gms | German Medical Science

Background: Pain, delayed oral intake and postoperative bleeding are major concerns in the recovery period following tonsillectomy. Despite others, surgical instruments may have an influence on the postoperative morbidity. Coblation-Tonsillectomy (CTE) is a novel technque based on radiofrequency transmitted through a medium of physiological saline solution which results in sodium ions, which are able to breakdown intercellular bonds at a temoperature <85°C. A prospective pilot study with a follow-up of 6 months was undertaken to evaluate problems and complicatrions that may be associated with the introduction of CTE at our department.

Materials and patients: The data of 61 patients (34 female, 27 male) were analysed, the youngest patient was 44 months, the oldest 69 years of age (mean: 21.2 years). Surgery was performed by one surgeon under general anesthesia with standard settings.

Results: Major episodes of post-tonsillectomy hemorrhage (PTH) occurred in 6 patients (group A) requiring 7 intervention under general anesthesia. Due to a massive edema of mucosa of the entire oropharynx one male patient of group A required prolonged intubation (35 h).There were 15 patients with minor bleeding episodes (group B) including one patient of group A with repeated PTH. Group C patients (n=41) did not experience PTH. Delayed PTH after dismission was reported by 2 (B) and 3 (C) patients, the mother of one child refused to give an interview. Blood transfusions were not required, there were no fatalities. Pain was documented on average for 8 (A), 6 (B) and 2.5 (C) days. Analgesics were administered for 9 (A), 6 (B) and 4 (C) days. In the interviews the patients reported pain to have last for 16.7 (A), 11.6 (B) and 11 (C) days on average. Patients reported PTH (A) or pain (B and C) as the most significant complication of surgery.

Conclusions: At least in our hands, CTE was associated with an increased rate of PTH. Postoperative pain was not abandoned and prevailed in the interviews as the most significant complication of CTE. Therefore, we will continue to use conventional instruments for tonsillectomy procedures.