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January 30, 2009

Less Pain and Quicker Recovery with Coblation Assisted Tonsillectomy

Filed under: ENT News — admin @ 1:31 pm

Results of a double-blinded, randomized, controlled trial indicate that when children diagnosed with sleep apnea must have their tonsils removed, Coblation-assisted intracapsular technique results in less post-operative pain and a quicker return to normal eating and activity than electrocautery. Interestingly, older children who had Coblation-assisted tonsillectomy exhibited the most dramatic reduction in pain.

Tonsillectomy remains one of the most common childhood surgeries with an increasing number of the surgeries being done to treat obstructive sleep apnea or sleep disordered breathing. In children, untreated obstructive sleep apnea and sleep disordered breathing can result in failure to thrive and behavior and learning problems.

Coblation is a non-heat driven process in which radiofrequency energy is applied to a conductive medium (usually saline) causing a highly focused plasma field to form around the electrodes. The plasma field is comprised of highly ionized particles. These ionized particles have sufficient energy to break organic molecular bonds within tissue. Instead of exploding tissue, Coblation causes a low temperature molecular disintegration, resulting in minimal tissue damage to surrounding areas.

Use of Coblation technology for tonsillectomy has grown in the last several years. A new study, undertaken by a single surgeon at one surgical location, asks the question of how Coblation-assisted intracapsular tonsillectomy compares to the traditional method of removing tonsils by electrocautery. The results of the study “Randomized controlled trial of Coblation versus electrocautery tonsillectomy,” will be presented by author Kay Chang, MD, of the Department of Otolaryngology-Head and Neck Surgery at Standford University School of Medicine at the American Academy of Otolaryngology-Head and Neck Surgery Foundation Annual Meeting & OTO EXPO, being held September 19-22, 2004, at the Jacob K. Javits Convention Center, New York City, NY.

Methodology: This study included 101 children scheduled to have tonsillectomy and adenoidectomy for obstructive sleep apnea or sleep disordered breathing. Patients with significant comorbidities or significant history of recurrent/chronic tonsillitis were excluded. Patients were randomized into two study groups; coblation-assisted intracapsular tonsillectomy and electrocautery tonsillectomy.

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