Development and clinical evaluation of bipolar radiofrequency cryptolysis

Abstract

Objectives: Cryptolysis is a highly efficient conservative procedure in halitosis caused by deep tonsillar crypts or tonsilloliths. It can be carried out by laser, coblation or radiofrequency application, with radiofrequency application being the most cost effective. Monopolar methods generate a wider electrical field with more side effects; therefore, it is necessary to develop and test a new bipolar electrode. Methods:In a prospective non-randomized study seventy-one patients were treated with a monopolar probe-like electrode and three radiofrequency generators. Sixteen patients underwent treatment with a bipolar electrode. In total, 200--300 J was applied. Tonsil specimens underwent histology.Results: Application of a bipolar electrode led to better results than those elicited with a monopolar electrode for cryptolysis. Conclusion:Bipolar radiofrequency cryptolysis should be the first-choice procedure for the treatment of halitosis and tonsilloliths.

The Effect of Ultrasonic Surgery Tool in the Treatment of Tonsillolithiasis

“…RF application with bipolar and monopolar rods have been studied several times. RF cryptolysis targeted to destruct the epithelium with the formation of fibrosis which tends to close the crypt openings (10,14,21,22). Vogt et al reported that the RF cryptolysis is a day case procedure that is minimally invasive with lower complaint rates, bipolar RF cryptolysis can cause less pain than the monopolar technique also.…”

“…In several studies, it is indicated that laser cryptolysis has higher costs though it has a faster healing period with less postoperative pain, immediate return to normal dietary habits, and fewer complication rates (10,22). RF ablation costs are reported as less than laser cryptolysis and suggested as it can be more appropriate for the patients who have insufficient mouth opening and too much gag reflex (14). Our patients showed no significant gag reflex after applying lidocaine spray and DOI: 10.33808/clinexphealthsci.873557…”

“…In LTC, crypts are vaporised with thermal energy, and scar tissue occurs with the new formation of collagen tissue (14,23). LTC is also reported as one of the effective treatment methods for tonsilloliths and halitosis in patients.…”

“…If clinical treatment with topical antiseptics and oral antibiotics does not provide relief, surgical removal of the tonsils is indicated. Laser and radiofrequency are already used powered instruments in the treatment of tonsillolith and its concurrent complaints (12,13,14), yet this is the first study in the literature in which we aimed to reveal the effect of ultrasound energy in the tonsillolith treatment.…”

Bipolar-assisted tonsil reduction: a simple and inexpensive tonsillotomy technique

“…Vogt et al [9] presented their results of bipolar radiofrequency cryptolysis in hypertrophic tonsillar tissue and claimed that bipolar technique showed better results when compared to the monopolar method, with emphasis on the fact that lesser lateral heat damage around the bipolar electrodes could be achieved resulting in a hypothetic minor reaction of the tonsillar tissue; however, their results were not supported by a cohort study. Identical results have been observed in bipolar and monopolar applications for the reduction of the lower turbinates, where the energy was delivered by a bipolar double-needle electrode and the epithelium would be preserved, whereas monopolar usagealso known as so-called "coblation tunneling" leads to histological changes similar to CO2 laser therapy involving the transformation of columnar epithelium into cuboidal or squamous epithelium due to inevitable burn injury.…”