Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-27T09:12:20.388Z Has data issue: false hasContentIssue false
  • English
  • Français

The debate continues: a prospective, randomised, single-blind study comparing Coblation and bipolar tonsillectomy techniques

Published online by Cambridge University Press:  20 November 2017

D Wiltshire ,
M Cronin ,
N Lintern ,
K Fraser-Kirk ,
S Anderson ,
R Barr ,
D Bennett  and
C Bond
D Wiltshire*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Ipswich Hospital, Australia
M Cronin
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Ipswich Hospital, Australia
N Lintern
Affiliation:
Department of Surgery, Cairns Hospital, Australia
K Fraser-Kirk
Affiliation:
Department of Surgery, Nambour General Hospital, Australia
S Anderson
Affiliation:
Department of Surgery, Townsville Hospital, Australia
R Barr
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Ipswich Hospital, Australia
D Bennett
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Ipswich Hospital, Australia
C Bond
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Ipswich Hospital, Australia
*
Address for correspondence: Dr Danielle Wiltshire, Department of Otolaryngology, Head and Neck Surgery, Ipswich Hospital, PO Box 73, Ipswich, Queensland 4305, Australia E-mail: dwil0570@uni.sydney.edu.au
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

Tonsillectomy is a common procedure with significant post-operative pain. This study was designed to compare post-operative pain, returns to a normal diet and normal activity, and duration of regular analgesic use in Coblation and bipolar tonsillectomy patients.

Methods:

A total of 137 patients, aged 2–50 years, presenting to a single institution for tonsillectomy or adenotonsillectomy were recruited. Pain level, diet, analgesic use, return to normal activity and haemorrhage data were collected.

Results:

Coblation tonsillectomy was associated with significantly less pain than bipolar tonsillectomy on post-operative days 1 (p = 0.005), 2 (p = 0.006) and 3 (p = 0.010). Mean pain scores were also significantly lower in the Coblation group (p = 0.039). Coblation patients had a significantly faster return to normal activity than bipolar tonsillectomy patients (p < 0.001).

Conclusion:

Coblation tonsillectomy is a less painful technique compared to bipolar tonsillectomy in the immediate post-operative period and in the overall post-operative period. This allows a faster return to normal activity and decreased analgesic requirements.

Keywords

TonsillectomyCoblationPostoperative Pain
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 3 , March 2018 , pp. 240 - 245
Copyright
Copyright © JLO (1984) Limited 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Presented at the Australian Society of Otolaryngology Head and Neck Surgery 64th Annual Scientific Meeting, 29 March – 1 April 2014, Brisbane, Australia.

