in surgical technique that minimizes vascular injury, thus improving safety.

Improvement of Surgical View and Working Space at the Lower Pole by Three-Dimensional Exoscope-Assisted Coblation Tonsillectomy: A Case Series

Advantages of hot devices for tonsillectomy, represented by coblation, have been highlighted in recent years. During hot technique tonsillectomy it is important to identify and coagulate the vessels of the tonsillar capsule, especially at the lower pole of the tonsil. Hot technique tonsillectomy under microscope or endoscope has therefore been recommended to achieve accurate identification of the microstructure of the surgical field. We have applied ORBEYE, a three-dimensional surgical exoscope system, to coblation tonsillectomy. Advantages of using ORBEYE include high definition and high magnification images, and flexibility of camera position and angle. This means there is an improved surgical view and working space, particularly at the lower pole during performance of coblation tonsillectomy. Here, we demonstrate that ORBEYE can be an effective surgical instrument in coblation tonsillectomy.

A retrospective comparative study of postoperative bleeding after coblation tonsillectomy versus noncoblation tonsillectomy in North Indian population

Background: This study was done to look at the difference in incidence of postoperative bleeding after tonsillectomy using coblation or noncoblation. Methods: A review of all the cases of tonsillectomy done at NIMS Medical college from January 2019 to September 2022 was done to ascertain type of tonsillectomy performed and the presence of postoperative bleeding. Statistical analysis was done by chi-square test to determine a statistical difference between the postoperative bleeding rate of coblation and noncoblation method. The Cochraine-Armitage test of linear trend was done to measure change in the postoperative bleeds. The tested term was divided into two-month durations, and the coblation postoperative bleeds were checked for every 2-month period. Results: 238 tonsillectomies were performed. The postoperative bleed rate for noncoblation tonsillectomy was 3.4% (8/238) and 5/238 (2.1%) in coblation tonsillectomy. No statistical difference (p=0.93) was found between bleed rates for coblation versus noncoblation techniques. There was no difference seen in the need for operative intervention to control postoperative bleeding: 8 (5.4% of only non coblated patients and 3.4% of all tonsillectomy patients) for noncoblation procedure and 5 (5.6% of only coblated patients and 2.1% of all tonsillectomy patients) for coblation procedures (p=0.25). Postoperative bleed rates in coblation patients for the 2-month periods did not reveal an increasing or decreasing trend in the bleed rate (p=0.49). Conclusions: Coblation tonsillectomy is a safe method for performing tonsillar surgery with no significant difference in postoperative bleeding from previous techniques and no increased need for operative intervention to control postoperative bleeding.

Multicentre clinical study of haemorrhage after coblation tonsillectomy in children: a prospective study protocol

IntroductionPost-tonsillectomy haemorrhage (PTH) is the most common and significant life-threatening complication following tonsillectomy, especially in children. Coblation tonsillectomy (CTE) at low temperature is extensively used in China and has gradually...

A retrospective observational cohort study evaluating the postoperative outcomes of intracapsular coblation tonsillectomy in children

Coblation intracapsular tonsillectomy (ICT) is becoming popular due to its decreased postoperative complications. However, a concern exists about the need for revision surgery. We conducted a retrospective observational cohort study, with a null hypothesis that Coblation ICT is not associated with recurrence of the preoperative symptoms, obstructive tonsillar regrowth, or the need for revision tonsillar surgery. We reviewed 345 patients (median age of 4.5 years; IQR 3.2–6.3), operated by the senior author between Feb 2017 and Sep 2020, for a median follow-up of 395.0 days (IQR 221.5–654.5). Most patients had snoring (94.2%), mouth breathing (92.8%), restless sleep (62.6%), and sleep disorder breathing (52.8%); 12.5% had recurrent tonsillitis. The mean initial total symptoms score (TSS) was 5.2 (SD 1.4, range 1–8); 87.5% had three or more symptoms; 86.7% underwent ICT; TSS decreased postoperatively to a mean of 0.2, SD 0.8, range 0–7. The mean hospital stay was 0.96 day (SD 0.36, range 0–3). Secondary bleeding occurred in 0.7% of ICT patients. No patient required admission or intervention. There was no documented tonsillar regrowth resulting in upper airway obstruction. No one needed tonsillar revision surgery. Intracapsular tonsillectomy was shown to be an effective procedure with long-lasting results.

Outcomes of coblation tonsillectomy versus bipolar electrocautery tonsillectomy in pediatric population

BackgroundBipolar electrocautery tonsillectomy has been the preferred technique for many otolaryngologists, yet coblation tonsillectomy is gaining popularity in the current practice. This study aims at comparing both techniques in terms of pain, bleeding, and healing.ResultsA total of 120 patients were randomly divided into two equal groups. Overall mean pain score associated with coblation tonsillectomy was statistically less than that caused by bipolar electrocautery throughout the follow-up period (p < 0.001). The difference in pain duration was statistically longer for the bipolar group. The incidence of postoperative hemorrhage—both reactionary and secondary—was statistically higher in the bipolar group. Coblation tonsillectomy showed statistically shorter duration of healing (p < 0.001).ConclusionsCoblation tonsillectomy is associated with less pain severity and shorter pain duration, fewer bleeding incidents, and more prompt healing.

