The Efficacy of Radiofrequency in Tonsillectomy Procedures: A Comprehensive Systematic Review
Keywords:
Radiofrequency tonsillectomy, postoperative outcomes, surgical efficacyAbstract
Background: Tonsillectomy, a common surgical procedure, has seen advancements in radiofrequency (RF) technology, aiming to improve postoperative outcomes by reducing intraoperative bleeding, postoperative pain, and recovery time. However, the efficacy of RF in tonsillectomy remains a topic of ongoing research, requiring further evaluation for optimal patient care. Methods: This systematic review adhered to PRISMA 2020 principles and focused exclusively on full-text papers published in English between 2015 and 2025. Editorials and review articles without a DOI were omitted to preserve the integrity of high-quality sources. A literature review was conducted utilizing esteemed databases like ScienceDirect, PubMed, and SagePub to discover relevant studies. Result: The preliminary database search yielded over 500 relevant publications on the topic. Following a comprehensive three-stage screening process, eight papers met the specified inclusion criteria and were selected for in-depth analysis. Each study underwent a comprehensive critical assessment, enabling a thorough understanding of the efficacy of radiofrequency in tonsillectomy procedures. This methodical method guaranteed that the analysis relied on high-quality evidence, corresponded with the study's aims, and was capable of producing substantial insights into this intricate relationship. Conclusion: Radiofrequency tonsillectomy is a surgical technique that enhances postoperative comfort, reduces risks, and supports faster return to normal activity. However, long-term outcomes and recurrence rates require further exploration. Standardized protocols for radiofrequency tonsillectomy are essential for improving patient outcomes and redefining otolaryngologic surgery standards.
References
Bohr C, Shermetaro C. Tonsillectomy and Adenoidectomy. [Updated 2023 Jun 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK536942/
Wetmore R. F. (2017). Surgical management of the tonsillectomy and adenoidectomy patient. World journal of otorhinolaryngology - head and neck surgery, 3(3), 176–182. https://doi.org/10.1016/j.wjorl.2017.01.001
Dorkar, S. N., Nilakhe, S. S., & A L, S. (2025). A Comparative Study of Patients Undergoing Tonsillectomy Using the Cold Steel Dissection Method and Electrocautery Technique. Cureus, 17(2), e79724. https://doi.org/10.7759/cureus.79724
Ihnát, P., Ihnát Rudinská, L., & Zonča, P. (2014). Radiofrequency energy in surgery: state of the art. Surgery today, 44(6), 985–991. https://doi.org/10.1007/s00595-013-0630-5
De Vita, E., Lo Presti, D., Massaroni, C., Iadicicco, A., Schena, E., & Campopiano, S. (2023). A review on radiofrequency, laser, and microwave ablations and their thermal monitoring through fiber Bragg gratings. iScience, 26(11), 108260.
Tunthanathip, A., & Wongwattana, P. (2022). Radiofrequency Versus Electrocautery in Pediatric Tonsillectomy: A Double-Blind, Randomized Controlled Trial. Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 74(Suppl 3), 5616–5623. https://doi.org/10.1007/s12070-021-02950-w
Lee, Y. C., Hsin, L. J., Lin, W. N., Fang, T. J., Tsai, Y. T., & Luo, C. M. (2020). Adolescents and Adults Undergoing Temperature-Controlled Surgical Instruments vs Electrocautery in Tonsillectomy: A Systematic Review and Meta-analysis of Randomized Clinical Trials. JAMA otolaryngology-- head & neck surgery, 146(4), 339–346. https://doi.org/10.1001/jamaoto.2019.4605
Tschopp, S., Azalmad, K., & Tschopp, K. (2023). Tonsil volume and outcome of radiofrequency uvulopalatoplasty with or without tonsillectomy in adults with sleep-disordered breathing. European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 280(6), 3005–3013. https://doi.org/10.1007/s00405-023-07914-0
Mitchell, R. B., Archer, S. M., Ishman, S. L., Rosenfeld, R. M., Coles, S., Finestone, S. A., Friedman, N. R., Giordano, T., Hildrew, D. M., Kim, T. W., Lloyd, R. M., Parikh, S. R., Shulman, S. T., Walner, D. L., Walsh, S. A., & Nnacheta, L. C. (2019). Clinical Practice Guideline: Tonsillectomy in Children (UPdate). Otolaryngology, 160(S1). https://doi.org/10.1177/0194599818801757
Kucur, C., Ozbay, I., Oghan, F., Yildirim, N., Sivas, Z. Z., & Kabay, S. C. (2015). A rare complication of radiofrequency tonsil ablation: Horner syndrome. Case Reports in Otolaryngology, 2015, 1–3. https://doi.org/10.1155/2015/570520
Ozkull, M. H., Bayram, O., Balikci, H. H., Karakas, M., Bayram, A. A., Gurdal, M. M., & Chatzi, T. (2015). Impedance-controlled radiofrequency vs. cold dissection tonsillectomy. PubMed, 10(4), 285–289. https://pubmed.ncbi.nlm.nih.gov/25654952
