Safety of cold ablation (coblation) in the treatment of tonsillar hypertrophy of the tongue base

Abstract

The treatment of diseases of the lingual tonsils is still under debate, and surgical interventions are often associated with significant morbidity and complications. The aim of the present study was to evaluate the safety of lingual tonsillectomy using cold ablation (coblation) as a new treatment of lingual tonsil diseases. In this retrospective, bicentric study, we included all patients between 2005 and 2012 who underwent cold ablation (Coblation(®)) of the lingual tonsils. We assessed the frequency of postoperative complications based on the patients' charts. A total of 108 patients (47 ± 13, 6 years) underwent lingual tonsillectomy using coblation. All patients were operated on under general anesthesia as inpatients. Intraoperative complications did not occur. Three patients (2.8%) needed revision surgery due to postoperative hemorrhage, and in one of those cases, three revisions were necessary. There was no postoperative airway compromise and no need for tracheostomy. There was no hypoglossal nerve paralysis, but in the case needing multiple revisions, a weakness of the hypoglossal nerve persisted. In all the cases, oral intake was possible with adequate analgesia. Coblation of the tongue base is a safe procedure with a relatively low rate of postoperative complications. Postoperative hemorrhage is the most relevant complication that occurred in our series of patients. Future studies are needed to evaluate the efficacy of the procedure in the treatment of obstructive sleep apnea.

Lingual Thyroid Excision with Transoral Robotic Surgery

“…Coblation assisted lingual thyroid and lingual tonsil resection techniques were used and successful results were reported [ 13 – 15 ]. Leitzbach et al [ 14 ] reported successful results and low complication rates in 108 patients undergoing coblation assisted resection due to tongue root and lingual tonsil hypertrophy. However, transoral resection techniques have limited point of view and lead to difficulty in resection owing to difficulty in manipulation, which restricts their use [ 7 ].…”

Targeted Treatment With Radio Frequency Ablation for Lingual Tonsil

“…[13][14][15] It is noteworthy that procedures involving partial resection of the tongue base, in addition to the removal of lingual tonsils, tend to carry high morbidity with possible complications such as bleeding, hypoglossal nerve paralysis, risk of airway compromise, and infections, such as lingual or submental abscess. 7 The purpose of this study was to review the patients at our institute who have had lingual tonsil surgery for various indications. We also aimed to revisit the techniques used and their outcome.…”

“…3,6 Other more infrequently described symptoms are sore throat, lethargy, change of speech, and choking on food. 7 To evaluate possible LTH, endoscopic examination, magnetic resonance imaging (MRI), and computed tomographic imaging have been used. 2 The grading systems used to assess the LTH have been inconsistent, making the interpretation of different studies challenging.…”

A prospective randomised trial of LigaSure Small Jaw® versus conventional neck dissection in head and neck cancer patients

“…New energy instruments such as harmonic scalpel, LigaSure, coblation and plasma knife are increasingly being used during surgical procedures. Their safety and efficacy are well documented in the literature . The LigaSure vessel sealing system was reported to shorten the operative duration in patients receiving superficial parotidectomy when compared with the conventional method .…”