Sept. 19, 2003 -- An electronic probe may soon replace the scalpel in treating tonsillitis and may put a major dent in lime gelatin orders at hospital cafeterias.
A new study shows a radiofrequency treatment currently used to reduce enlarged tonsils associated with obstructive sleep apnea, a sleep disorder associated with snoring, may also be a safe and effective alternative to traditional tonsillectomy for treating people with chronic sore throats or tonsillitis.
Researchers say more than 400,000 tonsillectomies are performed each year, making it one of the most commonly performed surgical procedures. Despite its popularity, conventional tonsillectomy techniques have changed little in the past 50 years, and the procedure is known for producing a lot of postoperative pain that requires a long recovery time.
The electronic alternative treatment involves using a blunt-tipped probe that delivers a low-temperature dose of radio waves to the tonsils to promote shrinkage. Because the procedure doesn't create an open wound as in traditional tonsillectomy, there is less postoperative pain and less recovery time. And in most cases, the patient doesn't require anesthesia.
More Waves, Less Pain
In the first major test of the radiofrequency technique in treating people with persistent sore throats, researchers studied the effectiveness of the procedure on 85 patients.
Twelve of the patients were children between the ages of 4 and 12 years, and the rest were adults with an average age of 32. All of the patients were recommended for tonsillectomy because of persistent tonsillitis, obstructive sleep apnea, or enlarged tonsils.
The results are to be presented at the American Academy of Otolaryngology Head and Neck Surgery Annual Meeting in Orlando.
Overall, researchers found 92% of the patients treated with the new technique had an improvement in tonsil-related symptoms, and most said they would undergo the procedure again and would recommend it to friends.
After about 13 months of follow-up, 78 of the patients had a significant reduction in sore throats, number of tonsillitis episodes, use of antibiotics, and a reduction in snoring and sleep apnea symptoms.
Tonsil size was reduced in all patients, and both the patients and doctor noted that the initial effects of the treatment began to emerge about two weeks after the procedure. Shrinkage of the tonsils continues for up to nine months in some patients.
All patients were given narcotic pain relievers after the procedure, but the vast majority of patients switched to nonprescription pain relievers, such as Tylenol or Motrin, within the first 24 to 48 hours after treatment.
No bleeding or other major complications were reported. Eleven of the patients required anesthesia during the procedure, including three patients that had to be re-treated.
Researchers say the results suggest further research on the use of radiofrequency as an alternative to tonsillectomy is needed. Future studies should directly compare the safety and effectiveness of the two treatments in treating tonsillitis.