Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
Clin Exp Otorhinolaryngol. 2013 Jun;6(2):90-3. doi: 10.3342/ceo.2013.6.2.90. Epub 2013 Jun 14.
Coblation is operated in low temperature, so it is proposed that tonsillectomy with coblation involves less postoperative pain and allows accelerated healing of the tonsillar fossae compared with other methods involving heat driven processes. However, the results of the previous studies showed that the effect of coblation tonsillectomy has been equivocal in terms of postoperative pain and hemorrhage. Though, most of the previous studies which evaluated coblation tonsillectomy were performed in children. Recently, electrocautery tonsillectomy has been used most widely because of the reduced intraoperative blood loss and shorter operative time compared to other techniques. This prospective study compared intraoperative records and postoperative clinical outcomes in adolescents and adults following coblation and electrocautery tonsillectomies.
Eighty patients over 16 years of age with histories of recurrent tonsillitis were enrolled. The patients were randomly allocated into coblation (n=40) and electrocautery tonsillectomy groups (n=40). All operations were performed by one surgeon who was skilled in both surgical techniques. Intraoperative parameters and postoperative outcomes were checked.
Postoperative pain and otalgia were not significantly different between the two groups; however, there was a tendency towards reduced pain and otalgia in the coblation group. More cotton balls for swabbing the operative field were used introoperatively in the electrocautery group (P=0.00). There was no significant difference in postoperative hemorrhage, wound healing, commencement of a regular diet, and foreign body sensation between the groups.
Only cotton use, which represented the amount of blood loss, was less in the coblation tonsillectomy group. Coblation tonsillectomy warrants further study with respect to the decreased postoperative pain and otalgia.
由于等离子切割是在低温下进行的，因此有人提出，与其他涉及热能过程的方法相比，使用等离子切割进行扁桃体切除术时术后疼痛较少，且扁桃体窝的愈合速度更快。然而，先前的研究结果表明，等离子切割扁桃体切除术在术后疼痛和出血方面的效果尚不确定。尽管如此，大多数评估等离子切割扁桃体切除术的先前研究都是在儿童中进行的。最近，由于与其他技术相比术中出血量减少和手术时间缩短，电烙扁桃体切除术被广泛应用。本前瞻性研究比较了青少年和成年人接受等离子切割和电烙扁桃体切除术的术中记录和术后临床结果。
共纳入 80 例年龄在 16 岁以上、有反复发作性扁桃体炎病史的患者。将患者随机分配至等离子组（n=40）和电烙组（n=40）。所有手术均由一位熟练掌握这两种手术技术的外科医生进行。检查术中参数和术后结果。
两组间术后疼痛和耳痛无显著差异；然而，等离子组疼痛和耳痛有减轻的趋势。电烙组术中使用的用于擦拭手术区域的棉签数量更多（P=0.00）。两组间术后出血、伤口愈合、开始正常饮食和异物感无显著差异。
仅等离子组的术中棉用量（代表出血量）较少。等离子切割扁桃体切除术在减轻术后疼痛和耳痛方面值得进一步研究。
