Dr Paulose

Tonsillectomy remains one of the most common childhood surgeries with an increasing number of the surgeries being done to treat obstructive sleep apnea or sleep disordered breathing. In children, untreated obstructive sleep apnea and sleep disordered breathing can result in failure to thrive and behavior and learning problems.

Tonsillectomy in Children

Children diagnosed with sleep apnea and recurrent chronic tonsillitis must have their tonsils removed, Coblation-assisted intracapsular / subcapsular technique results in less post-operative pain and a quicker return to normal eating and activity than the traditional dissection method. Both Tonsils and Adenoid can be easily removed by Coblation method.

What is Coblation Technique?

Coblation is a non-heat driven process in which radiofrequency energy is applied to a conductive medium (usually saline) causing a highly focused plasma field to form around the electrodes.

The plasma field is comprised of highly ionized particles. These ionized particles have sufficient energy to break organic molecular bonds within tissue. Instead of exploding tissue, Coblation causes a low temperature molecular disintegration, resulting in minimal tissue damage to surrounding areas.

It is performed by disposable surgical wands by forming an ionized focused plasma field which has enough energy to cause molecular disintegration on the applied tissue without the heat of the process being transmitted to the surrounding tissue. The plasma field is generated by the bipolar radiofrequency current as it acts on the saline which flows through the surgical wand and is the key to the Coblation effect.

One of the advantages of Coblation technique is that there is less thermal or heat damage to the surrounding healthy tissue as the temperature is only around 40 to 70°C which further results in less pain. Also the bleeding is less as it has focused coagulation.

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Advantages of Coblation over Laser Tonsillectomy

• Significantly less pain and less frequent use of narcotic analgesics
• Significantly faster return to normal diet (2-4 days)
• Less incidence of postoperative nausea and throat swelling
• Less depth of thermal adjacent tissue necrosis
• No Fire Hazard
• Can reduce base of Tongue

Adult Tonsillectomy

Adults with chronic fibrotic, buried tonsils are not easy to be removed by Coblator device. Traditional method is easy and less time consuming. Partial tonsillectomy can be done to improve the airway in OSA-Snoring patients, using Coblator.