Microscope-assisted coblation tonsillectomy among paediatric patients – our experiences at an Indian teaching hospital

Introduction
Tonsillectomy is an established treatment option for chronic tonsillitis or sleep-disordered breathing defect in the paediatric age group.

Aim of the study
A retrospective study was done to compare surgical parameters such as intra-operative bleeding, duration of surgery, post-operative bleeding, postoperative pain, and hospital stay, in paediatric patients undergoing coblation tonsillectomy with or without assistance of an operating microscope.

Material and methods
Data regarding intra-operative bleeding, postoperative pain, post-operative bleeding, and hospital stay were collected from the medical records of the paediatric patients undergoing coblation tonsillectomy with or without microscope assistance during the preceding five years, from January 2014 to February 2019.

Results
A total of 394 children participated in this study. Out of the 394, 212 paediatric patients underwent coblation tonsillectomy under an operating microscope, and 182 underwent coblation tonsillectomy under a headlight. There was no significant difference between the two groups in terms of duration of surgery among coblation tonsillectomy with or without a microscope. The incidence of primary haemorrhage, reactionary haemorrhage, and secondary haemorrhage were significantly reduced in the case of microscope-assisted coblation tonsillectomy than direct tonsillectomy with the help of just a headlight. Pain scores and hospital stay are significantly reduced with microscope-assisted coblation tonsillectomy.

Conclusions
Microscope-assisted coblation tonsillectomy reduces the intra-operative and post-operative haemorrhage, post-operative pain, and length of hospital stay, thus helping in early improvement of the patient. The overall advantages of microscope-assisted coblation tonsillectomy compared to coblation tonsillectomy under just a headlight are the following: reduced intra- and post-operative bleeding, better safety, precision of tonsil removal, and less injury to the adjacent tissues. For these reasons, microscope-assisted coblation tonsillectomy in children is recommended as a safe and effective method for tonsillectomy.