Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-29T13:37:57.110Z Has data issue: false hasContentIssue false
  • English
  • Français

Coblation versus cold dissection in paediatric tonsillectomy: a systematic review and meta-analysis

Published online by Cambridge University Press:  02 March 2020

M U Ahmad ,
A N Wardak ,
T Hampton ,
M R S Siddiqui  and
I Street
M U Ahmad*
Affiliation:
Department of Otorhinolaryngology, Hull University Teaching Hospitals NHS Trust, UK
A N Wardak
Affiliation:
School of Medicine, University of Liverpool, UK
T Hampton
Affiliation:
Department of Otorhinolaryngology, Alder Hey Children's Hospital, Liverpool, UK
M R S Siddiqui
Affiliation:
Department of Surgery, Croydon University Hospital, London, UK
I Street
Affiliation:
Department of Otorhinolaryngology, Alder Hey Children's Hospital, Liverpool, UK
*
Author for correspondence: Dr Mohammad Usman Ahmad, Department of Otorhinolaryngology, Hull University Teaching Hospitals NHS Trust, Hull, UK E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Cold dissection is the most commonly used tonsillectomy technique, with low post-operative haemorrhage rates. Coblation is an alternative technique that may cause less pain, but could have higher post-operative haemorrhage rates.

Objective

This study evaluated the peri-operative outcomes in paediatric tonsillectomy patients by comparing coblation and cold dissection techniques.

Methods

A systematic review was conducted of all comparative studies of paediatric coblation and cold dissection tonsillectomy, up to December 2018. Any studies with adults were excluded. Outcomes such as pain, operative time, and intra-operative, primary and secondary haemorrhages were recorded.

Results

Seven studies contributed to the summative outcome. Coblation tonsillectomy appeared to result in less pain, less intra-operative blood loss (p < 0.01) and a shorter operative time (p < 0.01). There was no significant difference between the two groups for post-operative haemorrhage (p > 0.05).

Conclusion

The coblation tonsillectomy technique may offer better peri-operative outcomes when compared to cold dissection, and should therefore be offered in paediatric cases, before cold dissection tonsillectomy.

Keywords

TonsillectomyDissectionRadiofrequency AblationPediatricsPainHemorrhage
Type
Review Articles
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 3 , March 2020 , pp. 197 - 204
Copyright
Copyright © JLO (1984) Limited, 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr M U Ahmad takes responsibility for the integrity of the content of the paper

Presented orally at the Students and Foundation Doctors in Otolaryngology UK session at the British Academic Conference in Otolaryngology, 5 July 2018, Manchester, UK.

