OUTCOMES OF RADIOFREQUENCY VERSUS ELECTROCAUTERY TONSILLECTOMY: A SYSTEMATIC REVIEW OF RANDOMIZED CONTROL TRIALS

RESUMO

Ikechukwu Odeh Odeh, Maali Subhi T Alshammari*, Ibrahim Farhan B Alanazi, Daniya Sulaiman A Alanazi, Razan Owaid Alanazi, Shahad Obaid Aldalaan, Munirah Muhammed K Alharthi, Rayan Alhumaidi R Alruwaili, Sarah Mohammad Radwan, Lojain Mohammed A Maawadh, Ghadah Khalid H. Alanazi, Abdulrahman Omar A Alali

Objectives: To compare the postoperative outcomes after radiofrequency and electrocautery tonsillectomy.

Methods: A search across four databases identified 206 publications. After duplicate removal using Rayyan QCRI and relevance screening, 113 full-text articles were reviewed, leading to the inclusion of 4 studies.

Results: We included four studies with a total of 337 patients undergoing tonsillectomy (166 in the radiofrequency group and 171 in the electrocautery group) and more than half of them 197 (58.5%) were males. Radiofrequency and monopolar electrocautery tonsillectomy have similar overall complication rates, pain, and narcotic use. Radiofrequency tonsillectomy results in less blood loss, shorter hospital stays, and reduced early pain, though it may take longer to perform. While radiofrequency carries a higher risk of bleeding, monopolar electrocautery shows more adverse events and medication refills. Major bleeding is rare for both, with slightly more postoperative haemorrhage in monopolar electrocautery. Despite some differences, postoperative discomfort is comparable between the two techniques.

Conclusion: Radiofrequency tonsillectomy reduces blood loss, shortens hospital stays, and lowers postoperative discomfort, making it a favourable option. However, it carries a higher risk of postoperative bleeding, requiring close monitoring. Monopolar electrocautery, despite slightly more adverse events, remains reliable with similar pain outcomes. Clinicians can enhance patient care by choosing the method that best fits individual needs, balancing benefits and risks.