Bipolar tonsillotomy: A novel and effective tonsillotomy technique

Chanan Shaul, Pierre D. Attal, Yehuda Schwarz, Nidal Muhanna, Dvora Izgelov, Uri Peleg, Jean Yves Sichel

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Objective: To present, for the first time, tonsil size reduction using reusable bipolar forceps electrocautery (RBFE), as a treatment for pediatric OSAS and to assess the safety and efficacy of the procedure. Methods: A prospective interventional design study was performed. Thirty children aged 2-15 years with OSAS (AHI > 5) diagnosed by means of polysomnography were included. All children were treated with adenoidectomy and RBFE tonsillotomy without dissection. Re-polysomnography was performed after 1 year. The size of the tonsils was blindly assessed by two ENT specialists and the parents were asked to fill out 'Pediatric Sleep Questionnaires' (PSQ), before surgery, and one month and one year after surgery. Results: There were no complications during or after surgery. There were no events involving postoperative bleeding or dehydration. The surgery mean time, including adenoidectomy, was 20.6 min. The AHI was 10.9 before surgery and decreased to 1.8 after surgery (p < 0.001), minimum saturation (SaO2 min) increased from 86.1% to 93.2% (p < 0.001). The size of the tonsils decreased from a mean of +3.3 before surgery to +1.3 and +1.4 one month and one year after surgery, respectively. The mean of the PSQ scores went down from 23.6 to 5.5 and to 6.2 one month and one year after surgery, respectively. Conclusion: We demonstrated that simple cauterization of the tonsils using a RBFE device with an adenoidectomy is a safe and effective treatment to decrease tonsil size in OSAS. In addition, the method is inexpensive, rapid and does not cause bleeding, which may be particularly interesting in the presence of coagulation problems.

Original languageEnglish
Pages (from-to)1-5
Number of pages5
JournalInternational Journal of Pediatric Otorhinolaryngology
Volume84
DOIs
StatePublished - 1 May 2016
Externally publishedYes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Otorhinolaryngology

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