L. Back et al., Traditional tonsillectomy compared with bipolar radiofrequency thermal ablation tonsillectomy in adults - A pilot study, ARCH OTOLAR, 127(9), 2001, pp. 1106-1112
Objectives: To assess the morbidity and efficacy of bipolar radiofrequency
thermal ablation tonsillectomy and compare it with traditional cold dissect
ion tonsillectomy with diathermy hemostasis.
Design: Prospective, randomized, single-blinded, controlled clinical study.
Setting: Helsinki University Central Hospital, Department of Otorhinolaryng
ology-Head & Neck Surgery, Helsinki, Finland.
Patients: Forty healthy volunteer patients aged 18 to 65 years admitted for
elective tonsillectomy with recurrent or chronic tonsillitis, obstructive
tonsillar hypertrophy, or history of quinsy. Two patients were excluded fro
m the study and 1 patient cancelled the operation.
Interventions: Nineteen patients underwent a traditional cold dissection to
nsillectomy with diathermy hemostasis, and 18 patients underwent a bipolar
radiofrequency thermal ablation tonsillectomy. There was no intergroup diff
erence in age, sex, weight, and indications for tonsillectomy. The subjects
were not informed of the type of procedure until the telephone interview 3
weeks after the operation.
Main Outcome Measures: Operating time and intraoperative blood loss; need f
or anesthetics during the operation; different recovery indicators in the r
ecovery room (ie, duration and medications administered), surgical ward (ie
, medications administered, use of corticosteroids, general condition, and
status of the uvula on the first postoperative day), and in the 2 weeks fol
lowing surgery (ie, visual analog scale scores on 6 symptoms, medications n
eeded, the day patients returned to work, use of antibiotics, and retreatme
nt acceptance); and complications and certain laboratory parameters.
Results: There was a statistically significant but clinically insignificant
difference in operating time and intraoperative blood loss in favor of the
traditional tonsillectomy group. The other outcome measures showed no stat
istically significant differences.
Conclusion: Bipolar radiofrequency thermal ablation and traditional tonsill
ectomy were associated with similar postoperative morbidity.