Excellence in tonsillectomy is based on the time taken, blood loss and rapid recovery with minimal pain. In this study, 120 children underwent tonsillectomy by three methods, namely cold dissection, coblation and diode laser dissection in three randomly allocated groups of 40 children in each. In cold dissection and laser methods, bipolar diathermy was applied for hamostasis whereas in the coblation method plasma wand set at four was used, although it appears bipolar diathermy was also applied in some patients. The pain and discomfort was recorded on a standardised Wong-Baker FACES pain scale. Results were statistically analysed and showed that coblation required least time, followed by diode laser method. Cold dissection took longest. Blood loss was minimal in the coblation method and maximum in cold dissection technique. In terms of postoperative pain and recovery, coblation method fared best. This is attributed to lower temperatures with minimal collateral thermal tissue damage. Pain after a week was maximum in the diode laser technique. The results of the study which is reasonably powered are comparable with those of previous reports but may be limited due to use of bipolar diathermy. However, the differences between each of the assessment factors in the three methods are minimal and the method applied should not ignore skills and facilities available and bear in mind the cost effectiveness.
A comparison of cold dissection, coblation and diode laser tonsillectomy
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