Application of Coblation for Airway Disorder Management in ENT Practice: A Prospective Cohort Study

Abstract

Introduction: Coblation, a form of radiofrequency surgery, involves using radiofrequency energy to create a plasma field through a conductive medium. This technique dissociates the medium into high-energy ions that break intercellular bonds, leading to tissue dissociation. Coblation is performed at low temperatures, making it less painful and conducive to healing in airway surgeries. Aim: To evaluate the indications, advantages, and outcomes of coblation-assisted airway surgeries. Materials and Methods: A prospective cohort study was conducted from November 2019 to May 2021 at the Department of Ear, Nose and Throat (ENT), Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India. Patients with breathing difficulties, voice changes, or airway obstruction symptoms were included. A detailed history, physical examination, and diagnostic procedures were carried out. Coblation was employed under general anaesthesia for laryngeal or tracheal pathology. Data on intraoperative findings, blood loss, hospital stay, and postoperative improvements were recorded in a worksheet-based program, Numbers version 13.1 for macOS. Deductions based on the data were presented using bar charts and diagrams. Continuous variables were summarised using summary statistics, while categorical values were estimated using frequencies and percentages. Results: A total of 15 patients underwent coblation-assisted surgeries. Breathlessness was the most common symptom 11 (73.33%), followed by stridor in 10 (66.67%) and decreased oxygen levels in 8 (53.3%) were observed. Indirect laryngoscopy showed no findings compared to 70-degree scopy in detecting subglottic stenosis. Intraoperatively, 40% had Grade-II, and 27% had Grade-III subglottic stenosis. The average postoperative stay was five days. At one month, 73% showed improvement, particularly those with subglottic stenosis, while no improvement was seen in 27% of cases. Conclusion: Coblation-assisted airway surgeries offer benefits like minimal collateral damage and reduced blood loss. In this study, 73% of patients showed improvement, suggesting coblation’s potential advantages over other modalities. Although cost remains a concern, coblation’s ability to reduce postoperative morbidity and improve healing time makes it a promising tool in airway surgeries.