Comparison of the Outcome of Coblation Tonsillectomy versus Cold Dissection Tonsillectomy
DOI:
https://doi.org/10.51985/Keywords:
Coblation, tonsillectomy, post-operative pain, blood loss, hemorrhageAbstract
Objectives: To compare the outcome of coblation tonsillectomy versus cold dissection tonsillectomy.
Study design & settings: Randomized controlled trial from 26th September 2025 to 25th December 2025 at ENT Department at Sheikh Zayed Hospital, Lahore.
Methodology: All patients with chronic tonsillitis of duration >3 months, age 20 to 60 years of either gender were included. Tonsillar cancer, known bleeding disorders (INR >1.5), and a history of peritonsillar abscess were excluded. Patients in a group Group B's tonsils are removed via cold dissection, while group A's tonsils are removed by coblation. Seven days following the operation, the mean post-operative pain was assessed. There were additional reports of initial bleeding, secondary bleeding, and secondary infection. The postoperative discomfort in both groups was compared using the independent "t" test, and the primary, reactionary, and secondary hemorrhages were compared using the chi square test; a p-value of =0.05 was deemed significant.
Results: In this study, mean intra-operative blood loss in Group A (coblation tonsillectomy) was 28.90 ± 7.78 ml while in Group B (cold dissection tonsillectomy) was 42.07 ± 4.77 ml (p-value = 0.0001). Mean post-operative pain in Group A was 2.20 ± 0.89 while in Group B was 4.87 ± 1.14 (p-value = 0.0001). Secondary hemorrhage was found in 3.33% patients in the cold dissection group and 0.0% in the coblation group.
Conclusion: Coblation tonsillectomy offers benefits such decreased intraoperative blood loss, shorter surgery time, and quicker return to a normal diet
References
1. Krishnan RR, Lathadevi HT, Karadi RN, Shashikumar T. A
comparative study of coblation vs conventional tonsillectomy.
Int J Life Sci Biotechnol Pharma Res. 2024;13(11):91-5. DOI:
10.69605.
2. Budhiraja G, Kaur N, Singh H, Bharti P. Coblation
tonsillectomy versus conventional tonsillectomy. Adesh Univ
J Med Sci Res. 2023;5:5-8. doi:10.25259/AUJMSR_17_2022
3. George NS, Mathai J, Pillai NG. Comparison of tonsillectomy
with harmonic scalpel and conventional dissection
tonsillectomy in the management of patients with chronic
tonsillitis. Int J Acad Med Pharm. 2023;5(1):452-5. DOI:
10.47009/jamp.2023.5.1.94
4. Nelson J, Varghese N, Joseph AC, Menon AG, Antony R. A
comparative study of conventional cold dissection and
coblation method of tonsillectomy. Int J Adv Med Health Res.
2023;10:17-21. DOI: 10.4103/ijamr.ijamr_132_22.
5. Elahi MK, Mollik KH, Kazi M, Reza H, Islam A, Sarkar RK,
et al. Comparison of surgical complications between cold
steel dissection method and bipolar electro dissection method
in tonsillectomy. Sch J App Med Sci. 2024;12(5): 548-55.
DOI: 10.36347/sjams.2024.v12i05.008.
6. Ilyas M, Iqbal M, Iqbal A, Khan MA, Akhtar S, Hussain T,
et al. Coblation tonsillectomy versus dissection tonsillectomy.
Pak Postgrad Med J. 2021;32(4):147-150.
7. Prussin AJ, Babajanian E, Error M. Radiofrequency ablation
vs electrocautery blinded randomized trial: impact on clinically
meaningful outcomes. Otolaryngol Head Neck Surg 2021;164
(06):1186–92. https://doi.org/10.1177/0194599820964737.
8. Sheet MS, Al-Banna AF, Emanuel ES, Mohammed AA, Alnori
H. Coblation versus cold dissection tonsillectomy: a
comparative study. Indian J Otolaryngol Head Neck Surg.
2022;74(Suppl 3):5706–11.
9. Vyas S, Sharma P, Sharma N, Makwana A, Goyal VP.
Coblation vs dissection tonsillectomy: a prospective
randomized study comparing surgical and clinical outcomes.
