Cold dissection versus coblation-assisted adenotonsillectomy in children.
OBJECTIVE
To compare intraoperative efficiency and postoperative recovery between cold dissection adenotonsillectomy (CDA) and coblation-assisted adenotonsillectomy (CAA).


METHODS
A prospective, randomized, single-blind trial of pediatric patients aged 2 to 16 years undergoing adenotonsillectomy was conducted. Patients were randomized to undergo either CDA or CAA. Measured intraoperative parameters included surgical duration and intraoperative blood loss. Measured postoperative parameters included a 14 day caregiver questionnaire that recorded a daily pain rating using the Wong-Baker FACES pain scale, pain medication use, days to return to a normal diet, and days to return to a normal caregiver routine. Postoperative complications were also recorded. Intraoperative and postoperative measures were statistically compared between groups.


RESULTS
Forty-six children with a mean age of 6.7 years (23 CDA and 23 CAA) were randomized and completed the study. Mean age and sex distributions were similar between groups (P > .05). Surgical times were significantly shorter for the CAA group versus the CDA group (11.2 min vs. 17.0 min, P < .001). Intraoperative blood loss was statistically lower for both the adenoidectomy and tonsillectomy portions of the procedure for the CAA group versus the CDA group (P < .001 and P < .001, respectively). There was no statistically significant difference in reported daily pain scores between groups (P = .296, analysis of variance). Both groups returned to normal diet (P = .982), and caregivers returned to their normal routine on similar postoperative days (P = .631).


CONCLUSIONS
CAA offers better operative speed and intraoperative hemostasis as compared with CDA. However, CAA does not result in poorer postoperative pain scores or recoveries despite these intraoperative advantages.
Shapiro
Nina L
NL
Division of Head and Neck Surgery, David Geffen UCLA School of Medicine, Los Angeles, California, USA. nshapiro@ucla.edu
Bhattacharyya
Neil
N
D000233:Adenoidectomy / Q000379:methods*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004564:Electrocoagulation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010149:Postoperative Pain; D011446:Prospective Studies; D016037:Single-Blind Method; D014068:Tonsillectomy / Q000379:methods*; D014069:Tonsillitis / Q000601:surgery; D016896:Treatment Outcome