Pediatric tonsillotomy with the radiofrequency technique: less morbidity and pain.
OBJECTIVE
To compare two techniques for pediatric tonsil surgery with respect to pain and postoperative morbidity. The two methods were the partial tonsil resection using radiofrequency (RF) technique (tonsillotomy [TT]) versus traditional tonsillectomy (TE).


METHODS
Prospective clinical randomized study in one tertiary care ENT clinic and two secondary care clinics.


METHODS
One hundred fifty children, between 5 and 15 years of age, were randomized to either TT with RF using the Surgitron Ellman, 1.7 MHz, or regular TE. Randomization was performed from the waiting list, including children with both a history of obstructive problems and recurrent tonsillitis. The TT was performed with a specially made sling electrode using a cut/coagulation mode.


RESULTS
Forty-nine children were operated on with TT and 43 with TE. There was significantly less bleeding in the TT group, although two cases of primary postoperative bleeding occurred among the TT children and one in the TE group. The pain recordings showed significantly less pain for the TT children from the second hour postoperatively onward, and the TT children were pain free and in school 3 days earlier than the TE group. The TT group had less need of the prescribed drugs (diclofenac and paracetamol). After 9 days, 73% of the TT children were completely healed, but only 31% of the TE children. By that time, the TE children had lost a mean of 660 g, and the TT children had gained 127 g. The effect on snoring was the same for both groups.


CONCLUSIONS
RF appears to be a safe and reliable method for tonsil surgery with much less postoperative morbidity than regular TE.
Hultcrantz
Elisabeth
E
Department of Otorhinolaryngology, University of Linköping, Sweden. elihu@inr.liu.se
Ericsson
Elisabeth
E
D000082:Acetaminophen / Q000627:therapeutic use; D000293:Adolescent; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004008:Diclofenac / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D000078702:Radiofrequency Therapy; D014068:Tonsillectomy / Q000295:instrumentation*; D014069:Tonsillitis / Q000601:surgery*
D018712:Analgesics, Non-Narcotic; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac; D000082:Acetaminophen