Intracapsular versus extracapsular coblation tonsillectomy

Abstract

Objectives: The aim of study is to evaluate and compare between using coblation in intracapsular tonsillectomy (preserving the capsule) and extracapsular tonsillectomy (total). Patients and Methods: The study was conducted on 50 patients with symptomatic tonsillar hypertrophy such as recurrent sore throat, snoring, difficulty of swallowing and recurrent follicular tonsillitis proved by ENT specialist. The study was conducted from February 2022 to December 2022 at the Department of Otorhinolaryngology, Al-Azhar University Hospitals, Cairo, Egypt. Group A formed of 25 patients underwent intracapsular coblation tonsillectomy, and Group B formed of 25 patients underwent extracapsular coblation tonsillectomy. Intraoperative and postoperative blood loss was measured plus time of surgery and postoperative pain. Results: Fifty patient included in our study underwent adenotonsillectomy, 22 patients were males and 28 patients were female. In two groups, (Group A = 25 patients, Group B = 25 patients). Our results show highly statistically significant differences ( p-value < 0.001 ) between studied groups as regard blood loss. According to pain score, VAS in the first 4 days related to Group A was (5.0 ± 2.5) and in Group B was (7.5 ± 1.5) without statistically significant difference. The percentage of normal activity after one week related to Group A was (2.0 ± 1.0) and in Group B was (4.0 ± 2.0) with statistically significant difference. Conclusion: Although the intracapsular coblation tonsillectomy consumes more operative time and intraoperative blood loss than the extracapsular technique, but it had superiority in the diminishing the postoperative pain especially after one week and the complications especially postoperative bleeding and infection.