References

Younis, RT, Lazar, RH. History and current practice of tonsillectomy. Laryngoscope 2002;112:3–5CrossRefGoogle ScholarPubMed
Lowe, D, van der Meulen, J, Cromwell, D, Lewsey, J, Copley, L, Browne, J et al. Key messages from the National Prospective Tonsillectomy Audit. Laryngoscope 2007;117:717–24CrossRefGoogle ScholarPubMed
Barraclough, J, Anari, S. Tonsillectomy for recurrent sore throats in children: indications, outcomes, and efficacy. Otolaryngol Head Neck Surg 2014;150:722–9CrossRefGoogle Scholar
Greig, SR. Current perspectives on the role of tonsillectomy. J Paediatr Child Health 2017;53:1065–70CrossRefGoogle ScholarPubMed
Windfuhr, JP. Indications for tonsillectomy stratified by the level of evidence. GMS Curr Top Otorhinolaryngol Head Neck Surg 2016;15:Doc09Google ScholarPubMed
Husband, AD, Davis, A. Pain after tonsillectomy. Clin Otolaryngol Allied Sci 1996;21:99–101CrossRefGoogle ScholarPubMed
Blanchford, H, Lowe, D. Cold versus hot tonsillectomy: state of the art and recommendations. ORL J Otorhinolaryngol Relat Spec 2013;75:136–41CrossRefGoogle ScholarPubMed
Moher, D, Liberati, A, Tetzlaff, J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 2009;339:b2535CrossRefGoogle ScholarPubMed
Higgins, JP, Altman, DG, Gotzsche, PC, Juni, P, Moher, D, Oxman, AD et al. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ 2011;343:d5928CrossRefGoogle ScholarPubMed
Higgins, JPT, Thomas, J, Chandler, J, Cumpston, M, Li, T, Page, MJ et al. , eds. Cochrane Handbook for Systematic Reviews of Interventions, version 5.2.0 (updated June 2017). Cochrane Collaboration, 2017Google Scholar
Review Manager (RevMan) [Computer program]. Version 5.3. Copenhagen: Nordic Cochrane Centre, Cochrane Collaboration, 2014Google Scholar
Wang, J, Dong, C, Liang, CY, Fu, Q, Jiang, Z, Chen, L et al. Clinic study of plasma radiofrequency at low temperature in tonsillectomy [in Chinese]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2005;40:382–3Google Scholar
Wang, J, Liu, D, Huang, Z, Zhong, J, Tan, Z, Qiu, S. Low-temperature coblation-assisted versus conventional dissection tonsillectomy in surgeries for children [in Chinese]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2009;23:690–2Google Scholar
Wang, Y, Yang, B, Yang, X-Y. Application of temperature controlled radiofrequency ablation in pediatric tonsillectomy and adenoidectomy [in Chinese]. Journal of China Medical University 2010;39:585–6Google Scholar
Elbadawey, MR, Hegazy, HM, Eltahan, AE, Powell, J. A randomised controlled trial of coblation, diode laser and cold dissection in paediatric tonsillectomy. J Laryngol Otol 2015;129:1058–63CrossRefGoogle ScholarPubMed
Matin, MA, Chowdhury, MA, Haque, ME, Islam, MN, Shamim, T, Muqeet, MA et al. Coblation tonsillectomy versus blunt dissectomy tonsillectomy in children. Anwer Khan Modern Medical College Journal 2013;4:25–9CrossRefGoogle Scholar
Mitic, S, Tvinnereim, M, Lie, E, Saltyte, BJ. A pilot randomized controlled trial of coblation tonsillectomy versus dissection tonsillectomy with bipolar diathermy haemostasis. Clin Otolaryngol 2007;32:261–7CrossRefGoogle ScholarPubMed
Omrani, M, Barati, B, Omidifar, N, Okhovvat, AR, Hashemi, SA. Coblation versus traditional tonsillectomy: a double blind randomized controlled trial. J Res Med Sci 2012;17:45–50Google ScholarPubMed
Paramasivan, VK, Arumugam, SV, Kameswaran, M. Randomised comparative study of adenotonsillectomy by conventional and coblation method for children with obstructive sleep apnoea. Int J Pediatr Otorhinolaryngol 2012;76:816–21CrossRefGoogle ScholarPubMed
Roje, Z, Racic, G, Dogas, Z, Pisac, VP, Timms, M. Postoperative morbidity and histopathologic characteristics of tonsillar tissue following coblation tonsillectomy in children: a prospective randomized single-blind study. Coll Antropol 2009;33:293–8Google ScholarPubMed
Shapiro, NL, Bhattacharyya, N. Cold dissection versus coblation-assisted adenotonsillectomy in children. Laryngoscope 2007;117:406–10CrossRefGoogle ScholarPubMed
Garra, G, Singer, AJ, Domingo, A, Thode, HC Jr.The Wong-Baker pain FACES scale measures pain, not fear. Pediatr Emerg Care 2013;29:17–20CrossRefGoogle Scholar
Garra, G, Singer, AJ, Taira, BR, Chohan, J, Cardoz, H, Chisena, E et al. Validation of the Wong-Baker FACES Pain Rating Scale in pediatric emergency department patients. Acad Emerg Med 2010;17:50–4CrossRefGoogle ScholarPubMed
Pynnonen, M, Brinkmeier, JV, Thorne, MC, Chong, LY, Burton, MJ. Coblation versus other surgical techniques for tonsillectomy. Cochrane Database Syst Rev 2017;(8):CD004619CrossRefGoogle ScholarPubMed
Burton, MJ, Doree, C. Coblation versus other surgical techniques for tonsillectomy. Cochrane Database Syst Rev 2007;(3):CD004619CrossRefGoogle ScholarPubMed
Metcalfe, C, Muzaffar, J, Daultrey, C, Coulson, C. Coblation tonsillectomy: a systematic review and descriptive analysis. Eur Arch Otorhinolaryngol 2017;274:2637–47CrossRefGoogle ScholarPubMed