Coblation Tonsillectomy Versus Cold Dissection Tonsillectomy

Summary

The surgical removal of the tonsils is known as a tonsillectomy. Even though tonsillectomy rates have decreased recently, it is still one of the most common surgical operations carried out globally.1 In 30 BC, Celsus was the first to describe tonsil removal. Since then, a variety of surgical techniques and better tools have been developed for this aim.2 Postoperative discomfort and hemorrhage are the two main postoperative consequences following tonsillectomy. The guillotine procedure, cold dissection, electrocautery, harmonic scalpel, coblation, and laser surgery are among the many tonsillectomy techniques used in the literature.3 Regarding the various surgical procedures, the most crucial factors in determining which approach is optimal for this treatment are increasing intra-operative efficiency and lowering post-operative morbidity. Pain and bleeding are two of the main postoperative problems that result from cold steel dissection tonsillectomy, which leaves the incision accessible for secondary intention healing.4,5 It is evident from literature review that hemorrhage is one of the major complication of tonsillectomy resulting in increased rate of morbidity and increase hospital stay. In 2001, coblation tonsillectomy was first offered as a safer and more efficient tonsil removal technique. By creating a plasma field at the probe's surface, this method ablates tissue at comparatively low temperatures (between 40 and 70 °C). Unlike diathermic coagulation, which produces temperatures beyond 500 °C, this plasma field, which is composed of highly ionized particles, analyzes and breaks down the molecular connections of confined tissue, greatly decreasing heat dissipation to neighboring tissues. In order to achieve hemostasis, the radiofrequency generator can also be utilized for coagulation.6,7 Given the advantages of a shorter operating time and less intraoperative hemorrhage, several institutions in our nation have already made the use of the more recent technique of coblation the normal practice. Since there isn't much information on the application of coblation in tonsillectomy procedures, The investigator chosen to compare the results of coblation and cold dissection tonsillectomy in the local community. In addition to being a valuable addition to the body of existing literature, this study will also offer local facts. Additionally, clinicians can receive empirical support for improved tonsillectomy technique to lower morbidity.

Conditions

• Tonsillitis

Interventions

PROCEDURE

coblation tonsillectomy

Using subcapsular dissection along the tonsillar pillar mucosa, the EVAC70 T\&A (ArthroCare ENT, Sunnyvale, CA) hand piece will execute the coblation-assisted tonsillectomy while preserving muscle. Hemostasis will be achieved on the coagulate 3 setting, and dissection will be performed on the coagulate 7 setting.

PROCEDURE

cold dissection tonsillectomy

Using curved Metzenbaum scissors to penetrate the peritonsillar area, blunt dissection to remove the tonsil from superior to inferior, and a wire snare to separate the inferior pole, a cold dissection tonsillectomy will be carried out. At a setting of 35, a bipolar cautery will be used to achieve hemostasis

Sponsors & Collaborators

• Shahida Islam Medical Complex

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

20 Years

Max Age

60 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-11-20

Primary Completion

2026-02-19

Completion

2026-02-19

Countries

• Pakistan

Study Locations