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Novel radio-frequency technology (Coblation) for ear, nose, and throat surgery applications

Traditional radiofrequency devices use extreme heat (400-600 °C) to abruptly vaporize intracellular and extracellular fluids, causing tissue desiccation. On a new front, Coblation presents a unique method of delivering radiofrequency energy for soft tissue removal applications in medicine, including ENT surgery. Coblation involves energizing the ions in conductive fluid (saline), via a bipolar wand, to form a plasma field. The plasma has enough energy to break the tissue’s molecular bonds, creating an ablative path while resulting in minimal thermal penetration (70-90 °C) into surrounding tissue. Epithelial destruction, collateral tissue damage, and wound healing were observed in a rat tongue model. Coblation treated animals had significantly less epithelial destruction and collateral tissue damage, which resulted in less granulation tissue and faster wound healing. Clinical experience with coblation in otolaryngology has been very promising in a variety of situations. Specifically, coblation has been used for tonsillar surgery for total tonsillar excision, subtotal ablation and tonsil channeling with subsequent volume reduction . Clinical studies have shown that coblation has offered significant advantages compared to tradition techniques in each of these applications. In many cases patients operated on using coblation had a reduction of pain and a more rapid return to normal diet and activity. The blend of effective tissue ablation and hemostasis for bleeding that coblation offers may make it useful for most procedures that utilize electrocautery devices at this time.