Affiliation:
1. Department of Biomedical Sciences Humanitas University Pieve Emanuele (MI) Italy
2. Otorhinolaryngology Unit IRCCS Humanitas Research Hospital Rozzano (MI) Italy
Abstract
ObjectiveTo compare different tonsillectomy techniques in terms of postoperative bleeding incidence and postoperative pain.MethodsAn arm‐based network analysis was conducted using a Bayesian hierarchical model. The primary and secondary outcomes were postoperative bleeding incidence and mean postoperative pain score.ResultsA total of 6464 patients were included for five different interventions (cold dissection tonsillectomy; extracapsular coblation tonsillectomy; intracapsular coblation tonsillectomy [ICT]; bipolar diathermy tonsillectomy [BDT]; monopolar diathermy tonsillectomy). ICT showed the lowest absolute risk (4.44%) of postoperative bleeding incidence (73.31% chance of ranking first) and the lowest mean postoperative pain score (1.74 ± 0.68) with a 94.0% chance of ranking first, whereas BDT showed both the highest absolute risk of bleeding incidence (10.75%) and the highest mean postoperative pain score (5.67 ± 1.43).ConclusionsICT seems to offer better postoperative outcomes, in terms of reduced risk of bleeding and reduced pain. Further prospective studies are advised to confirm these findings.Level of EvidenceNA Laryngoscope, 2023