Dr. Lauren Styan
Ipswich Hospital, QLD, Australia
Title: Coblation tonsillotomy – An alternative to bipolar tonsillectomy in children with sleep disordered breathing
Biography
Biography: Dr. Lauren Styan
Abstract
Introduction
Tonsillectomy is one of the most commonly performed procedures in children, typically for the management of sleep disordered breathing and/or recurrent tonsillitis. Intra-capsular coblation tonsillotomy is an emerging technique that has become popular due to its reported reductions in postoperative pain when compared to other methods. We aimed to investigate the outcomes of children undergoing intra-capsular coblation tonsillotomy for management of sleep disordered breathing in our department.
Methods
44 paediatric patients undergoing intracapsular coblation tonsillotomy (with or without adenoidectomy) for the management of sleep disordered breathing were recruited. Post operative pain levels, diet, analgesia requirement, return to normal activity and complication rates were collected. Validated self reported T-14 paediatric throat disorders outcome tools were completed by parent’s pre and post-operatively to assess for resolution of sleep disordered breathing symptoms. The outcomes were compared to a cohort of paediatric patients undergoing bipolar tonsillectomy.
Results
Coblation tonsillotomy was associated with significantly less postoperative pain (P<0.0001), earlier return to normal diet (P = 0.008) and activity (P = 0.013), and reduced analgesia requirement (P = 0.001). There was no statistically significant difference in the rates of post-tonsillectomy haemorrhage between the two groups (P= 0.109). Sleep disordered breathing outcomes have been excellent, with significant improvements in parent reported symptoms at three week postoperative follow-up (mean total T-14 score (/70) 23.9 preoperative, 2.4 three weeks postoperative, P<0.0001). Only a portion of the cohort has reached 12-month follow-up, however at this early stage there have been no reported recurrence of symptoms and no requirement for revision tonsil surgery.
Conclusion
Children with sleep disordered breathing who undergoing intracapular coblation tonsillotomy have less postoperative pain and faster recovery, when compared to bipolar tonsillectomy. Effective reduction of sleep disordered breathing symptoms is also demonstrated. Further studies are required to determine the long-term outcomes and also investigate the utility of this method for the management of recurrent tonsillitis.