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Hi guys,

Background on me:

I'm a 25 year old guy, and have been recommended by my ENT that I get a tonsillectomy and uvuloplasty for sleep apnea specifically related to recurrent hypopneas. My Apnea + Hypopnea Index (AHI) is 18.9. I used to have frequent tonsillitis in college, but that hasn't been a problem recently. Instead I think all the tonsillitis I got back then left my tonsils large and cryptic (leading to tonsil stones). Another issue I face in addition to the apnea is that I wake up with a sore throat every morning, but I can't tell if the sore throat is coming from my uvula and tonsils vibrating all night from snoring or acid reflux. My ENT said either could be the culprit and wasn't sure which was more likely.

Tonsillectomy techniques:

After I learned I should get the surgery to help with the apnea, I started reading all the horror stories on the message board here mixed in with the occasional positive story. The thing I'm curious about is for these positive and negative experiences, what surgical procedure was used (so coblation vs electrocautery vs scalpel).

What I've learned so far from reading on the internet is that with the Coblation technique, the recovery time is often quicker, less painful, and there is less chance of unintended thermal damage to the surrounding tissue in the mouth, as compared to electrocautery. However, some studies have shown that the rate of secondary bleeding when the scabs come off is greater with Coblation. Electrocautery seems to have the least amount of bleeding, but because of the high heat (400 degrees Celsius I think) that is employed, it can cause unintended tissue damage which means recovery is longer and more painful. Could unintended tissue damage also mean increased scaring resulting in long term complications such as chronic throat irritation and cough? In my paranoid pre-surgery mindset I'm interpreting it that way, but nothing I've read has stated that directly. The final technique that I've seen discussed is with cold steel / scalpel. In this method they cut the tonsils with the scalpel and then cauterize the wound. At least that is how it was described to me by one doctor. On the internet I've read this can be less painful than electrocautery because your not burning everything, but the chance of bleeding is higher.

What has everyone's experience been on here? Whenever I read one of the positive (or should I say less negative) experiences with a tonsillectomy on here, it makes me feel better about getting this surgery done... but then I start to wonder if it just because their surgeon used the coblation technique. For example, I've read zero positive experiences in which the person said they had electrocautery. Similarly, for all the horror stories on here, is it all coming from people who had electrocautery? Or is it just a mixed bag? My current ENT says he uses the electrocautery technique, and I've had trouble finding a surgeon who does coblation... and I want to know if its worthwhile to keep looking for an ENT who uses coblation.

Personally, I'm not that concerned about the level of pain or post operative bleeding, other than how both of those may be correlated to longer term complications related to the tonsillectomy and uvuloplasty such as long term nerve damage in the throat, resulting in a chronic cough and irritation, etc. Other complications I'm scared of are excessive scaring leading to respiratory problems, permanent taste loss, nasily voice, and having constant problems swallowing because things start going up your nose without the uvula.

I should also mention that I saw one article that said in reality it doesn't matter what technique is used, what instead is important is how skilled the surgeon is. Hopefully this thread will help shed light on whether the technique in fact doesn't matter.

Thanks for any and all advice and information!!!


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