title: Cold dissection versus coblation-assisted adenotonsillectomy in children.
abstract: 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.
authors.affiliation: Division of Head and Neck Surgery, David Geffen UCLA School of Medicine, Los Angeles, California, USA. nshapiro@ucla.edu
authors.forename: Nina L
authors.initials: NL
authors.lastname: Shapiro
authors.forename: Neil
authors.initials: N
authors.lastname: Bhattacharyya
mesh_terms: 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