A comparative study of coblation versus conventional tonsillectomy.

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A comparative study of coblation versus conventional tonsillectomy.

Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 4

Abstract

Objective: To compare the efficacy of coblation and conventional tonsillectomy in the same patient. To compare morbidity and complications associated with these procedures by each method in the same patient. Materials and Methods: 50 patients aged 3 to 30 years with chronic tonsillitis who underwent tonsillectomy surgery from march 2016 to march 2017 in Coimbatore medical College and Government hospital were be included in the study, after obtaining the ethical committee clearance.. Chronic tonsillitis patients with adenoid hypertrophy and serous otitis media were excluded by diagnostic nasal endoscopy, imaging and impedence audiogram. Chronic tonsillitis patients identified as candidates for tonsillectomy were selected randomly and one tonsil was removed using coblation and the other by conventional dissection method. In this study, half of the patients had their right tonsil removed by coblation and the left tonsil by conventional dissection method. The other half of the patients had the left tonsil removed by coblation and the right by conventional dissection method. All patients were examined regularly after surgery on first, second and seventh post operative days to assess the post operative morbidity and efficacy of both conventional and coblation methods. Results: The duration if surgery in coblation was compared with conventional method. It was 11.8 minutes in conventional and 16.4 minutes in coblation. The intraoperative blood loss was compared in both methods. In coblation method it was 18.74 ml and in conventional it was 43.44ml so obviously 20-25 ml of intraoperative blood loss was minimized in coblation method. The post operative pain was measured using VAS scale was compared in both methods on 1st, 2nd and 7th post operative days. For coblation the mean post operative pain scores was 3.92, 3.64 and 2.74 respectively whereas in conventional method it was 7.42, 6.20 and 3.52. so about 60-70% patients had lesser pain in coblation side compared to the conventional side. The post operative tonsillar fossa healing was estimated by the amount of slough covered in the tonsillar fossa and it was compared on 1st, 2nd and 7th post operative days. In coblation side mean area of slough covered was 80%,74% and 4,5% and on conventional side it was 40%, 47% and 18%. So slough formation is more in coblation side copared to conventional side so the healing was delayed. Conclusion: Coblation tonsillectomy is relatively easy technique to perform providing a near bloodless field and minimal surrounding tissue damage. The operative time required to perform coblation tonsillectomy was more than the conventional technique. The longer time did not cause more intraoperative blood loss and post operative pain. The intraoperative blood loss was significantly less on coblation side than on the dissection side. Most importantly, postoperative pain scores were significantly lower on the coblation side on the first, second and seventh post operative days. It helped the patients to resume their normal activities early. Healing was slightly delayed on the coblation side.

Authors and Affiliations

Dr. M. Nallasivam MS. , Dr. M. Sivakumar MS

Keywords

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EP ID EP594766
DOI 10.9790/0853-160406102107.
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