Effectiveness of laser tonsillectomy compared to conventional cold steel tonsillectomy in children
DOI:
https://doi.org/10.3329/bsmmuj.v17i4.76147Keywords:
tonsillectomy, CO2 laser technique, cold steel dissectionAbstract
Background: The Effectiveness of CO2 laser tonsillectomy is not conclusively known. The current study aimed to determine its effectiveness compared to the cold steel dissection for tonsillectomy in children.
Methods: This interventional study was done in the Department of Otolaryngology of AL-Yarmouk Teaching Hospital, Baghdad, Iraq. It was done in 80 children eligible for tonsillectomy, evenly divided into cold steel dissection tonsillectomy (group A) and CO2 laser tonsillectomy (group B). The surgical outcomes of the two groups were analysed for operative time, intra-operative blood loss, post-operative pain, bleeding, tonsillar fossae sloughing, and the time taken to return to daily activity.
Results: The CO2 tonsillectomy group showed better effectiveness in terms of operative time (37.6 versus 19.5 min), intra-operative blood loss (42.7 versus 15.8 mL), postoperative pain at days 1, 7 and 14), and tonsillar bed sloughing (25.0% versus 32.5%). However, primary and secondary postoperative haemorrhages were similar between the groups.
Conclusions: Although the results are not generalisable, the CO2 laser tonsillectomy was more effective than the cold steel dissection tonsillectomy.
Downloads
123
42 Review report
9
References
Verma R, Verma RR, Verma RR. Tonsillectomy-Comparative Study of Various Techniques and Changing Trend. Indian J Otolaryngol Head Neck Surg. 2017 Dec;69(4):549-558. DOI: https://doi.org/10.1007/s12070-017-1190-6
Keltie K, Donne A, Daniel M, Stephenson K, Wyatt M, Kuo M, Saunders M, Kumar NB, Philpott CM, Bruce I, Smith ME, Hardman JC, Cognigni P, Richardson H, Gross S, Sims AJ, Powell S. Paediatric tonsillectomy in England: A cohort study of clinical practice and outcomes using Hospital Episode Statistics data (2008-2019). Clin Otolaryngol. 2021 May;46(3):552-561. DOI: https://doi.org/10.1111/coa.13707
Altun H, Hanci D. Post-operative outcome of thermal welding tonsillectomy versus monopolar electrocautery tonsillectomy: a randomized control study. J Otolaryngol ENT Res 2018; 10(6): 400-404. DOI: https://doi.org/10.15406/joentr.2018.10.00390
Kumar A, Kumar S, Krishnan A, Verma M, Garg U, Sharma N. A Comparative Analysis of Outcomes of Conventional Cold Dissection Versus Laser Tonsillectomy in Pediatric Cases in a Tertiary Care Hospital in Haryana. Indian J Otolaryngol Head Neck Surg. 2022 Dec;74(Suppl 3):5311-5318. DOI: https://doi.org/10.1007/s12070-020-02301-1
Randel A. AAO-HNS Guidelines for Tonsillectomy in Children and Adolescents. Am Fam Physician. 2011 Sep 1;84(5):566-73. PMID: 21888309.
Prasad KC, Prasad SC. Assessment of Operative Blood Loss and the Factors Affecting it in Tonsillectomy and Adenotonsillectomy. Indian J Otolaryngol Head Neck Surg. 2011 Oct;63(4):343-348. DOI: https://doi.org/10.1007/s12070-011-0268-9
Sarny S, Ossimitz G, Habermann W, Stammberger H. Hemorrhage following tonsil surgery: a multicenter prospective study. Laryngoscope. 2011 Dec;121(12):2553-2560. DOI: https://doi.org/10.1002/lary.22347
Persino PR, Saleh L, Walner DL. Pain control following tonsillectomy in children: A survey of patients. Int J Pediatr Otorhinolaryngol. 2017 Dec;103:76-79. DOI: https://doi.org/10.1016/j.ijporl.2017.10.016
Darin J. Correll. The Measurement of Pain: Objectifying the Subjective. Eds: Steven D. Waldman, Joseph I. Bloch W.B. Saunders. Pain management chapter 18, 2007, Pages 197-211. DOI: https://doi.org/10.1016/B978-0-7216-0334-6.50022-4
Ifthikhar M, Ahmed J, Khan NUH. Tonsillectomy: A comparison between the conventional cold steel dissection method with contact diode laser. Pakistan J Med Health Sci 2018;12: 807–809. URL: https://pjmhsonline.com/2018/april_june/pdf/807.pdf
Aziz MA, Atef A, Sabry OA, Yousef AI, Ahmed AS, Hussien AA, Abdel-Haleem M, Samir A. Different tonsillectomy techniques in Egypt: advantages and disadvantages-experience and review of literature. Egypt J Otolaryngol 2023; 39: 127. DOI: https://doi.org/10.1186/s43163-023-00493-1
Ishlah LW, Fahmi AM, Srinovianti N. Laser versus dissection technique of tonsillectomy. Med J Malaysia. 2005 Mar;60(1):76-80. PMID: 16250284
Bohr C, Shermetaro C. Tonsillectomy and Adenoidectomy. 2023 Jun 26. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 30725627
Ghiyali VS, Minhas RS, Azad RK, Thakur JS. Is Laser Better than Cold Steel (Dissection and Snare) for Tonsillectomy? Indian J Otolaryngol Head Neck Surg. 2023 Jun;75(2):343-346. DOI: https://doi.org/10.1007/s12070-022-03182-2
Atiyah JR. Tonsillectomy by Diode Laser Versus Cold Steel Dissection Method in Children, Basra, South of Iraq Glob J Otolaryngol 2020;21(4): 60-63. DOI: https://doi.org/10.19080/GJO.2019.20.556067
Aldamluji N, Burgess A, Pogatzki-Zahn E, Raeder J, Beloeil H; PROSPECT Working Group collaborators*. PROSPECT guideline for tonsillectomy: systematic review and procedure-specific postoperative pain management recommendations. Anaesthesia. 2021 Jul;76(7):947-961. DOI: https://doi.org/10.1111/anae.15299
Matin MA, Chowdhury MA. Diode laser versus blunt dissection tonsillectomy Bangladesh J Otorhinolaryngol 2012;18(2): 114–118. DOI: https://doi.org/10.3329/bjo.v18i2.11983
Tsikopoulos A, Fountarlis A, Tsikopoulos K, Dilmperis F, Tsikopoulos I, Garefis K, Karkos P, Skoulakis C, Triaridis S. CO2 laser or dissection tonsillectomy: A systematic review and meta-analysis of clinical outcomes. Auris Nasus Larynx. 2023 Feb;50(1):2-16. DOI: https://doi.org/10.1016/j.anl.2022.05.002
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Manar Qasim Mohammed Raoof, Mohammed Radef Dawood
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
