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Laryngoscope. 2014 Aug;124(8):1959-64. doi: 10.1002/lary.24632. Epub 2014 Jun 3.

Coblation total tonsillectomy and adenoidectomy versus coblation partial intracapsular tonsillectomy and adenoidectomy in children.

Author information

1
Department of Head and Neck Surgery, David E. Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A.

Abstract

OBJECTIVES/HYPOTHESIS:

To evaluate the postoperative course of children who underwent coblation T&A versus those who underwent coblation partial intracapsular tonsillectomy and adenoidectomy (PITA).

STUDY DESIGN:

Retrospective cohort study.

METHODS:

Records of children undergoing consecutive tonsillectomies from July 2009 to October 2012 were analyzed. All surgeries used a coblation device. Outcomes including intraoperative and postoperative bleeding, pain, and return to preoperative diet were analyzed comparing the coblation T&A and coblation PITA patients.

RESULTS:

Of 415 patients evaluated, 258 (62.2%) underwent coblation T&A and 157 (37.8%) underwent coblation PITA. Seventeen (4.1%) patients experienced postoperative hemorrhage, 15 (88.2%) of whom underwent T&A and two (11.8%) of whom underwent PITA (P = 0.024). Multivariate analysis demonstrated that coblation T&A was a significant contributor to postoperative hemorrhage, with an odds ratio of 4.8 (95% confidence interval [CI]: 1.08-21.21) compared to coblation PITA. Patients who underwent T&A resumed normal diets significantly later (8 days, SD 4.6) than those who underwent PITA (5.4 days, standard deviation [SD]: 3.4) (P = 0.022). In terms of pain severity, more T&A patients reported "severe" pain and more PITA patients reported "moderate" pain (P = 0.047). More T&A patients experienced a "post-op dip," defined as increased pain during postoperative days 5-9, than did PITA patients (P < 0.001).

CONCLUSIONS:

Coblation PITA is a safe procedure that has a lower incidence of intraoperative and postoperative bleeding in children compared to coblation T&A. Patients may have less pain and return to preoperative diets sooner than those undergoing coblation T&A.

KEYWORDS:

Adenotonsillectomy; coblation; partial intracapsular tonsillectomy; pediatric; posttonsillectomy hemorrhage

PMID:
24493326
DOI:
10.1002/lary.24632
[Indexed for MEDLINE]

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