Preoperative thromboelastography in the prediction of post-tonsillectomy hemorrhage by coblation tonsillectomy: a post-hoc analysis.

Post-tonsillectomy hemorrhage (PTH) affects around 4% of patients after tonsillectomy. We hypothesized that preoperative thromboelastography (TEG) might identify patients at higher risk of PTH. Investigate whether evaluation of coagulation function by preoperative TEG might help to predict PTH after tonsillectomy by coblation tonsillectomy (TE). Post-hoc analysis of randomized controlled study. Otolaryngology Department between January 2017 and August 2019. This post-hoc analysis included adults who underwent coblation TE for benign tonsillar disorders. Routine blood tests and TEG were performed preoperatively. The TEG parameters evaluated included coagulation reaction time (R) and maximum thrombus amplitude (MA). The main outcome was PTH during the 4-week postoperative period. 284 RESULTS: The 19 patients (6.7%) that experienced PTH had a higher prevalence of diabetes mellitus, lower use of intraoperative suturing, fewer patients with grade I and II tonsillar enlargement, a higher white blood cell count, lower platelet count, lower fibrinogen level, lower R value, and a lower MA value than patients without PTH (all P<.05). Multivariate logistic regression revealed that diabetes mellitus (P<.053), fibrinogen level ≤2.735 g/L (P<.027), R≤6.55 min (P<.011) and MA≤59.15 mm (P<.012) were independently associated with PTH. A regression model incorporating these four factors predicted PTH with a sensitivity of 73.7% and specificity of 83.8%. Preoperative evaluation of diabetes mellitus history, fibrinogen level, and TEG parameters might help to identify patients at higher risk of PTH after coblation TE. Single-center study with a small sample size; possibly underpowered statistically. TEG measurements might not accurately reflect coagulation function, and a validation cohort was unavailable. None. CHINESE CLINICAL TRIAL REGISTRY NUMBER OF STUDY USED IN THIS ANALYSIS: ChiCTR2000032171. http://www.chictr.org.cn/showprojen.aspx?proj=52553.

COBLATION TONSILLECTOMY VERSUS DISSECTION TONSILLECTOMY IN MANAGEMENT OF PATIENTS WITH CHRONIC TONSILLITIS

BACKGROUND: Tonsillectomy is the most routinely performed surgical operation in the recent years. There have been lots of controversies about tonsillectomy techniques to provide better conditions with more benefits and less complications. Coblation tonsillectomy is an advanced surgical technique and demands further research to be proven as a suitable and standard method of tonsillectomy. For more than a century, traditional dissection tonsillectomy has remained the gold standard for tonsil removal. &#x0D; OBJECTIVE: The objective of this study is to compare mean operation time and blood loss after radiofrequency coblation tonsillectomy versus dissection tonsillectomy in management of patients with chronic tonsillitis&#x0D; RESULTS: The mean age of cases in this study was 33.78±16.21 years with 56(46.67%) male and 64(53.335) female cases in this study. In dissection group mean blood loos was 143.63±34 mL and in Coblation group the mean blood loos was 113.45±24.61 mL, p-value &lt; 0.001. The mean surgery time in dissection group was 40.08±6.64 minutes and in Coblation group was 32.62±4.21 minutes with significantly less in Coblation method when compared with dissection group, p-value &lt;&#x0D; 0.001. &#x0D; Conclusion: Through the findings of this study we found that radiofrequency Coblation yields less mean operation time and mean blood loss when compared with dissection tonsillectomy in management of patients with chronic tonsillitis. Using radiofrequency Coblation better outcome can be achieved along with patient’s and surgeons satisfaction.

Intracapsular tonsillectomy in the treatment of recurrent and chronic tonsillitis in adults: a protocol of a prospective, single-blinded, randomised study with a 5-year follow-up (the FINITE trial)

IntroductionThe standard surgical treatment for recurrent or chronic tonsillitis is extracapsular tonsillectomy. Recent studies show that intracapsular tonsillectomy has the potential to reduce the postoperative morbidity of patients undergoing tonsil...

Intrapatient Comparison of Coblation versus Electrocautery Tonsillectomy in Children: A Randomized, Controlled Trial.

Many surgical instruments have been introduced and compared for safety and surgical efficiency in tonsillectomy. This study aimed to compare postoperative pain between coblation and conventional monopolar electrocautery tonsillectomy by intrapatient comparison in children. Thirty pediatric patients over six years of age undergoing tonsillectomies were enrolled. Coblation and electrocautery were used to remove both tonsils in one patient; one was removed by coblation and the other by electrocautery. The coblation side was randomly selected, and it was blinded to the patients. Each side’s daily pain scores were collected on the visual analogue scale (VAS) during ten postoperative days. On the day of surgery, 22 (73%) patients identified less pain on the coblation side, while others felt similar pain. The mean pain scores were significantly lower on the coblation side during the postoperative ten days (except for the 6th and 8th) than on the electrocautery side. The duration of severe pain (VAS > 5) was significantly shorter on the coblation side than on the electrocautery side (2.0 versus 3.7 days, respectively; p = 0.042). Coblation tonsillectomy induced less pain than electrocautery in pediatric patients; therefore, surgeons could choose the coblator as a surgical instrument for tonsillectomy to improve the pediatric postoperative quality of life.

