Radiofrequency for tonsillectomy
Reviewed by Sunil Sharma

This Turkish study compared the use of radiofrequency (RF) tonsillectomy to the more traditional cold steel dissection (CD) technique. The authors enrolled 114 patients undergoing tonsillectomy for chronic tonsillitis and tonsil hypertrophy (causing upper airway obstruction) over a 4-month period. Each patient underwent RF tonsillectomy on one side and CD tonsillectomy for the other side. Both patients and the surgeons were blinded as to which method was used on which side. The RF system utilises an alternating RF current which has dual functions for cutting and coagulation. The device calibrates the power output by measuring the tissue impedance, and cuts out once tissue death is achieved. Interestingly, all patients were given a 10-day prophylactic antibiotic course post-operatively and only oral paracetamol as analgesia. There was no significant difference between the two groups in terms of the mean operation time, but there was significantly lower intraoperative bleeding in the RF group. Post-operative pain was measured using a VAS scale, and throughout the post-operative period, the mean pain score was higher in the RF group compared to the CD group. Return to a painless dietary regime took four days longer in the RF group. This study describes yet another technique that can be used for tonsillectomy, but whether there is any superiority of this method over cold steel is debatable, particularly in terms of post-operative pain.

Impedance-controlled radiofrequency vs. cold dissection tonsillectomy.
Ozkul MH, Bayram O, Balikci HH, et al.
B-ENT 2014;
10:285-89.