Reducing Pain and Complications in Tonsil Surgery

Researchers at the Catholic University of Louvain (UCL) University Hospital at Mont-Godinne (Yvoir, Belgium) randomly assigned 52 adult patients to have one tonsil removed with bipolar radiofrequency (RF) ablation and the other subtotally ablated (intracapsular vaporization of 80-90% of the tonsil) with a carbon dioxide (CO2) laser scanner. Outcome measures included time to treat each tonsil, blood loss, patient-reported pain intensity measured with a visual analog scale, number of days of pain, day of maximum pain, postoperative hemorrhage, and amount of healing two weeks after surgery.

The results of the study by Marc J Remacle, M.D., Ph.D, and colleagues found that both alternatives were more efficient than conventional surgery with regard to pain (three times less), recovery time (six to seven days), bleeding during surgery, and both offered a one-day procedure period. The study was presented at the annual meeting of the American Academy of Otolaryngology - Head and Neck Surgery (AAO-HNSF), held during September 2007 in Washington (DC, USA).

Bipolar radiofrequency ablation works by passing a bipolar radiofrequency current through a medium of normal saline. This creates a plasma field of sodium ions. As the energy is transferred to the tissue, ionic dissociation occurs, which results in vaporization of tissue and coagulation of vessels at low temperatures (60 °C). In carbon dioxide laser ablation, short wavelength energy is transmitted in a focused light beam, vaporizing tonsil tissue in 15-20 minutes.


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