Comparative study of Coblation tonsillectomy Vs Conventional tonsillectomy

Mathumithaa, S (2020) Comparative study of Coblation tonsillectomy Vs Conventional tonsillectomy. Masters thesis, Stanley Medical College, Chennai.

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Abstract

INTRODUCTION: In otorhinolaryngological practice most patients present with the complaints of sore throat, difficulty in swallowing with tonsillar enlargement. Tonsillitis is the most common condition present in paediatric age group. Tonsillectomy is the most frequent procedure done in otorhinoloaryngology. Primary hemorrhage, postoperative pain and secondary hemorrhage are the most common complications of tonsillectomy. The traditional methods of tonsillectomy are ‘cold steel’ techniques using metal instruments. Several other methods have been introduced with perceived advantages in terms of reduced bleeding, reduced pain, more rapid healing and ease of surgical technique. Dissection method, bipolar method, cryosurgery, coblation, harmonic scalpel, radiofrequency, laser method are the various techniques. Dissection technique is routinely followed. Coblation is a relatively newer technique in otorhinolaryngology. It is more popular and accepted due to patient’s early recovery. This technology utilizes the radio-frequency bipolar electrical current. In Coblation method (controlled ablation) two different techniques are used 1. Total subcapsular tonsillectomy: (Removal of entire tonsil), 2. Subtotal intracapsular tonsillectomy (some tonsil tissue left behind). AIMS AND OBJECTIVES: To compare the following parameters in Coblation tonsillectomy patients and Conventional tonsillectomy patients. 1. Intraoperative blood loss, 2. Operative duration, 3. Intraoperative complications, 4. Postoperative complications, 5. Postoperative pain, 6. Recovery time. MATERIALS AND METHODS: Study place: Department of Otorhinolaryngology, Govt Stanley Medical College, Chennai. Study design: Prospective study. Study period: 6 months April 2019-September 2019. Study population: 50 patients. Inclusion criteria: Chronic tonsillitis patients above 5yrs of age, Paradise criteria for tonsillectomy (episodes of sore throat), 7 or more episodes n the preceding year, 5 or more episodes in each of the preceding 2year, 3 or more episodes in each of the preceding 3 year. Exclusion criteria: 1. Bleeding disorders, 2. less than 5 yrs of age, 3. acute tonsillitis. RESULTS: The results were significantly different. In our study, the intraoperative blood loss and operation time were significantly less in the coblation group. The reduction of intraoperative blood loss and operation time in coblation tonsillectomy was obvious and reduction of the postoperative pain and early return to normal diet and activities were clinically and statistically significant. Therefore, we believe that the coblation tonsillectomy is an effective and cost-effective method. CONCLUSION: 1. Intraoperative blood loss was less in Coblation tonsillectomy when compared to conventional method. 2. Operative time was less in Coblation tonsillectomy. As longer the time taken in conventional method the blood loss was more. 3. Intraoperative complications were more in conventional tonsillectomy when compared to Coblation tonsillectomy. 4. Post operative pain is significantly less in Coblation tonsillectomy, as compared to conventional method. 5. Recovery time was early in Coblation tonsillectomy, as patient returns to routine daily activities earlier. 6. Postoperative complications are equal in Coblation and conventional tonsillectomy. Coblation tonsillectomy is preferrable to conventional method. It is a safe procedure to do. As it is easy to perform, produce less tissue damage and blood less operating field.

Item Type: Thesis (Masters)
Additional Information: 221814052
Uncontrolled Keywords: Coblation tonsillectomy, Conventional tonsillectomy, Comparative study.
Subjects: MEDICAL > Otolaryngology
Depositing User: Subramani R
Date Deposited: 15 Feb 2021 03:02
Last Modified: 15 Feb 2021 03:02
URI: http://repository-tnmgrmu.ac.in/id/eprint/14218

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