Different Tonsillectomy Techniques: Our Experience

Abstract

Aim of the study: This study investigates how different tonsillectomy techniques, including the cold steel method, coblation technique, and a device using ultrasonic energy, affect patients’ recovery, specifically pain management. Each technique was compared postoperatively using the visual analogue scale, and the study assessed whether the different techniques increased the risk of revision surgery during the short and long postoperative periods.

Methods: Sixty patients were assigned to three groups, with 20 patients in each group (cold steel, coblation, and harmonic ultrasonic scalpel). Patients underwent adenotonsillectomy under general anesthesia using these techniques from November 2024 to July 2025. On the seventh postoperative day, a regular check-up was performed to evaluate pain management using the visual analogue scale. Before surgery, parents of minor children completed the T-14 questionnaire (Throat Disorder Outcome Test), a parent-reported tool used to assess the primary indication for tonsillectomy and adenoidectomy in children.

Results: The study included 60 patients, comprising 26 males (43%) and 34 females (57%). Most patients who experienced postoperative hemorrhage had been operated on with the cold steel method, while there was no statistically significant difference in complications between the ultrasound knife and coblation technique. Visual Analogue Scale (VAS) scores were statistically significantly higher among patients operated on with the cold steel method compared to those who underwent coblation or ultrasound knife procedures.

Conclusion: Both the harmonic scalpel and coblation techniques for tonsillectomy result in better pain management within the first postoperative week, allowing for an earlier return to everyday activities.

Keywords: tonsillectomy, adenoidectomy, pain, tonsillitis, OSA