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<p>Adenotonsillectomy is a common pediatric surgical procedure for airway obstruction&#xa0;and recurrent infections. While improvements in airway patency following surgery are&#xa0;well documented, the comparative impact of different surgical techniques—particularly&#xa0;coblation versus cold steel dissection—on objective acoustic voice parameters in&#xa0;children remains underexplored.&#xa0;To compare postoperative changes in fundamental frequency (F0), jitter, shimmer, and&#xa0;harmonics-to-noise ratio (HNR) following coblation and cold steel adenotonsillectomy&#xa0;in children aged 5–10 years.&#xa0;This prospective randomised comparative study was conducted over 18 months in a&#xa0;tertiary care hospital in Western Maharashtra after ethics approval. Forty children aged&#xa0;5–10 years with adenotonsillar hypertrophy were randomly allocated to two equal&#xa0;groups: coblation adenotonsillectomy and cold steel adenotonsillectomy. Voice&#xa0;samples of sustained vowels (/a/, /i/, /u/) were recorded preoperatively, and at 1 and 3&#xa0;months postoperatively using Voice software. Acoustic parameters (F0, jitter, shimmer,&#xa0;and HNR) were analyzed using SPSS v26. Independent t-tests compared intergroup&#xa0;differences, with <i>p</i> &lt; 0.05 considered significant.&#xa0;Baseline demographic and vocal parameters were comparable between groups. At 1&#xa0;month post-surgery, no significant intergroup differences were observed, likely due to&#xa0;transient postoperative edema. At 3 months, the coblation group demonstrated&#xa0;significantly higher F0 for vowels /a/ (272.85 Hz vs. 255.45 Hz, <i>p</i> &lt; 0.01), /i/ (283.25 Hz&#xa0;vs. 256.35 Hz, <i>p</i> &lt; 0.05), and /u/ (306.00 Hz vs. 269.90 Hz, <i>p</i> &lt; 0.01). HNR also improved&#xa0;significantly for vowels /i/ (25.43 dB vs. 23.38 dB, <i>p</i> = 0.015) and /u/ (25.70 dB vs. 24.39&#xa0;dB, <i>p</i> = 0.048), with a near-significant improvement for /a/ (<i>p</i> = 0.060), indicating&#xa0;enhanced vocal clarity. Jitter and shimmer showed no significant differences,&#xa0;suggesting preserved vocal fold stability across both techniques.&#xa0;Coblation adenotonsillectomy yielded superior improvement in fundamental frequency&#xa0;and harmonics-to-noise ratio compared to cold steel dissection at 3 months&#xa0;postoperatively, indicating better pitch control and voice clarity. These findings support&#xa0;coblation as a favorable technique for preserving and enhancing voice quality in&#xa0;pediatric patients, though larger multicenter studies with longer follow-up and&#xa0;perceptual voice assessments are warranted to confirm these outcomes.</p>

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Coblation Versus Cold Steel Adenotonsillectomy—Unravelling the Impact on Children’s Voice: A Pilot Randomised Comparative Study

  • 期刊论文

  • 发表日期：

    2026年3月17日

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  • Kamalpreet Singh,
  • Shanmugadevi,
  • Poonam Raj,
  • Vikas Gupta,
  • Anandita Gupta,
  • Salil Kumar Gupta,
  • Kiran Upadhayay,
  • Rahul Kurkure,
  • Meenakshi Rajput,
  • Sreejith

摘要

Adenotonsillectomy is a common pediatric surgical procedure for airway obstruction and recurrent infections. While improvements in airway patency following surgery are well documented, the comparative impact of different surgical techniques—particularly coblation versus cold steel dissection—on objective acoustic voice parameters in children remains underexplored. To compare postoperative changes in fundamental frequency (F0), jitter, shimmer, and harmonics-to-noise ratio (HNR) following coblation and cold steel adenotonsillectomy in children aged 5–10 years. This prospective randomised comparative study was conducted over 18 months in a tertiary care hospital in Western Maharashtra after ethics approval. Forty children aged 5–10 years with adenotonsillar hypertrophy were randomly allocated to two equal groups: coblation adenotonsillectomy and cold steel adenotonsillectomy. Voice samples of sustained vowels (/a/, /i/, /u/) were recorded preoperatively, and at 1 and 3 months postoperatively using Voice software. Acoustic parameters (F0, jitter, shimmer, and HNR) were analyzed using SPSS v26. Independent t-tests compared intergroup differences, with p < 0.05 considered significant. Baseline demographic and vocal parameters were comparable between groups. At 1 month post-surgery, no significant intergroup differences were observed, likely due to transient postoperative edema. At 3 months, the coblation group demonstrated significantly higher F0 for vowels /a/ (272.85 Hz vs. 255.45 Hz, p < 0.01), /i/ (283.25 Hz vs. 256.35 Hz, p < 0.05), and /u/ (306.00 Hz vs. 269.90 Hz, p < 0.01). HNR also improved significantly for vowels /i/ (25.43 dB vs. 23.38 dB, p = 0.015) and /u/ (25.70 dB vs. 24.39 dB, p = 0.048), with a near-significant improvement for /a/ (p = 0.060), indicating enhanced vocal clarity. Jitter and shimmer showed no significant differences, suggesting preserved vocal fold stability across both techniques. Coblation adenotonsillectomy yielded superior improvement in fundamental frequency and harmonics-to-noise ratio compared to cold steel dissection at 3 months postoperatively, indicating better pitch control and voice clarity. These findings support coblation as a favorable technique for preserving and enhancing voice quality in pediatric patients, though larger multicenter studies with longer follow-up and perceptual voice assessments are warranted to confirm these outcomes.