Radiofrequency Excision versus Monopolar Electrosurgical Excision for Tonsillectomy

Abstract

OBJECTIVE: We previously compared radiofrequency (Evac) tonsillotomy with monopolar electrosurgical (Bovie) tonsillectomy and showed significantly less pain with the Evac. Tonsillotomy leaves a cuff of tonsil behind, the significance of which is unknown. We hypothesize that Evac tonsillectomy also is less painful than Bovie tonsillectomy. STUDY DESIGN AND SETTING: We compared Evac (ENTec Evac 70; ArthroCare, Sunnyvale, CA) and Bovie tonsillectomy in a prospective, blinded fashion. Each participant had 1 tonsil removed by each device. We recorded, by side, the surgical time, blood loss, operative difficulty, pain (postoperative days 1, 3, 5, 7, 10, and 14), and the side that each patient preferred. RESULTS: Data were analyzed for 17 patients. They reported significantly less pain with the Evac ( P < 0.036, F = 5.87). The Evac was preferred by 12 of 14 patients. CONCLUSION: Evac tonsillectomy is significantly less painful than Bovie tonsillectomy. Patients blinded to treatment preferred the Evac technique. SIGNIFICANCE: The Evac device decreases postoperative pain.

A Prospective, Randomized, Double-Blind Study of Coblation versus Dissection Tonsillectomy in Adult Patients

“…In most of these studies, postoperative pain was significantly less in the coblation group [11,13,18,24]. A fifth study showed no difference in pain between the two procedures [23].…”

“…There are various studies describing the use of coblation in tonsillectomy with varying conclusions regarding intraoperative blood loss, postoperative hemorrhage rates, postoperative pain, and healing rates [12][13][14][15][16][17][18][19][20][21][22][23][24].…”

“…One study reports intraoperative blood loss value of 24 ml on an average per tonsil with coblation subcapsular adult tonsillectomy [24]. Postoperative hemorrhage rates after coblation subcapsular tonsillectomy has been reported in two studies.…”

Age-related tonsillar regrowth in children undergoing powered intracapsular tonsillectomy

“…While each modality promises a reduction in the recovery time and morbidity associated with tonsillotomies, each has its potential drawbacks and various rates of tonsillar regrowth. They are discussed at greater length elsewhere [11][12][13][14][15]. In a search for a less invasive and more efficacious technique, Koltai et al developed PIT, which utilizes a microdebrider for resection [10].…”

Comparative Study between Radiofrequency Sinus Excision and Open Excision in Sacro-Coccygeal Pilonidal Sinus Disease

“…In juxtaposition, electrocautery, diathermy, or laser temperatures are significantly high (750–900°C) and result in significant heat propagation far in excess of the therapeutic needs [33, 34.] The radiofrequency waves have a property of sealing small blood vessels while dissecting the tissues without creating any char [35, 36]. Use of electrocautery or diathermy invariablyresults in burning of the adjacent healthy tissues and causes more pain and delay in wound healing [37].…”