Bipolar tonsillotomy: A novel and effective tonsillotomy technique

作者：Shaul Chanan^*; Attalal Pierre D; Schwarz Yehuda; Muhanna Nidal; Izgelov Dvora; Peleg Uri; Sichel Jean Yves

来源：International Journal of Pediatric Otorhinolaryngology, 2016, 84: 1-5.

DOI：10.1016/j.ijporl.2016.02.012

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 (SaO(2) 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.

• 出版日期2016-5