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A randomised controlled trial of coblation, diode laser and cold dissection in paediatric tonsillectomy

Published online by Cambridge University Press:  18 September 2015

M R Elbadawey ,
H M Hegazy ,
A E Eltahan  and
J Powell
M R Elbadawey*
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Freeman Hospital, Newcastle upon Tyne, UK Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, Tanta University Hospitals, Egypt
H M Hegazy
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, Tanta University Hospitals, Egypt Department of Otolaryngology and Head and Neck Surgery, Magrabi Eye and Ear Center, Riyadh, Saudi Arabia
A E Eltahan
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, Aswan University Hospitals, Aswan, Egypt
J Powell
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Freeman Hospital, Newcastle upon Tyne, UK
*
Address for correspondence: Mr M R ElBadawey, Freeman Hospital, University of Newcastle, Freeman Road, Newcastle upon Tyne NE7 7DN, UK Fax: +44 191 2231246 E-mail: mohamed.reda@nuth.nhs.uk
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Abstract

Objective:

This study aimed to compare the efficacy of diode laser, coblation and cold dissection tonsillectomy in paediatric patients.

Methods:

A total of 120 patients aged 10–15 years with recurrent tonsillitis were recruited. Participants were prospectively randomised to diode laser, coblation or cold dissection tonsillectomy. Operative time and blood loss were recorded. Pain was recorded on a Wong–Baker FACES® pain scale.

Results:

The operative time (10 ± 0.99 minutes), blood loss (20 ± 0.85 ml) and pain were significantly lower with coblation tonsillectomy than with cold dissection tonsillectomy (20 ± 1.0 minutes and 30 ± 1.0 ml; p = 0.0001) and diode laser tonsillectomy (15 ± 0.83 minutes and 25 ± 0.83 ml; p = 0.0001). Diode laser tonsillectomy had a shorter operative time (p = 0.0001) and less blood loss (p = 0.001) compared with cold dissection tonsillectomy. However, at post-operative day seven, the diode laser tonsillectomy group had significantly higher pain scores compared with the cold dissection (p = 0.042) and coblation (p = 0.04) tonsillectomy groups.

Conclusion:

Both coblation and diode laser tonsillectomy are associated with significantly reduced blood loss and shorter operative times compared with cold dissection tonsillectomy. However, we advocate coblation tonsillectomy because of the lower post-operative pain scores compared with diode laser and cold dissection tonsillectomy.

Keywords

TonsillectomyLasersPediatrics
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 11 , November 2015 , pp. 1058 - 1063
Copyright
Copyright © JLO (1984) Limited 2015 

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