Comparative Evaluation of Coblation and Cold-Steel Dissection Tonsillectomy: A Prospective Randomized Study of Intraoperative and Postoperative Outcomes

Background: Tonsillectomy is one of the most frequently performed ENT procedures. Coblation tonsillectomy has been introduced as an alternative to conventional cold-steel dissection with the aim of reducing tissue injury, postoperative pain, and recovery time. Methods: This prospective randomized comparative study was conducted in the Department of Otorhinolaryngology at Sudha Medical College, Kota, Rajasthan, India, over a six-month period from 14 January to 30 June 2026. Fifty patients undergoing elective tonsillectomy were randomly allocated into two groups: Group A underwent conventional cold-steel dissection tonsillectomy (n=25), while Group B underwent coblation tonsillectomy (n=25). Operative time, intraoperative blood loss, postoperative pain using the Visual Analogue Scale (VAS), time to oral intake, hospital stay, and postoperative complications were compared. Results: Baseline demographic characteristics were comparable between the two groups. Coblation tonsillectomy showed significantly shorter operative time (24.5±3.8 vs. 30.8±4.9 minutes; p<0.001), lower intraoperative blood loss (31.4±9.8 vs. 74.6±16.2 mL; p<0.001), and reduced requirement for additional haemostasis (12% vs. 40%; p=0.024). Postoperative pain scores at 24 hours and day 7 were significantly lower in the coblation group (p<0.001). Patients treated with coblation resumed oral intake earlier, returned to a normal diet sooner, and had a shorter hospital stay (all p<0.01). Although postoperative haemorrhage and other complications were numerically lower in the coblation group, the differences were not statistically significant. Conclusion: Coblation tonsillectomy offers superior operative efficiency and improved postoperative recovery compared with conventional cold-steel dissection while maintaining a similar safety profile. It represents an effective and reliable alternative for elective tonsillectomy.