Coblation tonsillectomy versus laser tonsillectomy: a systematic review and meta-analysis of randomized controlled trials.

This systematic review and meta-analysis of randomized controlled trials (RCTs) evaluated coblation versus laser (carbon dioxide and diode) tonsillectomy, with regard to various surgical and clinical outcomes. We searched PubMed, CENTRAL, Scopus, and Web of Science for relevant from inception until March 2021. We evaluated risk of bias using the Cochrane Collaboration Tool. We summarized the outcomes as risk ratio (RR) or mean difference/standardized mean difference (MD/SMD) with 95% confidence interval (CI). We conducted subgroup analysis based on the day of postoperative pain (day 1, day 7, and day 14) and type of postoperative hemorrhage (reactionary and secondary). In addition, we conducted subgroup analysis according to the type of laser. Five RCTs were analyzed. Three and two RCTs were evaluated as having "some concerns" and "low risk of bias", respectively. Coblation tonsillectomy correlated with lower intraoperative blood loss (MD = -5.08ml, 95% CI [- 7.33 to - 2.84], P < 0.0001) and lower operative time (MD = - 4.50min, 95% CI [- 6.10 to - 2.90], P < 0.0001) compared with the laser tonsillectomy. However, there was no significant difference between both groups regarding the postoperative pain score (SMD = - 0.27, 95% CI [- 0.72 to 0.17], P = 0.27) and rate of postoperative hemorrhage (RR = 0.95, 95% CI [0.27-3.40], P = 0.23). Subgroup analysis reported similar insignificant difference between both groups according to the day of postoperative pain and type of postoperative hemorrhage. Coblation tonsillectomy correlated with a significant reduction in intraoperative blood loss and operative time compared with the laser technique. Nevertheless, these effects do not seem clinically meaningful in surgical practice.

A COMPARATIVE STUDY OF COBLATION VERSUS CONVENTIONAL TONSILLECTOMY

Tonsillectomy is a surgery done for chronic tonsillitis. Various techniques are available for Tonsillectomy .Regularly used procedure is Dissection and snare Method . Because of latest innovations Coablation has emerged as a better tool for tonsillectomy with less bleeding and complications . Our study is done as a comparative study to know about the above both techniques. This study comprised of 100 patients with chronic tonsillitis who were above 3 years of are without adenoid hypertrophy. In half of the randomly selected patients, tonsils were removed by coblation method and remaining patient tonsils were removed by conventional method. The patients were examined regularly on rst second and seventh postoperative days. Coblation tonsillectomy proved to be a better tool than conventional Tonsillectomy according to our study AIMS AND OBJECTIVES 1. To compare the efcacy of coblation and conventional tonsillectomy in randomly selected patients. 2. To compare morbidity and complications associated with these procedures by each method in randomly selected patients.

Coblation intracapsular tonsillectomy: A cohort study of NHS practice in England using Hospital Episode Statistics.

ObjectivesTo identify paediatric intracapsular Coblation tonsillectomy procedures from routine administrative data in England, and determine their safety.DesignRetrospective observational cohort study of four ENT centres using routine data from Hospital Episode Statistics (HES).SettingAcute NHS trusts in England conducting exclusively intracapsular Coblation tonsillectomy.ParticipantsChildren (≤16 years old) undergoing bilateral intracapsular Coblation tonsillectomy.Main outcome measuresNumber of procedures, readmissions for pain, readmissions for bleeding and requirement for additional surgery for regrowth.ResultsA total of 5525 procedures were identified. The median patient age was 4 (IQR 2–5). In‐hospital complications occurred in 1%, with 0.1% returning to theatre for arrest of primary tonsil bleeding. Almost half of the procedures were conducted as a day‐case (44%), with only a small proportion staying in hospital more than one night (7%). Within 28 days, 1.2% of patients were readmitted with bleeding, 0.7% with infection and 0.3% with pain; 0.2% of patients required return to theatre for control of secondary haemorrhage. Longitudinal follow‐up has found that revision tonsil surgery is 0.3% at 1 year (n = 4498), 1.1% at 2 years (n = 2938), 1.7% at 3 years (n = 1781), 1.9% at 4 years (n = 905) and 2.2% at 5 years (n = 305).ConclusionsIntracapsular coblation tonsillectomy safety outcomes in this study show primary and secondary bleeding rates and emergency return to theatre rates are lower than all tonsillectomy techniques reported in the National Prospective Tonsillectomy Audit and also lower than previously published Hospital Episode Statistics analysis of tonsillectomy procedures.