A Comparative Study of Cold Knife Adenotonsillectomy and Coblation Adenotonsillectomy

Abstract

S: AIMS & OBJECTIVES: To compare intra and postoperative recovery after Cold dissection adenotonsillectomy (Procedure 1) and Coblation assisted adenotonsillectomy (Procedure 2) and to determine whether there is a significant difference between the two methods in terms of benefit to the patients. METHODS: A single blind comparative study of 60 pediatric patients aged 5 to 16 years undergoing adenotonsillectomy was conducted. The study assessed the results of two procedures in terms of duration, intra and post-operative bleeding, resumption to normal activity and quality of life assessment. The parameters were statistically compared between the two groups. RESULTS: 60 patients who underwent surgery (30 for cold dissection and 30 for coblation adenoton sillectomy) were found to have comparable demographic data with a mean age of 9.33 and 9.37 in procedure 1 & 2 respectively. The distribution of symptoms and grades of adenoid and tonsil hypertrophy was found statistically insignificant. The duration of the surgical procedure was significantly higher in the coblation group with a mean of 29.18 minutes in comparison to the other procedure with a mean of 22.8 minutes. The blood loss was around 20 ml for coblation versus 35 ml for cold steel method which was significant. The mean pain scores at 6hrs post-surgery were low in coblation group, similar results were seen at 12hrs and again at 2days there was low pain score. There was not much difference after 1 month in both the groups. Coblation procedure had a quicker return to normal diet with a mean duration of 2.67 days which was significant than the cold dissection method (mean-4.16 days). The quality of life scores were found similar in both the groups at the end of 6 months. CONCLUSION: The reduction of intraoperative blood loss in Coblation tonsillectomy was obvious and reduction of the postoperative pain and early return to normal diet were statistically significant. But the duration of surgery was found lengthened which can be attributed to inexperience. There was no significant variation recorded in long term pain and quality of life assessment.