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Comparison of three tonsillectomy techniques in children

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European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Tonsillectomy is still one of the most common surgical procedures worldwide performed by otorhinolaryngologists. This single-blind randomized study aimed to compare cold dissection tonsillectomy, coblation tonsillectomy, and harmonic scalpel tonsillectomy in pediatric patients in respect of intraoperative blood loss, operating time, and postoperative pain and bleeding.

Methods

This single-blind randomized clinical trial evaluated 82 pediatric patients aged 3–16 years (mean age: 7.23 ± 3.26 years) applied with tonsillectomy between April 2017 and March 2020. Harmonic scalpel tonsillectomy was applied to 33 (40.2%) patients, the cold knife technique to 25 (30.5%), and coblation tonsillectomy to 24 (29.3%).

Results

There was no statistically significant difference between the three techniques in respect of postoperative pain levels and post-tonsillectomy bleeding rates. The intraoperative bleeding rate and mean operating time were determined to be significantly lower in the harmonic scalpel group (p < 0.05).

Conclusion

Harmonic scalpel tonsillectomy is associated with a shorter operating time and lower intraoperative bleeding rates and similar postoperative pain score and postoperative bleeding rates compared with coblation tonsillectomy and cold dissection tonsillectomy. Harmonic scalpel tonsillectomy is a fast, safe, and effective method for tonsillectomy in children.

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References

  1. Dutta NN, Bordoloi BM (2002) Tonsillectomy using harmonic scalpel. Indian J Otolaryngol Head Neck Surg 54:74–76. https://doi.org/10.1007/BF02911016

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Temple RH, Timms MS (2001) Paediatric coblation tonsillectomy. Int J Pediatr Otorhinolaryngol 61:195–198. https://doi.org/10.1016/S0165-5876(01)00553-5

    Article  CAS  PubMed  Google Scholar 

  3. Verma R, Verma RR, Verma RR (2017) Tonsillectomy-comparative study of various techniques and changing trend. Indian J Otolaryngol Head Neck Surg 69:549–558. https://doi.org/10.1007/s12070-017-1190-6

    Article  PubMed  PubMed Central  Google Scholar 

  4. Wındfuhr JP, Chen YS, Remmert S (2005) Hemorrhage following tonsillectomy and adenoidectomy in 15,218 patients. Otolaryngol Head Neck Surg 132:281–286. https://doi.org/10.1016/j.otohns.2004.09.007

    Article  PubMed  Google Scholar 

  5. McClelland L, Jones NS (2005) Historical article Tonsillectomy: haemorrhaging ideas. J Laryngol Otol 119:753–758. https://doi.org/10.1258/002221505774481336

    Article  CAS  PubMed  Google Scholar 

  6. Roje Z, Racic G, Zoran D, Pisac VP, Timms M (2009) Postoperative morbidity and histopathologic characteristics of tonsillar tissue following coblation tonsillectomy in children: a prospective randomized single-blind study. Coll Antropol 33:293–298

    PubMed  Google Scholar 

  7. Paramasivan VK, Arumugam SV, Kameswaran M (2012) Randomised comparative study of adenotonsillectomy by conventional and coblation method for children with obstructive sleep apnoea. Int J Pediatr Otorhinolaryngol 76:816–821. https://doi.org/10.1016/j.ijporl.2012.02.049

    Article  PubMed  Google Scholar 

  8. Bellosa A, Chidambaram A, Morar P, Timms MS (2003) Coblation tonsillectomy versus dissection tonsillectomy: postoperative hemorrhage. Laryngoscope 113:2010–2013. https://doi.org/10.1097/00005537-200311000-00029

    Article  Google Scholar 

  9. Shakeel M, Trinidade A, Al-Adhami A, Kubba H (2010) Pediatric Tonsillectomy Cold Steel vs Harmonic Scalpel. Otolaryngol Head Neck Surg 143:116–117. https://doi.org/10.1016/j.otohns.2010.06.215

