ADENOTONSILLECTOMY: COMPARISON BETWEEN THE COLD AND HOT METHOD

Abstract

Objective: The present study aims to analyze and compare adenotonsillectomy techniques performed by cold and hot methods, seeking to identify which surgical approach is associated with better clinical outcomes and lower incidence of postoperative complications. Methodology: A systematic review was carried out based on searches in the PubMed and VHL databases using the descriptors "Tonsillectomy" and "hot and cold technique", connected by the Boolean operator AND. Articles from the last five years were included, being systematic reviews, meta-analyses or controlled clinical trials. At the end of the screening, seven articles were analyzed. Results: Among the studies analyzed, it was observed that warm coblation presented better results in relation to pain. On the other hand, radiofrequency and bipolar diathermy showed higher rates of pain and bleeding. The cold technique demonstrated hemostatic safety, but with greater pain intensity. Irrigation with cold water proved to be efficient for pain control. Advanced age and the presence of recurrent tonsillitis were associated with a higher risk of bleeding. Conclusion: The cold technique remains safe for bleeding control, while the hot technique, especially with coblation, can reduce postoperative pain. The choice of technique should consider the patient's clinical profile, seeking a balance between safety and postoperative comfort.