Cold Meets Heat: A Prospective Comparison of Coblation versus Bipolar Diathermy Tonsillectomy

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Background: Coblation tonsillectomy is increasingly adopted for its purported reduction in postoperative morbidity, yet evidence remains heterogeneous. Objective: To compare postoperative pain, hemorrhage, operative time, and blood loss between coblation and bipolar diathermy tonsillectomy in a balanced cohort. Methods: Forty?eight consecutive patients (24 coblation, 24 diathermy) were prospectively enrolled. Primary outcomes were day?1 pain (VAS), intra?operative blood loss, operative time, primary/secondary hemorrhage. Secondary outcomes included time to normal diet and return to routine activity. Results: Coblation reduced early pain (VAS 4.6???1.2 vs?6.1???1.5), intra?operative blood loss (30???7 mL vs?43???6 mL) and hastened recovery (diet 3.4 vs?5.0 days). Diathermy was 6 minutes faster on average. Hemorrhage rates were comparable (4.2?% each). Conclusion: Coblation offers tangible benefits in patient comfort and convalescence without compromising safety, whereas diathermy retains an edge in surgical speed and widespread familiarity. Large multi?centre trials are warranted to refine patient?centred decision making.

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