Efficiency of surgical treatment methods for chronic tonsillitis in a comparative perspective

Abstract

Background: Tonsillectomy is a common surgical procedure performed for various indications, and different techniques have been developed for its execution. One such method is coblation, which utilizes controlled radiofrequency energy to remove tonsil tissue. In this study, we compared coblation with a new monopolar electrosurgical extracapsular tonsillectomy technique. Methods: A prospective clinical investigation was conducted at the Department of Otorhinolaryngology and Pediatric Otorhinolaryngology at the "Happy Life" Clinic. The study included 45 patients aged 6–18 years who had undergone extracapsular coblation and monopolar electrosurgical tonsillectomy for chronic tonsillitis. Data regarding age, gender, disease duration, operation duration, estimated intraoperative blood loss, postoperative pain assessment, post-tonsillectomy hemorrhage (PTH), and complications were collected. Results: Coblation exhibited significantly lower average pain scores than the monopolar technique on the first (p < 0.001) and second postoperative days (p = 0.02). However, pain assessments were comparable at all other time points. The monopolar group had significantly shorter operation times (16.09 ± 6.53 minutes) compared to the coblation group (20.12 ± 5.12 minutes, p < 0.001). Intraoperative blood loss did not significantly differ between the groups (p = 0.39). PTH occurred in 6 patients (13.3%) and required surgical intervention. Secondary PTH rates were 4.44% (2/45) and 2.2% (1/45) in the coblation and monopolar therapy groups, respectively (p < 0.001). Conclusion: Coblation and the new monopolar electrosurgical extracapsular tonsillectomy exhibited similar postoperative pain outcomes, except for the first and second postoperative days. Nevertheless, the monopolar technique provides substantial advantages with shorter operation times, reduced secondary PTH risk, and cost-effectiveness, making it a preferred choice, particularly in resource-constrained settings.