Irreversible Electroporation for Tonsillar Ablation in Adults

To evaluate the safety and efficacy of irreversible electroporation for non-thermal ablation of tonsils in adults.

Prospective interventional case series of 24 adult patients referred for tonsillectomy that were followed for 3 months.

Academic medical center.

The procedures were performed under general anesthesia or sedation. Irreversible electroporation was applied to the tonsils using the ENTire^TM system. Pain was assessed daily using a pain scale for the first postoperative week. Tonsil sizes were assessed at baseline and 1 and 3 months postoperatively. The Tonsil and Adenoid Health Status Instrument and the Snore-Visual Analog Scale (VAS) questionnaires were administered at baseline and at 3 months.

In total, 23 adult patients (mean age: 36.5 ± 14.0; mean body mass index [BMI]: 25.5 ± 4.1) completed the study. No bleeding was observed intra- or postoperatively. Procedural time was 7.98 ± 2.62 minutes. A pain scale score below 2 was reported 4.5 ± 1.7 days after intervention. Reduction in tonsillar size was observed from 2.4 ± 0.9 pre-intervention to 1.3 ± 1.0 at 3 months post-intervention (P < .001). Tonsil and Adenoid Health Status scores decreased from 17.7 ± 13.0 to 0.96 ± 1.7 (P < .001). The Snore- VAS score decreased by 72%.

This is the first clinical study to investigate the use of irreversible electroporation for tonsillar ablation. Irreversible electroporation shows promise as a minimally invasive procedure for reducing the size of tonsillar hypertrophy and alleviating symptoms, with negligible bleeding and significantly less pain. Multicenter studies are in progress to evaluate long-term efficacy including in children.