Postoperative morbidity in traditional versus coblation tonsillectomy

The aim of this study was to compare levels of postoperative pain after traditional (cold steel with bipolar cautery) and Coblation tonsillectomies.

Patients with recurrent or chronic tonsillitis, including tonsillar hyperplasia, were randomized to undergo tonsillectomies using either a traditional cutting technique or the Coblation technique. Patients and staff on the relevant wards were blinded regarding patient allocation. Pain, odynophagia, and activity limitations were recorded on a visual analog scale. Analgesics were self-administered, and daily analgesic consumption by patients was reported. All complications were also registered.

Fifty-seven patients (between 6 and 57 years of age) completed the study. No significant difference was found between the two techniques with regard to reported pain, odynophagia, activity limitations, or use of analgesics. A slight tendency toward decreased pain and decreased use of analgesics in the Coblation group reached statistical significance only when the adult patients were analyzed separately. Two cases of hospital readmission occurred because of postoperative bleeding following Coblation tonsillectomies.

Overall,the two methods are equivalent in terms of postoperative pain,including the use of analgesics. The risk of postoperative bleeding after the Coblation method requires further evaluation with specifically designed studies.