Related Experiment Video
Updated: Jun 8, 2026
CO2-Lasertonsillotomy Under Local Anesthesia in Adults
Published on: November 6, 2019
Cost and outcomes after cold and mixed adenotonsillectomy in children
Rodrigo Fernando Ferreira1, Carlos Jose Serapiao, Ana Paula Ribeiro Bonilauri Ferreira
1Univille, Joinville, Brazil.
Insights
The mixed technique for adenotonsillectomy is more cost-effective and faster than the cold technique, with less blood loss. However, it may cause slightly more pain later in the recovery period.
Area of Science:
- Pediatric Otolaryngology
- Surgical Techniques
- Cost-Effectiveness Analysis
Background:
- Adenotonsillectomy is a common surgical procedure in children.
- Comparing different surgical techniques is crucial for optimizing patient outcomes and resource utilization.
Purpose of the Study:
- To compare the costs, surgical efficiency, blood loss, and postoperative pain between cold and mixed adenotonsillectomy techniques in pediatric patients.
Main Methods:
- A randomized clinical trial was conducted in community hospitals involving 72 children aged 3-12 years.
- Data collected included hospital medication and material costs, surgical time, aspirated blood volume, and postoperative pain using a validated scale.
Main Results:
- The mixed technique demonstrated lower material costs, reduced surgical time, and less aspirated blood volume compared to the cold technique.
- Postoperative pain was more intense with the cold technique on the day of surgery, but the mixed technique showed higher pain levels from postoperative days 4 to 6.
Conclusions:
- The mixed adenotonsillectomy technique offers a safer, faster, and more cost-effective approach regarding material expenses.
- While generally beneficial, the mixed technique may result in slightly increased postoperative pain in the later recovery phase compared to the cold technique.
Objective/Hypothesis:
To compare cold and mixed (electrocautery tonsillectomy with curettage adenoidectomy) adenotonsillectomies in children in terms of hospital medications' and materials' costs, surgical time, aspirated blood volume, and postoperative pain.
Study Design:
Randomized clinical trial in community hospitals.
Methods:
Seventy-two patients aged 3 to 12 years, undergoing adenotonsillectomy, were randomized in two groups through sealed envelopes that were opened just prior to the procedure. Surgical time and aspirated blood volume were measured by a staff nurse. Hospital medication and material costs were supplied by the hospital's accounting department. A validated facial pain scale was used from the day of surgery to the 10th postoperative day to quantify pain.
Results:
Bicaudal t test showed that materials' cost was lower in the mixed technique. Surgical time and aspirated blood volume were also lower with the mixed technique. The postoperative pain was more intense in the cold technique on the day of surgery, but was more intense in the mixed technique from the 4th day to the 6th day. Linear regression showed a weak association between materials' cost and aspirated blood volume.
Conclusions:
Mixed technique reduces the costs of materials while offering the patient and the surgeon a safer and faster method to perform adenotonsillectomy, although it is slightly more painful than the cold technique in the latter part of the postoperative period.
Related Concept Videos
01:26Tonsillitis II: Management
01:23Chronic Pharyngitis
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
01:30Tonsillitis I: Introduction
Etiology
Three primary contributing factors have been identified.
01:29Suctioning the Nasopharyngeal Airway
Equipment Required