Otolaryngology, ENT Conference

Biography

Mr Sam Khemani is an Otolaryngologist and Clinical Lead at Surrey and Sussex Healthcare NHS Trust in the UK. He has a specialist interest in paediatric ENT and Otology.

He trained at Guys and St Thomas’ Hospital Medical Schools and completed his specialty training in London, working at a number of prestigious surgical centres including University College Hospital, Charing Cross Hospital and the Royal National Throat Nose and Ear Hospital, before being awarded a fellowship in Surgery from the Royal College of Surgeons of England. He also holds a Masters in Surgical Education from Imperial College London.

Mr Khemani is a regular member of the faculty for training international surgeons in the use of coblation for tonsil surgery.

Mr. Jack Faulkner is a Core Surgical Trainee in Otolaryngology in the South East of England. He is currently working at Surrey and Sussex NHS Trust and is a member of Royal College of Surgeons of England.

 

Abstract

Objectives: The use of Coblation intracapsular tonsillectomy has been described for the treatment of sleep disordered breathing (SDB) / obstructive sleep apnoea (OSA).  However, the results for tonsillitis as the predominant indication for surgery are not as clear. We present our initial results from 80 paediatric cases undergoing Coblation intracapsular tonsillectomy for infective indications.

Design: Prospective case series, January 2016- July 2018, all with completed follow-up

Setting: Secondary paediatric otolaryngologic practice

Participants: 80 consecutive patients (age range 2-16 years and mean 7.2 years) undergoing Coblation intracapsular tonsillectomy (with or without adenoidectomy) predominantly for infective reasons although some also had concomitant adenoidectomy for snoring/ sleep disordered breathing.

Main Outcome measures: We utilised the validated T14 tonsil symptom questionnaire pre- and postoperatively and also collected data regarding postoperative complications.

Results: Mean follow-up was at 13 months postoperatively. 38 children had tonsillitis (with or without snoring) and 42 children had SDB in combination with tonsillitis. The mean over-all total T14 score was 32.7 preoperatively and 2.7 postoperatively (p<0.0001). The mean infective score was 22.1 preoperatively and 1.5 postoperatively (p<0.0001). The mean SDB score was 10.6 preoperatively and 1.5 postoperatively (p<0.0001). There were no cases of haemorrhage, re-admission or regrowth noted.

Conclusion: Coblation intracapsular tonsillectomy appears to be a safe and effective technique for treating children with recurrent tonsillitis. Future studies should incorporate longer term follow-up.