References

1 Polites, N, Joniau, S, Wabnitz, D, Fassina, R, Smythe, C, Varley, P et al. Postoperative pain following coblation tonsillectomy: randomized clinical trial. Aust N Z J Surg 2006;76:226–9Google Scholar
2 Lowe, D, van der Meulen, J; National Prospective Tonsillectomy Audit. Tonsillectomy technique as a risk factor for postoperative haemorrhage. Lancet 2011;364:697–702 Google Scholar
3 Temple, R, Timms, M. Paediatric coblation tonsillectomy. Int J Pediatr Otorhinolaryngol 2001;61:195–8Google Scholar
4 Stoker, K, Don, D, Kang, R, Haupert, M, Magit, A, Madgy, D. Pediatric total tonsillectomy using coblation compared to conventional electrosurgery: a prospective, controlled, single-blind study. Otolaryngol Head Neck Surg 2004;130:666–75Google Scholar
5 Paramasivan, V, Arumugam, S, Kamesaran, M. Randomised comparative study of adenotonsillectomy by conventional and coblation method for children with obstructive sleep apnoea. Int J Pediatr Otorhinolaryngol 2012;76:816–21CrossRefGoogle ScholarPubMed
6 Praveen, C, Parthiban, S, Terry, R. High incidence of post-tonsillectomy secondary haemorrhage following coblation tonsillectomy. Indian J Otolaryngol Head Neck Surg 2013;65:24–8Google Scholar
7 Windfuhr, J, Deck, J, Remmert, S. Hemorrhage following coblation tonsillectomy. Ann Otol Rhinol Laryngol 2005;114:749–56Google Scholar
8 Mosges, R, Hellmich, M, Allekotte, S, Albrecht, K, Bohm, M. Hemorrhage rate after coblation tonsillectomy: a meta-analysis of published trials. Eur Arch Otorhinolaryngol 2011;268:807–16Google Scholar
9 Burton, M, Doree, C. Coblation versus other surgical techniques for tonsillectomy. Cochrane Database Syst Rev 2007;(3):CD004619 Google Scholar
10 Noordzij, J, Affleck, B. Coblation versus unipolar electrocautery tonsillectomy: a prospective, randomised, single blind study in adult patients. Laryngoscope 2006;116:1303–9Google Scholar
11 Rakesh, S, Anand, T, Payal, T. A prospective, randomized, double-blind study of coblation versus dissection tonsillectomy in adult patients. Indian J Otolaryngol Head Neck Surg 2012;64:290–4CrossRefGoogle ScholarPubMed
12 Parker, N, Walner, D. Post-operative pain following coblation or monopolar electrocautery tonsillectomy in children: a prospective, single-blinded, randomised comparison. Clin Otolaryngol 2011;36:468–74CrossRefGoogle ScholarPubMed
13 Mitic, S, Tvinnereim, M, Lie, E, Saltyte, B. A pilot randomized controlled trial of coblation tonsillectomy versus dissection tonsillectomy with bipolar diathermy haemostasis. Clin Otolaryngol 2007;32:261–7Google Scholar
14 Timms, M, Temple, R. Coblation tonsillectomy: a double blind randomized controlled study. J Laryngol Otol 2002;116:450–2Google Scholar
15 Jones, D, Kenna, M, Guidi, J, Huang, L, Johnston, P, Licameli, R. Comparison of postoperative pain in pediatric patients undergoing coblation tonsillectomy versus cautery tonsillectomy. Otolaryngol Head Neck Surg 2011;144:972–7Google Scholar
16 Magdy, E, Elwany, S, El-Daly, A, Abdel-Hadi, M, Morshedy, M. Coblation tonsillectomy: a prospective, double-blind, randomised, clinical and histopathological comparison with dissection-ligation, monopolar electrocautery and laser tonsillectomies. J Laryngol Otol 2008;122:282–90Google Scholar
17 Gustavii, N, Bove, M, Dahlin, C. Postoperative morbidity in traditional versus coblation tonsillectomy. Ann Otol Rhinol Laryngol 2010;19:755–60Google Scholar
18 Hong, S, Cho, J, Chae, S, Lee, H, Woo, J. Coblation vs. electrocautery tonsillectomy: a prospective randomized study comparing clinical outcomes in adolescents and adults. Clin Exp Otorhinolaryngol 2013;6:90–3Google Scholar
19 Philpott, C, Wild, D, Mehta, D, Daniel, M, Banerjee, A. A double blinded randomized controlled trial of coblation versus conventional dissection tonsillectomy on post-operative symptoms. Clin Otolaryngol 2005;30:143–8Google Scholar
20 Hasan, H, Raitola, H, Chrapek, W, Pukander, J. Randomized study comparing postoperative pain between coblation and bipolar scissor tonsillectomy. Eur Arch Otorhinolaryngol 2008;265:817–20Google Scholar
21 Tan, A, Hsu, P, Eng, S, Ng, Y, Lu, P, Tan, S et al. Coblation vs electrocautery tonsillectomy: postoperative recovery in adults. Otolaryngol Head Neck Surg 2006;135:699–703 Google Scholar
22 Rogers, M, Grauenfelder, C, Woods, C, Wee, C, Carney, A. Bleeding following coblation tonsillectomy: a 10-year, single-surgeon audit and modified grading system. J Laryngol Otol 2015;129:s32–7 Google Scholar
23 Amir, I, Belloso, A, Broomfiled, S, Morar, P. Return to theatre in secondary post-tonsillectomy haemorrhage: a comparison of coblation and dissection techniques. Eur Arch Otorhinolaryngol 2012;269:667–71Google Scholar
24 Khan, I, Ableardo, E, Scott, N, Shakeel, M, Memakaya, O, Jaramillo, M et al. Coblation tonsillectomy: is it inherently bloody? Eur Arch Otorhinolaryngol 2012;269:579–83Google Scholar
25 Walner, D, Miller, S, Villines, D, Bussell, G. Coblation tonsillectomy in children: incidence of bleeding. Laryngoscope 2012;122:2330–6Google Scholar
26 Clark, M, Smithard, A, Jervis, P. How we do it: coblation tonsillectomy complication rates from a single ENT department compared with the National Prospective Tonsillectomy Audit. Clin Otolaryngol 2006;31:156–9Google Scholar
27 Javed, F, Sadri, M, Uddin, J, Mortimore, S, Parker, D. A completed audit cycle on post-tonsillectomy haemorrhage rate: Coblation versus standard tonsillectomy. Acta Otolaryngol 2007;127:300–4Google Scholar
28 Divi, V, Nenninger, M. Postoperative tonsillectomy bleed: coblation versus noncoblation. Laryngoscope 2005;115:31–3Google Scholar
29 Belloso, A, Chidambaram, A. Coblation tonsillectomy versus dissection tonsillectomy: postoperative haemorrhage. Laryngoscope 2003;113:2010–13Google Scholar