Coblation® intracapsular tonsillectomy in children with recurrent tonsillitis: Initial experience

Objectives: The use of Coblation (R) intracapsular tonsillectomy for the treatment of sleep disordered breathing (SDB)/obstructive sleep apnoea (OSA) has an increasing evidence base. However, the results for tonsillitis as the predominant indication for surgery are not as clear. We present our initial results from 80 paediatric cases undergoing Coblation (R) intracapsular tonsillectomy for infective indications. Methods: Prospective case series within the secondary care environment, January 2016-July 2018, all with completed follow-up. We utilised the validated T14 tonsil symptom questionnaire pre-and postoperatively and also collected data regarding postoperative complications. Results: 80 consecutive patients (age range 2-16 years and mean 7.2 years) undergoing Coblation (R) intracapsular tonsillectomy (with or without adenoidectomy) predominantly for infective reasons although some also had concomitant adenoidectomy for snoring/sleep disordered breathing were included. Mean follow-up was at 13 months postoperatively. 38 children had tonsillitis (with or without snoring) and 42 children had SDB in combination with tonsillitis. The mean over-all total T14 score was 32.7 preoperatively and 2.7 postoperatively (p < 0.0001). The mean infective score was 22.1 preoperatively and 1.5 postoperatively (p < 0.0001). The mean SDB score was 10.6 preoperatively and 1.5 postoperatively (p < 0.0001). There were no cases of haemorrhage, re-admission or regrowth noted. Conclusion: Coblation (R) intracapsular tonsillectomy is a safe and effective technique for treating children with recurrent tonsillitis. Future studies should incorporate longer term follow-up.