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<p>This prospective observational study compared postoperative outcomes between bipolar tonsillotomy (TT) and cold dissection tonsillectomy (TE) in 368 pediatric patients (198 TE, 170 TT) undergoing tonsil surgery between April 2023 and August 2025 for sleep-disordered breathing or recurrent tonsillitis. Postoperative pain (Visual Analog Scale), oral intake, complications, and OSA-18 scores were assessed with multivariate logistic regression analysis adjusting for age and gender. Mean follow-up was 6 months. TT demonstrated significantly better short-term outcomes across multiple domains. Pain duration was 43% shorter (4.2 vs. 7.4 days, <i>p</i> &lt; 0.001, Cohen’s d = 1.84), and patients returned to normal diet 5.7 days earlier (<i>p</i> &lt; 0.001). Hospital readmission rate was 68% lower with TT (5.29% vs. 16.66%, <i>p</i> &lt; 0.001; number needed to treat [NNT] = 9). Total bleeding occurred in 12.94% of TT vs. 30.30% of TE patients (<i>p</i> &lt; 0.001), with no TT patients requiring surgical intervention compared to 2.02% of TE patients (<i>p</i> &lt; 0.05). Multivariate regression confirmed surgical technique as an independent predictor of outcomes (odds ratio = 0.34, 95% confidence interval: 0.18–0.65, <i>p</i> &lt; 0.001). OSA-18 scores improved significantly in both groups (TT: 73.47 to 46.71; TE: 77.17 to 41.21) with no intergroup difference (<i>p</i> &gt; 0.05). Reoperation was required in 7.05% of TT patients during follow-up. These findings demonstrate that bipolar tonsillotomy offers substantial advantages over tonsillectomy in pediatric patients, including reduced postoperative morbidity, faster recovery, and comparable improvement in sleep-disordered breathing symptoms, representing a safe and effective alternative for selected pediatric patients, particularly those with sleep-disordered breathing.</p>

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Bipolar Tonsillotomy Shows Faster Recovery and Lower Morbidity than Cold Dissection Tonsillectomy: A Comparative Study in Pediatric Patients

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月8日

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  • Çağlar Günebakan,
  • Fatih Çelenk,
  • Selçuk Kuzu,
  • Orhan Kemal Kahveci,
  • Abdulkadir Bucak,
  • Erkan Yıldız,
  • Hüseyin Ruhullah Ercan,
  • Murat Akın

摘要

This prospective observational study compared postoperative outcomes between bipolar tonsillotomy (TT) and cold dissection tonsillectomy (TE) in 368 pediatric patients (198 TE, 170 TT) undergoing tonsil surgery between April 2023 and August 2025 for sleep-disordered breathing or recurrent tonsillitis. Postoperative pain (Visual Analog Scale), oral intake, complications, and OSA-18 scores were assessed with multivariate logistic regression analysis adjusting for age and gender. Mean follow-up was 6 months. TT demonstrated significantly better short-term outcomes across multiple domains. Pain duration was 43% shorter (4.2 vs. 7.4 days, p < 0.001, Cohen’s d = 1.84), and patients returned to normal diet 5.7 days earlier (p < 0.001). Hospital readmission rate was 68% lower with TT (5.29% vs. 16.66%, p < 0.001; number needed to treat [NNT] = 9). Total bleeding occurred in 12.94% of TT vs. 30.30% of TE patients (p < 0.001), with no TT patients requiring surgical intervention compared to 2.02% of TE patients (p < 0.05). Multivariate regression confirmed surgical technique as an independent predictor of outcomes (odds ratio = 0.34, 95% confidence interval: 0.18–0.65, p < 0.001). OSA-18 scores improved significantly in both groups (TT: 73.47 to 46.71; TE: 77.17 to 41.21) with no intergroup difference (p > 0.05). Reoperation was required in 7.05% of TT patients during follow-up. These findings demonstrate that bipolar tonsillotomy offers substantial advantages over tonsillectomy in pediatric patients, including reduced postoperative morbidity, faster recovery, and comparable improvement in sleep-disordered breathing symptoms, representing a safe and effective alternative for selected pediatric patients, particularly those with sleep-disordered breathing.