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Radiofrequency excision versus monopolar electrosurgical excision for tonsillectomy
Philip D Littlefield1, Daniel J Hall, Michael R Holtel
1Department of Otorhinolaryngology-Head and Neck Surgery, Tripler Army Medical Center, HI 96859-5000, USA. philip.littlefield@kor.amedd.army.mil
Summary
Radiofrequency (Evac) tonsillectomy results in significantly less postoperative pain compared to monopolar electrosurgical (Bovie) tonsillectomy. Patients preferred the Evac technique in a blinded study.
Area of Science:
- Otolaryngology
- Surgical Innovation
- Pain Management
Background:
- Previous research indicated reduced pain with radiofrequency (Evac) tonsillotomy versus monopolar electrosurgical (Bovie) tonsillectomy.
- The clinical significance of tonsillotomy leaving a tonsil cuff is not fully understood.
- Further investigation is warranted to compare pain levels between Evac tonsillectomy and Bovie tonsillectomy.
Purpose of the Study:
- To compare the postoperative pain experienced by patients undergoing Evac tonsillectomy versus Bovie tonsillectomy.
- To evaluate patient preference between the two surgical techniques.
Main Methods:
- A prospective, blinded study design was employed.
- Each participant had one tonsil removed using the Evac device and the other using the Bovie device.
- Surgical time, blood loss, operative difficulty, and postoperative pain (days 1, 3, 5, 7, 10, 14) were recorded and analyzed.
Main Results:
- Seventeen patients were analyzed.
- Significantly less pain was reported with the Evac technique (P < 0.036).
- The Evac technique was preferred by 12 out of 14 patients.
Conclusions:
- Evac tonsillectomy is demonstrably less painful than Bovie tonsillectomy.
- Patients in a blinded setting preferred the Evac surgical technique.
- The Evac device offers a significant reduction in postoperative pain.