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Randomised comparative study of adenotonsillectomy by conventional and coblation method for children with obstructive
Vijaya Krishnan Paramasivan1, Senthil Vadivu Arumugam, Mohan Kameswaran
1Madras ENT Research Foundation, No.1 1st Cross Street, Off. 2nd Main Road, Raja Annamalaipuram, Chennai Tamil Nadu, India. drpvk77@gmail.com
Insights
Coblation adenotonsillectomy is a safe and effective alternative to dissection for treating pediatric Obstructive Sleep Apnoea (OSA), offering reduced pain and complications. This method shows significant advantages for children undergoing this common otolaryngology procedure.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Sleep Medicine
Background:
- Adenotonsillectomy is a frequent surgical procedure in children.
- Adenotonsillar hypertrophy causing Obstructive Sleep Apnoea (OSA) is a key indication.
- Surgical technique impacts outcomes and morbidity.
Purpose of the Study:
- Compare coblation adenotonsillectomy with dissection.
- Assess efficacy and safety.
- Evaluate morbidity and complications.
Main Methods:
- Prospective comparative study.
- 50 children (5-12 years) with OSA in each group (coblation vs. dissection).
- Measured operative time, blood loss, post-op pain, and bleeding.
Main Results:
- Coblation had shorter operative time and less blood loss than dissection.
- Post-operative pain was significantly lower with coblation.
- Both methods had minimal post-operative bleeding.
Conclusions:
- Coblation adenotonsillectomy offers advantages over standard dissection.
- It is efficacious, practical, and safe for pediatric OSA.
- Coblation is associated with less morbidity and fewer complications.
Introduction:
Adenotonsillectomy is one of the most common surgical procedures throughout the world for children in otolaryngology. One of the current indications for adenotonsillectomy is adenotonsillar hypertrophy causing Obstructive Sleep Apnoea (OSA). The choice of surgical tools and technique affects the outcome and morbidity due to adenotonsillectomy.
Aim Of The Study:
To assess the efficacy and safety of coblation adenotonsillectomy as compared to dissection method. To evaluate the morbidity and to study complications associated with each procedure.
Materials And Methods:
This prospective and comparative study of dissection and coblation method of adenotonsillectomy was conducted in our institute, Madras ENT Research Foundation, Chennai over a period of 6 months. 50 cases of children with OSA age group between 5 and 12 years were randomly selected for each group and studied. Duration of surgical procedure, blood loss, post operative pain, post operative reactionary and secondary bleeding was noted and compared.
Observation And Results:
Operative time was more in dissection method compared to coblation technique. Blunt dissection tonsillectomy was associated with greater blood loss than coblation tonsillectomy. Post operative pain was more in dissection method and it was less in coblation technique. Post operative bleeding in both the techniques were found to be minimal.
Conclusion:
We conclude that the use of coblation for adenotonsillectomy may have several advantages over standard methods for the treatment of children with Obstructive Sleep Apnoea. It is highly efficacious, practical and safe with less morbidity and less complications.
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