Randomized Controlled Trial Comparing Treatment Outcomes of Monopolar Cautery vs BiZact Total Tonsillectomy in Children

Saturday, September 28, 2024

9:36 AM – 9:42 AM EDT

Location: MBCC, 225

Disclosure(s):

Taylor D. Leavitt, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Anna H. Messner, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Yi-Chun Carol Liu, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Adenotonsillectomy is the second most common pediatric surgery in the United States. Optimizing treatment outcomes, primarily postoperative pain and hemorrhage, is an area of active research. We hypothesized that tonsillectomies performed with the novel BiZact device, a bipolar tissue sealer device, to have better postoperative outcomes than the more traditional method of monopolar cautery.

Methods: This is a single-blinded prospective randomized control trial performed at Texas Children’s Hospital (TCH) between 2021 to 2023. Children aged 3-18 requiring tonsillectomy were randomized into two cohorts: BiZact tonsillectomy (BT) and monopolar cautery tonsillectomy (MCT). Perioperative outcomes including operative time, postoperative pain, and postoperative hemorrhage were recorded. Standard chi-squared analysis was performed between the two groups with statistical significance set at p = 0.05.

Results: A total of 144 patients were recruited in the study with 73 (50.7%) assigned to the MCT treatment group and 71 (49.3%) to the BT group. Mean age was 8.2 years old with 58.5% female. Average time to remove tonsils in the MCT group (519 s) was significantly slower than the BT group (386 s; p = 0.0262). Only 6 patients (4.2%) returned for postoperative pain (3 from each cohort). Another 10 patients (6.9%) had postoperative hemorrhage: 6 from the MCT group and 4 from the BT group (P = 0.3221). Eight (80%) of these patients (4 from each cohort) were taken back to the operating room to achieve hemostasis. Pain scores were found to be statistically lower in the MCT group (p = 0.0075).

Conclusions: The BiZact device is a safe, novel treatment modality for pediatric tonsillectomies. However, patients with BiZact tonsillectomy showed higher pain scores than those with traditional monopolar cautery, in spite of BiZact tonsillectomy being faster than monopolar cautery. Higher powered studies are needed to evaluate the differences between outcomes of BiZact and other treatment methods for pediatric tonsillectomy.

Presenting Author(s)

Taylor D. Leavitt, MD

Resident
Baylor College of Medicine Department of Otolaryngology
Manvel, TX, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

Taylor D. Leavitt, MD

Resident
Baylor College of Medicine Department of Otolaryngology
Manvel, TX, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Senior Author(s)

Ronald J. Vilela, MD

Associate Professor
Texas Children's Hospital/Baylor College of Medicine
Houston, TX, United States

Disclosure information not submitted.

Co-Author(s)

AM

Anna H. Messner, MD

Bobby Alford Endowed Chair in Pediatric Otolaryngology, Chief of Pediatric Otolaryngology
Texas Children's Hospital
Houston, TX, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Sonal V. Saraiya, MD

Associate Professor
Baylor College of Medicine
Houston, TX, United States

Disclosure information not submitted.
MS

Matthew Sitton, MD

Assistant Professor
Texas Children's Hospital, United States

Disclosure information not submitted.
Yi-Chun Carol Liu, MD

Associate Professor
Texas Children's Hospital
Bellaire, TX, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
JC

Jeffrey Carter

Research Assistant
Texas Children's Hospital, United States

Disclosure information not submitted.
KH

Kathleen Hosek

Disclosure information not submitted.
UM

Ugochukwu Madueke

Medical Student Research Assistant
Tulane University, United States

Disclosure information not submitted.