Objectives: To compare postoperative recovery in children between 4 and 12 years undergoing tonsillectomy, using either coblation tonsillectomy or dissection tonsillectomy with bipolar diathermy haemostasis. Design: A prospective, single blind, randomised controlled trial. Setting: ENT clinic, University Teaching Hospital. Participants: Forty paediatric patients, aged between 4 and 12 years and between 16 and 60 kg in weight with standard indication for tonsillectomy. Methods: Patients were randomly allocated to either coblation tonsillectomy or dissection tonsillectomy groups. Patients, parents, and nurses were blinded for operation method. Parents were asked to fill out a postoperative diary from 1 to 10 days. Main outcome measures: Primary outcomes were scored for postoperative pain, nutrition, activity, and use of analgetics for each of the 10 postoperative days. Secondary outcomes were estimated from the nurses' postoperative data and 10-day follow-up statistics regarding crossing of the two-score limit.Results: The groups were statistically comparable by age, weight and operation type. There was no significant difference in operation time in two groups. Intra-operative bleeding was significantly less in the coblation group. Statistically significant differences between dissection tonsillectomy and coblation tonsillectomy were found in the day when a score of two of five was passed in pain scores (9.6 versus 6.2), nutrition scores (8.9 versus 6.6), activity score (8.4 versus 6.6) and medicine intake (9.4 versus 6.4), We found parallelism, between regression lines, that indicates better postoperative life quality for the coblation tonsillectomy group and approximately 2 days' shorter recovery time. Conclusion: In our pilot study, patients undergoing coblation tonsillectomy reported less pain, quicker return to normal diet, quicker return to normal activity, and less use of analgetics over a 10-day period than patients undergoing dissection tonsillectomy. Our results indicate that the recovery period for coblation tonsillectomy was approximately 2 days shorter and demonstrated less morbidity.Tonsillectomy continues to be one of the most common procedures performed by ENT surgeons in Norway as well as worldwide. The most commonly used techniques in Norway include blunt dissection, guillotine, bipolar diathermy haemostasis, bipolar diathermy scissors and laser. Despite the use of multiple analgesics, postoperative pain and postoperative morbidity remain the major side effects of the operation.Coblation tonsillectomy has not been used routinely in public hospitals in Norway up to now. Coblation (cold ablation) is a relatively new technique in soft tissue surgery. Recently, the use of this new technique in the treatment of snoring, nasal congestion and sleep apnoea has received considerable research interest.Coblation is a bipolar system that involves passing radiofrequency through a medium of normal saline, which results in the production of a plasma field of sodium ions. These ions are able to break down interc...

A comparison was made between polysomnographic recordings and recordings of airflow pressures in the pharynx and respiratory pressures in the esophagus of 10 adult sleeping subjects with differing degrees of apnea. Pressure measurements were obtained by microsensors mounted on a 7F gauge flexible catheter which sited them in the epi-, meso- and hypopharynx and the esophagus. Digitized overnight pressure data were stored on a PC memory card and subsequently displayed for analysis by means of a notebook computer. In 2 patients examination of 200 obstructive, mixed and central apneic events showed no significant differences in recordings of their incidence, duration of classification between polysomnographic and either pharyngeal or esophageal pressure techniques. Onset of apnea was demonstrated with particular clarity by computer integration of the pressure tracings. The multiple pressure sensor method offered a further important advantage in detecting the caudal limits of pharyngeal obstructions by steep elevation of the pressure gradient in the pharyngeal segment between adjacent sensors in which the caudal limit of the obstruction was sited. The multiple pressure sensor technique provided reliable and comprehensive diagnostic information of breathing disorders in sleeping subjects and together with its miniaturized recording equipment the method commends itself as suitable for home monitoring.

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CAUP preceded by site-specific obstruction diagnosis using pressure recording is a well-tolerated outpatient treatment that is well suited for treating SRBD.

Repeatability of sites of obstructive events is influenced by the severity of illness and the degree of upper or lower obstructive predominance. The distribution of sites of obstructive events (classified as mainly "upper"/"lower" or as percent upper obstructive events of all) can be identified with relative confidence in patients who have frequent apneic events (AI > or = 5) or a high degree of upper or lower obstructive predominance and especially in those who have a combination of these two criteria.