Coblator is a preferred option in many institutions for tonsillectomy as it is associated with significantly less blood loss and intraoperative time. This retrospective cohort study compared the revision rates after paediatric partial intracapsular tonsillectomy and adenoidectomy (PITA) with microdebrider and coblation. A total of 827 children with obstructive sleep-disordered breathing undergoing surgeries between 2016 and 2023 were included in the study. The median follow-up period was 60 months. In this single institutional cohort, microdebrider was associated with lower (99.4%) long-term revision rates compared to coblation (96.1%). The authors discuss that microdebrider tonsillectomy provides a clear anatomical margin for resection and no residual tissue is left behind. Additionally, the use of diathermy after the use of microdebrider further reduces residual tonsil tissue. This contrasts with the coblator which may leave a layer of superficial coagulated eschar on the tonsillar bed, obscuring visualisation of residual tonsil tissue with subsequent recurrence. It will be interesting to know whether other institutions using both these devices have observed these results.
Higher revision rates with coblator after paediatric partial tonsil-adenoidectomy
Reviewed by Gauri Mankekar
Revision rates after pediatric PITA: A comparative study of microdebrider and coblation techniques.
CONTRIBUTOR
Gauri Mankekar
Department of Otolaryngology-Head Neck Surgery, Louisiana State University Shreveport, Louisiana, USA.
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