Int J Otorhinolaryngol Head Neck Surg. 2019;5:306-9.
https://doi.org/10.18203/issn.2454-5929.ijohns20190492.
10. Shih MC, Long BD, Pecha PP, White DR, Liu YC, Brennan
E, et al. A scoping review of randomized clinical trials for
pain management in pediatric tonsillectomy and
adenotonsillectomy. World J Otorhinolaryngol Head Neck
Surg. 2022;9(1):9-26. doi: 10.1002/wjo2.54.
11. Regmi D, Bista M, Shrestha S. Comparison of clinical and
functional outcome of cold steel dissection versus coblation
technique in tonsillectomy. J Nepal Health Res Counc.
2022;19(4):820-3. doi: 10.33314/jnhrc.v19i04.3961.
12. Izny Hafiz Z, Rosdan S, Mohd Khairi MD. Coblation
tonsillectomy versus dissection tonsillectomy: a comparison
of intraoperative time, intraoperative blood loss and postoperative pain. Med J Malaysia. 2014 Apr;69(2):74-8. PMID:
25241816.
13. Rakesh S, Anand TS, Payal G, Pranjal K. A prospective,
randomized, double-blind study of coblation versus dissection
tonsillectomy in adult patients. Indian J Otolaryngol Head
Neck Surg. 2012;64:290-4. 10.1007/s12070-011-0355-y.
14. Pachar K, Singh A, Khanadelwal D. Comparison of
postoperative pain and analgesic requirement in coblation
versus cold dissection tonsillectomy: a retrospective study at
a tertiary care hospital in Rajasthan. Int J Curr Pharma Rev
Res. 2025;17(9):1287-90. Available online on http://
www.ijcpr.com/.
15. Nallasivam M, Sivakumar M. A comparative study of coblation
versus conventional tonsillectomy. IOSR J Dent Med Sci.
2017;16:102-7. 10.9790/0853-160406102107.
16. Goyal A, Chavan P, Shinde V, Mahajan G, Ingale M. A
comparative study between coblation-assisted tonsillectomy
and conventional dissection and snare tonsillectomy. Cureus.
2024;16(8):e68281. DOI: 10.7759/cureus.68281.
17. Muddaiah D, Srinivas V. Coblation adenotonsillectomy vs.
cold steel dissection adenotonsillectomy: a prospective
observational study of pediatric population at tertiary care
hospital. Int J Curr Pharma Rev Res. 2025;17(7):211-7.
Available online on http://www.ijcpr.com/.
18. Lavania A and Gupta AK. Coblation versus conventional
tonsillectomy: a comparative study. J Current Res Oto.
2025;6(1):180051.
19. Jat SL, Jat KS, Sehra R, Sharma MP, Sharma A. Traditional
and coblation tonsillectomy in pediatrics population: a
comparative study. Indian J Otolaryngol Head Neck Surg.
2022;74:6414-21. 10.1007/s12070-020-01874-1.
20. Karathia NM, Kansara AH. Comparison of tonsillectomy by
coblation and tonsillectomy by conventional method. Int J
Otorhinolaryngol Head Neck Surg. 2020;6:923-8.
10.18203/issn.2454-5929.ijohns20201688.
21. El-Taher M, Aref Z. Coblation versus conventional
tonsillectomy: a double blind randomized controlled trial.
Indian J Otolaryngol Head Neck Surg. 2019;71:172-5.
10.1007/s12070-017-1189-z.
22. Muthubabu K, Rekha A, Thejas SR. Tonsillectomy by cold
dissection and coblation techniques: a prospective comparative
study. Indian J Otolaryngol Head Neck Surg. 2019;71:665-
70. 10.1007/s12070-018-1472-7.
23. Ahmad M, Wardak A, Hampton T, Siddiqui M, and & Street,
I. Coblation versus cold dissection in paediatric tonsillectomy:
A systematic review and meta-analysis. J Laryngol.
2020;134(3):197-204. & Otology, doi:10.1017/ S002221512
0000377.
24. Regmi D, Bista M, Shrestha S. Comparison of Clinical and
Functional Outcome of Cold Steel Dissection versus Coblation
Technique in Tonsillectomy. J Nepal Health Res Counc.
2022;19(4):820-3.
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