Abstract
Coblation is one of the more recent techniques for tonsillectomy; however, it remains unclear whether it exhibits any benefit or increased risk when compared to other techniques. This review provides an updated assessment of coblation tonsillectomy and how it compares to other tonsillectomy techniques. Systematic review and descriptive analysis of published literature. Electronic searches of MEDLINE, EMBASE, Web of Science and the Cochrane Database were performed. We included all randomized control trials comparing coblation tonsillectomy (not ‘tonsillotomy’) with any other tonsillectomy technique. Studies were excluded if tonsils, rather than individuals, were randomized. 16 eligible studies were identified, including a total of 567 patients, both adults and children. Coblation was compared with a variety of other tonsillectomy techniques. Outcomes included pain, primary and secondary haemorrhage, intraoperative bleeding and operation time. Postoperative pain was the primary outcome in most studies. There was a trend towards less pain in the coblation group in seven of the included studies. More recent studies appeared to fare more favourably in terms of pain outcomes and operating time. The coblation technique appears to be comparable with other commonly employed techniques for tonsillectomy; however, there is still no strong evidence to suggest that it possesses any definitive benefits. Findings would advocate further work being done through carefully designed randomised control trials, which compare coblation with cold dissection as the ‘gold standard’ and place an emphasis on reducing the amount of adjuvant electrocautery used so as to maximise the benefits of coblation and the lower temperature it generates.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Younis RT, Lazar RH (2002) History and current practice of tonsillectomy. Laryngoscope 112:3–5. doi:10.1002/lary.5541121403
Scottish Intercollegiate Guidelines Network (2010) Management of sore throat and indications for tonsillectomy. A national clinical guideline. http://www.sign.ac.uk/pdf/sign117.pdf. Accessed 15 March 2017
The Royal College of Surgeons England (2005) National Prospective Tonsillectomy Audit.
Husband AD, Davis A (1996) Pain after tonsillectomy. Clin Otolaryngol Allied Sci 21:99–101
Burton MJ, Doree C (2007) Coblation versus other surgical techniques for tonsillectomy. Cochrane Database Syst Rev 3:CD004619. doi:10.1002/14651858.CD004619.pub2
Moher D, Liberati A, Tetzlaff J et al (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement (reprinted from Annals of Internal Medicine). Phys Ther 89:873–880. doi:10.1371/journal.pmed.1000097
Guo J, Kong Q (2012) Comparing the effect of low-temperature plasma radiofrequency and traditional method in tonsillectomy. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 26:325–326
Bäck L, Paloheimo M, Ylikoski J (2001) Traditional tonsillectomy compared with bipolar radiofrequency thermal ablation tonsillectomy in adults: a pilot study. Arch Otolaryngol Head Neck Surg 127:1106–1112
Hasan H, Raitiola H, Chrapek W, Pukander J (2008) Randomized study comparing postoperative pain between coblation and bipolar scissor tonsillectomy. Eur Arch Oto-Rhino-Laryngol Off J Eur Fed Oto-Rhino-Laryngol Soc EUFOS Affil Ger Soc Oto-Rhino-Laryngol - Head Neck Surg 265:817–820. doi:10.1007/s00405-007-0537-0
Hong S-M, Cho J-G, Chae SW et al (2013) Coblation vs. electrocautery tonsillectomy: a prospective randomized study comparing clinical outcomes in adolescents and adults. Clin Exp Otorhinolaryngol 6:90–93. doi:10.3342/ceo.2013.6.2.90
Philpott CM, Wild DC, Mehta D et al (2005) A double-blinded randomized controlled trial of coblation versus conventional dissection tonsillectomy on post-operative symptoms. Clin Otolaryngol Off J ENT-UK Off J Neth Soc Oto-Rhino-Laryngol Cervico-Facial Surg 30:143–148. doi:10.1111/j.1365-2273.2004.00953.x
Ragab SM (2012) Six years of evidence-based adult dissection tonsillectomy with ultrasonic scalpel, bipolar electrocautery, bipolar radiofrequency or “cold steel” dissection. J Laryngol Otol 126:1056–1062. doi:10.1017/S0022215112002022
Tan AKL, Hsu PP, Eng SP et al (2006) Coblation vs electrocautery tonsillectomy: postoperative recovery in adults. Otolaryngol–Head Neck Surg Off J Am Acad Otolaryngol-Head Neck Surg 135:699–703. doi:10.1016/j.otohns.2006.03.008
Chimona T, Proimos E, Mamoulakis C et al (2008) Multiparametric comparison of cold knife tonsillectomy, radiofrequency excision and thermal welding tonsillectomy in children. Int J Pediatr Otorhinolaryngol 72(9):1431–1436
Hegazy HM, Albirmawy OA, Kaka AH, Behiry AS (2008) Pilot comparison between potassium titanyl phosphate laser and bipolar radiofrequency in paediatric tonsillectomy. J Laryngol Otol 122:369–373. doi:10.1017/S0022215107008328
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 Off J ENT-UK Off J Neth Soc Oto-Rhino-Laryngol Cervico-Facial Surg 32:261–267. doi:10.1111/j.1365-2273.2007.01468.x
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. doi:10.1016/j.ijporl.2012.02.049
Parker NP, Walner DL (2011) Post-operative pain following coblation or monopolar electrocautery tonsillectomy in children: a prospective, single-blinded, randomised comparison. Clin Otolaryngol Off J ENT-UK Off J Neth Soc Oto-Rhino-Laryngol Cervico-Facial Surg 36:468–474. doi:10.1111/j.1749-4486.2011.02384.x
Roje Z, Racić G, Dogas Z et al (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
Shah UK, Galinkin J, Chiavacci R, Briggs M (2002) Tonsillectomy by means of plasma-mediated ablation: prospective, randomized, blinded comparison with monopolar electrosurgery. Arch Otolaryngol Head Neck Surg 128:672–676
Stoker KE, Don DM, Kang DR et al (2004) Pediatric total tonsillectomy using coblation compared to conventional electrosurgery: a prospective, controlled single-blind study. Otolaryngol–Head Neck Surg Off J Am Acad Otolaryngol-Head Neck Surg 130:666–675. doi:10.1016/j.otohns.2004.02.012
Temple RH, Timms MS (2001) Paediatric coblation tonsillectomy. Int J Pediatr Otorhinolaryngol 61:195–198
Parsons SP, Cordes SR, Comer B (2006) Comparison of posttonsillectomy pain using the ultrasonic scalpel, coblator, and electrocautery. Otolaryngol–Head Neck Surg Off J Am Acad Otolaryngol-Head Neck Surg 134:106–113. doi:10.1016/j.otohns.2005.09.027
Carney AS, Harris PK, MacFarlane PL et al (2008) The coblation tonsillectomy learning curve. Otolaryngol–Head Neck Surg Off J Am Acad Otolaryngol-Head Neck Surg 138:149–152. doi:10.1016/j.otohns.2007.10.031
Technology Assessment Unit of the McGill University Health Centre (2008) Comparison of coblation tonsillectomy and electrocautery tonsillectomy in pediatric patients. https://www.mcgill.ca/tau/files/tau/Coblation_ND_MMG_LFM_Final.pdf. Accessed on 19 Feb 2017
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors have no conflict of interests to declare.
Rights and permissions
About this article
Cite this article
Metcalfe, C., Muzaffar, J., Daultrey, C. et al. Coblation tonsillectomy: a systematic review and descriptive analysis. Eur Arch Otorhinolaryngol 274, 2637–2647 (2017). https://doi.org/10.1007/s00405-017-4529-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00405-017-4529-4