    Article  Google Scholar 

  10. Collison PJ, Weiner R (2004) Harmonic scalpel versus conventional tonsillectomy: a double blind clinical trial. Ear Nose Throat J 83:707–710

    Article  Google Scholar 

  11. Basu S, Sengupta A, Dubey AB, Sengupta A (2019) Harmonic scalpel versus coblation tonsillectomy a comparative study. Indian J Otolaryngol Head Neck Surg 71:498–503. https://doi.org/10.1007/s12070-019-01679-x

    Article  PubMed  PubMed Central  Google Scholar 

  12. Oko MO, Ganly I, Loughran S, Clement WA, Young D, Geddes NK (2005) A prospective randomized single-blind trial comparing ultrasonic scalpel tonsillectomy with tonsillectomy by blunt dissection in a pediatric age group. Otolaryngol Head Neck Surg 133:579–584. https://doi.org/10.1016/j.otohns.2005.08.002

    Article  PubMed  Google Scholar 

  13. Parsons SP, Cordes SR, Comer B (2006) Comparison of posttonsillectomy pain using the ultrasonic scalpel, coblator, and electrocautery. Otolaryngol Head Neck Surg 134:106–113. https://doi.org/10.1016/j.otohns.2005.09.027

    Article  PubMed  Google Scholar 

  14. Mitic S, Tvinnereim M, Lie E, Saltyte BJ (2007) A pilot randomized controlled trial of coblation tonsillectomy versus dissection tonsillectomy with bipolar diathermy haemostasis. Clin Otolaryngol 32:261–267. https://doi.org/10.1111/j.1365-2273.2007.01468.x

    Article  CAS  PubMed  Google Scholar 

  15. Chimona T, Proimos E, Mamoulakis C, Tzanakakis M, Skoulakis CE, Papadakis CE (2008) Multiparametric comparison of cold knife tonsillectomy, radiofrequency excision and thermal welding tonsillectomy in children. Int J Otorhinolaryngol 72:1431–1436

    Article  CAS  Google Scholar 

  16. Pajic-Penavic I, Danic D, Mrzljak-Vucinic N, Matic I, Vukonic-Arar Z, Dikanovic M (2013) Postoperative quality of life after two different methods of tonsillectomy. Wien Klin Wochenschr 125:524–528. https://doi.org/10.1007/s00508-013-0411-6

    Article  PubMed  Google Scholar 

  17. Zhang LY, Zhong L, David M, Cervin A (2017) Tonsillectomy or tonsillotomy? A systematic review for paediatric sleepdisordered breathing. Int J Pediatr Otorhinolaryngol 103:41–50. https://doi.org/10.1016/j.ijporl.2017.10.008

    Article  PubMed  Google Scholar 

  18. Sathe N, Chinnadurai S, McPheeters M, Francis D (2017) Comparative Effectiveness of Partial Versus Total Tonsillectomy in Children: A Systematic Review. Otolaryngol Head Neck Surg 156:456–463. https://doi.org/10.1177/0194599816683916

    Article  PubMed  PubMed Central  Google Scholar 

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Funding

No funding was received for this work from any organizations. There is no financial disclosure.

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Authors and Affiliations

  1. Faculty of Medicine, Department of Otorhinolaryngology, Kutahya Health Sciences University, 43000, Kütahya, Turkey

    Bugra Subasi, Fatih Oghan, Hamdi Tasli, Seckin Akbal & Nesibe Esra Karaman

Authors
  1. Bugra Subasi
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  2. Fatih Oghan
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  3. Hamdi Tasli
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  4. Seckin Akbal
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  5. Nesibe Esra Karaman
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Each of the authors has contributed to read and approved this manuscript.

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Correspondence to Bugra Subasi.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Subasi, B., Oghan, F., Tasli, H. et al. Comparison of three tonsillectomy techniques in children. Eur Arch Otorhinolaryngol 278, 2011–2015 (2021). https://doi.org/10.1007/s00405-020-06299-8

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  • DOI: https://doi.org/10.1007/s00405-020-06299-8

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