Vol. 6, Issue 1, Part A (2024)

Background: Tonsillectomy is one of the most frequent surgical procedures in the treatment of diseases like chronic tonsillitis and obstructive sleep apnea. Two common techniques are performed: coblation and dissection. Coblation has been introduced as a less invasive alternative to the conventional dissection method, utilizing controlled ablation at temperatures between 60–70°C, thus potentially reducing thermal tissue damage, postoperative pain, and complications. The present study compared the outcomes of coblation versus dissection tonsillectomy in terms of intraoperative time, blood loss, and recovery.

Objective: To compare the intraoperative time, blood loss, postoperative pain, and recovery times for both coblation and dissection tonsillectomy.

Method: A cross-sectional study was carried out in Shaheed Suhrawardy Medical College Hospital, Dhaka, from July to December 2020. Sixty patients aged between 5 and 45 years, diagnosed with chronic tonsillitis or tonsillar hypertrophy, were included in this trial and were divided into two groups: 30 patients underwent coblation tonsillectomy, while the other 30 were subjected to conventional dissection tonsillectomy. Intraoperative time and blood loss were measured, while postoperative recovery, pain, and return to normal activities were assessed.

Results: The operative time (18.7±2.3 minutes vs 25.4±4.1 minutes) and blood loss (20.62±4.23 milliliters vs 48.72±6.31 milliliters) were significantly lower in the coblation group than in the dissection group (p< 0.001). The postoperative pain scores on days 1, 5 to 8, and 9 to 15 were significantly lower in the coblation group. Recovery, including return to a normal diet and activities, was quicker in the coblation group (6.1 days vs. 7.8 days for diet; 5.1 days vs. 6.4 days for activities).

Conclusion: Coblation tonsillectomy has clear advantages over traditional dissection by virtue of reduced intraoperative time, blood loss, and pain in the postoperative period and faster recovery. Though more expensive, coblation may prove to be the better way of performing tonsillectomy with improved patient outcomes and efficiency, hence proving to be an important option in clinical practice, especially in high-volume surgical settings.