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Traditional Tonsillectomy Compared With Bipolar Radiofrequency Thermal Ablation Tonsillectomy in Adults
A Pilot Study
Leif Bäck, MD;
Markku Paloheimo, MD, PhD;
Jukka Ylikoski, MD, PhD
Arch Otolaryngol Head Neck Surg. 2001;127:1106-1112.
Objectives To assess the morbidity and efficacy of bipolar radiofrequency thermal
ablation tonsillectomy and compare it with traditional cold dissection tonsillectomy
with diathermy hemostasis.
Design Prospective, randomized, single-blinded, controlled clinical study.
Setting Helsinki University Central Hospital, Department of Otorhinolaryngology–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 from the study
and 1 patient cancelled the operation.
Interventions Nineteen patients underwent a traditional cold dissection tonsillectomy
with diathermy hemostasis, and 18 patients underwent a bipolar radiofrequency
thermal ablation tonsillectomy. There was no intergroup difference 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 for anesthetics during
the operation; different recovery indicators in the recovery 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 following surgery (ie, visual
analog scale scores on 6 symptoms, medications needed, the day patients returned
to work, use of antibiotics, and retreatment 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 statistically significant
differences.
Conclusion Bipolar radiofrequency thermal ablation and traditional tonsillectomy
were associated with similar postoperative morbidity.
From the Departments of Otorhinolaryngology–Head & Neck Surgery
(Drs Bäck and Ylikoski) and Anesthesiology and Intensive Care Medicine
(Dr Paloheimo), Helsinki University Central Hospital, Helsinki, Finland.
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Arch Otolaryngol Head Neck Surg. 2001;127(9):1146-1148.
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