- Design
- Retrospective case series
- Population
- 1,734 children having tonsillotomy with adenoidectomy, 2018–2024
- Primary outcome
- Operating time, postoperative bleeding, revision surgery
- Effect
- Bleeding 1.0% vs 0.9%, OR 1.1 (0.35–3.47); time 22 vs 24 min
This retrospective series from one children's hospital compared 1,734 intracapsular tonsillotomies with adenoidectomy: 385 by coblation (two surgeons) and 1,349 by microdebrider (13 surgeons).
Coblation was slightly quicker (median 22 vs 24 minutes). Postoperative bleeding (1.0% vs 0.9%, OR 1.1, 95% CI 0.35–3.47) and revision surgery (0.5% vs 1.0%) did not differ significantly. Younger age was associated with revision.
Both techniques are safe in experienced hands, and a two-minute difference is unlikely to drive choice. The finding that younger children are more likely to need revision is the more useful point for consent.
- Either coblation or microdebrider is reasonable for intracapsular tonsillotomy on these data.
- Bleeding rates were around 1% with both techniques.
- Mention the higher chance of regrowth and revision when consenting younger children.
- Choose by surgeon experience and equipment cost rather than outcome differences.
Why it matters
It removes a reason to buy new equipment and shifts attention to who needs revision.
Don't overread it
Retrospective, with coblation performed by only two surgeons; pain was not compared.
The statistics, in plain English
The bleeding odds ratio of 1.1 with an interval from 0.35 to 3.47 means the study cannot rule out a meaningful difference either way — events were too few.
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