Lupine Publishers | Journal of Otolaryngology
Abstract
Methods
RF Tonsillectomy
Exposing the tonsil on either side, the To-bite radiofrequency forceps or the RF needle was used to incise /open the plane for tonsillar dissection. Dissection was carried out with the same achieving haemostasis at the same time. If properly done bleeding was minimal and pain scores were low post operatively. Fossa deepened and stiffened post operatively. RF setting of 2-3 in cutting mode and 5-6 in coagulation mode was used.RF Adenoidectomy
Can be performed after retracting lower edge of the palate with tongue depressors or tourniquets and coagulating the adenoid with bipolar forceps, the lower edge of the adenoid can be dissected using RF needle or ball point. Bleeding is negligible and wound heals well. There was no case of postoperative haemorrhage. Ideal for recurrent adenoids. RF setting of 5-6 in the coagulation mode.RF Palate
It is temperature controlled RF volumetric reduction of the palate in order to stiffen or scar the soft palate. The Sutter RF bipolar probe is used to deliver energy to the soft palate at various points. Blanching has to be avoided. The subsequent stiffening occurs over 6 weeks. It was done under local anaesthesia as an outpatient procedure with no bleeding and low pain scores. Subjective decrease in snoring was achieved even in one sitting.RF Tongue Base
It is temperature controlled volumetric tongue base reduction by giving RF energy to multiple sites of post tongue base with Sutter RF bipolar forceps [2]. Three sittings of reduction gave a significant reduction in tongue base tissue. There was no incidence of tongue base oedema or infection. The procedure could be done under local or general anaesthesia.RF UP3
It is achieved by uvular and periuvular lateral cuts and trimming of lower edge soft palate with rf in cutting mode and subsequent suturing and tonsillectomy with pillar suturing. The postoperative widening contracture /stiffening helps in achieving a good result.RAUP
For snoring is done by uvular and lateral cuts and redefining the post pillars. Tonsillectomy may be combined. It achieves its result due to removal of the redundant mucosa and subsequent healing with fibrosis. Subjective decrease in snoring is achieved by most patients. RF is used in the cutting mode.Result (Table 1)
Table 1:
Discussion
Conclusion
a) Ability to cut fast and maintain a relatively bloodless field.
b) Ability to cut and coagulate at various settings.
c) Decrease intraoperative blood loss.
d) Induces fibrosis and stiffening of tissues.
e) Decrease postoperative pain.
Other Advantages
a) The instrument /unit appears dynamic with a good unique feel.b) Procedures can be performed under local / gen. Anaesthesia.
c) Instruments are autoclavable/recurring cost is lower.
d) Machine is ambulatory.
e) Minimally invasive.
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