Kumar, S., Padiyar, B. V., & Rai, A. K. (2018). Cold Dissection Tonsillectomy and Radiofrequency Tonsil Ablation: A Prospective Comparative study. Dubai Medical Journal, 1(1–4), 6–12. https://doi.org/10.1159/000493513
Elsherif, H. S., & Elzayat, S. (2020). Bipolar radiofrequency (RF) in Pediatric Tonsillectomy: a Prospective Controlled study. International Journal of Otolaryngology and Head &Amp Neck Surgery, 09(04), 124–132. https://doi.org/10.4236/ijohns.2020.94016
Prussin, A. J., Babajanian, E., Error, M., Grimmer, J. F., Ku, J., McRae, B., Meier, J., Thiesset, H., & Skirko, J. R. (2021). Radiofrequency Ablation vs Electrocautery Blinded Randomized Trial: Impact on Clinically Meaningful Outcomes. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 164(6), 1186–1192. https://doi.org/10.1177/0194599820964737
Cai, F., Hong, W., Ye, Y., & Liu, Y. (2022). Comparative systematic review and meta-analysis of the therapeutic effects of coblation tonsillectomy versus electrocautery tonsillectomy. Gland Surgery, 11(1), 175–185. https://doi.org/10.21037/gs-21-832
Karthikeyan, P., Govindarajan, A., & Rasmika, K. (2022). Review of Radiofrequency Ablation in Tonsillectomy. Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 74(Suppl 3), 5008–5011. https://doi.org/10.1007/s12070-021-02626-5
Virkkunen, J., Nokso-Koivisto, J., & Sakki, A. J. (2024). Long-term effectiveness of tonsillotomy versus tonsillectomy: A 12-year follow-up study. European Archives of Oto-Rhino-Laryngology. https://doi.org/10.1007/s00405-024-09000-5
Hong, S. M., Cho, J. G., Chae, S. W., Lee, H. M., & Woo, J. S. (2013). Coblation vs. Electrocautery Tonsillectomy: A Prospective Randomized Study Comparing Clinical Outcomes in Adolescents and Adults. Clinical and experimental otorhinolaryngology, 6(2), 90–93. https://doi.org/10.3342/ceo.2013.6.2.90
Pediatric obstructive sleep apnea. (2019). In Georg Thieme Verlag eBooks. https://doi.org/10.1055/b-0039-169071
Mesolella, M., Allosso, S., Coronella, V., Massimilla, E. A., Mansi, N., Motta, G., Salerno, G., & Motta, G. (2023). Extracapsular Tonsillectomy versus Intracapsular Tonsillotomy in Paediatric Patients with OSAS. Journal of personalized medicine, 13(5), 806. https://doi.org/10.3390/jpm13050806
Fornazieri, M. A., Miyazato, E. S., Yamamoto, H. M., de Lima Navarro, P., de Rezende Pinna, F., & Voegels, R. L. (2018). Reducing the exposure of the tonsillar fossa does not impact postoperative pain levels in children undergoing tonsillectomy: A double-blind randomized controlled trial. International journal of pediatric otorhinolaryngology, 111, 63–68. https://doi.org/10.1016/j.ijporl.2018.05.029
Abdel-Aziz, M., Atef, A., Sabry, O. A., Yousef, A. I., Ahmed, A. S., Hussien, A. A., Abdel-Haleem, M., & Samir, A. (2023). Different tonsillectomy techniques in Egypt: advantages and disadvantages — experience and review of literature. The Egyptian Journal of Otolaryngology, 39(1). https://doi.org/10.1186/s43163-023-00493-1
Omrani, M., Barati, B., Omidifar, N., Okhovvat, A. R., & Hashemi, S. A. (2012). Coblation versus traditional tonsillectomy: A double blind randomized controlled trial. Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences, 17(1), 45–50.
Yun, J. H., Jang, J. Y., Shin, Y. S., Kim, H. J., Kim, C. H., & Park, D. Y. (2024). Effect of monopolar diathermy power settings on postoperative pain, wound healing, and tissue damage after tonsillectomy: a randomized clinical trial. Scientific reports, 14(1), 267. https://doi.org/10.1038/s41598-023-50633-z
Stelter K. (2014). Tonsillitis and sore throat in children. GMS current topics in otorhinolaryngology, head and neck surgery, 13, Doc07. https://doi.org/10.3205/cto000110
Burton, M. J., Glasziou, P. P., Chong, L. Y., & Venekamp, R. P. (2014). Tonsillectomy or adenotonsillectomy versus non-surgical treatment for chronic/recurrent acute tonsillitis. The Cochrane database of systematic reviews, 2014(11), CD001802. https://doi.org/10.1002/14651858.CD001802.pub3
Windfuhr J. P. (2016). Indications for tonsillectomy stratified by the level of evidence. GMS current topics in otorhinolaryngology, head and neck surgery, 15, Doc09. https://doi.org/10.3205/cto000136
Mitchell, R. B., Archer, S. M., Ishman, S. L., Rosenfeld, R. M., Coles, S., Finestone, S. A., Friedman, N. R., Giordano, T., Hildrew, D. M., Kim, T. W., Lloyd, R. M., Parikh, S. R., Shulman, S. T., Walner, D. L., Walsh, S. A., & Nnacheta, L. C. (2019). Clinical Practice Guideline: Tonsillectomy in Children (Update)-Executive Summary. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 160(2), 187–205. https://doi.org/10.1177/0194599818807917
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