Temperature-Controlled Radiofrequency Treatment of Tonsillar Hypertrophy for Reduction of Upper Airway Obstruction in Pediatric Patients

Abstract

To determine if temperature-controlled radiofrequency (TCRF) tonsil reduction and adenoidectomy (TCRF&A) and conventional tonsillectomy and adenoidectomy (T&A) are statistically similar in outcome and to compare morbidity between TCRF&A and conventional T&A.

Tonsillotomy: it's time to clarify the facts

“…Shrinkage of the hypertrophic tonsil is achieved by heat application with a bipolar radiofrequency probe at multiple sites and starts after 2 weeks with a peak after 3 months. The technique works without any incision or resection and is therefore not considered equivalent to Class I and II dissection techniques [59][60][61]. …”

Effectiveness and Safety of Radiofrequency Tonsils Reduction in Pediatric Obstructive Sleep Apnea

“…Hence several authors support a reduction of tonsils volume instead of extracapsular tonsillectomy [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. In fact, a shift from tonsillectomy to tonsillotomy already happened in Sweden, where the majority of children presenting tonsils obstructive symptoms are submitted to tonsillotomy [19].…”

“…In tonsils hypertrophy causing upper airway obstruction, partial techniques present several advantages, such as minimum intraoperative hemorrhage, shorter duration of surgery, lower postoperative hemorrhage, lower postoperative pain, lower swallowing and speaking difficulties [3][4][5][6][7]9,[13][14][15][16]18]. Besides reduction in morbidity, partial tonsillectomy offers improvement in quality of life and satisfaction [12,17].…”

“…Besides reduction in morbidity, partial tonsillectomy offers improvement in quality of life and satisfaction [12,17]. In terms of outcomes, total and partial techniques seem to be equally effective [4,5,[8][9][10][11][14][15][16]18] and safe [2,3,15,16]. Several instruments are available to perform partial techniques, being the radiofrequency ones very popular.…”

Microdebrider Tonsillotomy in Children with Obstructive Tonsillar Hypertrophy

“…Complaints of bleeding and pain stem from direct and indirect traumas (such as excessive dissection or thermal effects and post operative inflammation) on pharyngeal muscles where nervous and capillary network take place. Several methods such as using analgesics locally or sytemically are preferred for decreasing post operative pain problem [2,3], diverse devices and techniques (unipolar cautery, bipolar cautery, dissection) [4], subtotal resection of tonsils, in recent years and in chosen cases tonsillotomy (microdebrider,CO2 laser, lowheated plasmo lancet) [5][6][7][8].…”