Tonsillectomy is one of the most frequently carried out surgical operations worldwide. Numerous surgical techniques have been recorded and various devices have been developed since Celsus performed the first tonsillectomy in 30 B.c.

The literature describes a variety of tonsillectomy techniques. These include cryosurgery , guillotine, dissection, suction diathermy, bipolar scissor dissection, monopolar and bipolar diathermy dissection, ultrasonic removal, radiofrequency and laser surgery. Any enhancement of these techniques should result in a reduction in operating time, a decrease in intraoperative and postoperative blood loss, and a decrease in postoperative morbidity.

Cold dissection tonsillectomy, also known as dissection tonsillectomy or cold knife technique has been the  standard procedure for decades. Either the electrocautery or the ligation technique is used to achieve the surgical hemostasis. Recently, the new technology known as ‘Coblation tonsillectomy’ has come to light as a potentially appealing option for this procedure. In contrast to electrocautery which cuts tissue at 400⁰C, Coblation  involves passing a radiofrequency bipolar electrical current through a medium of normal saline to create a plasma field of highly ionized particles, which in turn breakdown intercellular bonds and melt tissue at about 70⁰C. There are two methods for doing a coblation tonsillectomy: (1) Subtotal, intracapsular ablation, which may leave some tonsil tissue intact, and (2) Total, subcapsular tonsillectomy, which involves separating the entire tonsil from the surrounding pharyngeal muscle and tonsillar capsule. 

Despite tonsillectomy being the most common and simple surgery, the surgeon is constantly concerned about the high risk of complications, including intra and post-operative haemorrhage, which can even result in shock and death. Because the oropharynx and tonsils have an abundant blood supply, tonsillectomy carries a very high risk of heamorrahge. Following a tonsillectomy, morbidity is significant. It includes both perioperative and postoperative bleeding as well as postoperative pain. Dehydration and extended hospital stay come from the patient’s inability to return to a regular diet due to postoperative pain and difficulty in swallowing.The postoperative pain that might result in decreased oral intake, dehydration, and prolonged reduction in daily activities is the most significant morbidity following adult tonsillectomy. Additionally, pain that limits pharyngeal muscle movement may decrease tonsillar fossa clearance which may lead to infection, which may then result in bleeding. It is believed that the muscle fibers (palatoglossal, palatopharyngeal, and superior pharyngeal constrictor muscle) and nerve endings (Vagus and glossopharyngeal nerves) around the tonsillar bed are damaged and exposed during tonsillectomy surgery, which causes pain. Because of this, it is thought that surgical methods that carefully preserve the peritonsillar plane and prevent harm to the underlying tissues can reduce postoperative pain.

Our study aims to measure the efficacy of coblation method of tonsillectomy against dissection method in terms of operative time, intraoperative blood loss, postoperative pain and postoperative  heamorhage.