Indeed, researchers found, there are fewer than 30 articles in the otolaryngology literature on APP, compared with 400 published in the oral and maxillofacial literature.
Explore this issue:April 2016
In the literature that has examined its use, conclusions have been mixed in both fields. Dr. Bensoussan noted that results are hard to compare across studies because of the use of different products and methods. Plus, some of the procedures in which APP has been studied, including functional endoscopic sinus surgery and tonsillectomy, tend to heal well on their own already, making it difficult to show that APP improves healing. “Since we know that the products are safe [and] minimally invasive and that the cost can be minimal if you are in a hospital setting, we believe that otolaryngologists would benefit from learning about these products,” Dr. Bensoussan said.
Further study should include randomized controlled trials studying PRP and PRF separately and carefully analyzing the different methods used to apply or inject the product. She also suggested that research focus on “surgeries for which healing is problematic, such as tympanoplasty or wound healing in diabetic patients, in order to prove superiority of the products.”
Impact of Surgical Technique on Postoperative Pain in Recovery Unit in Pediatric Patients Undergoing Tonsillectomy
Study results presented by Chen Lin, BA, a fourth-year medical student at The Ohio State University in Columbus, examined pain levels after tonsillectomy with coblation compared with electrocautery.
Coblation uses radiofrequency energy, which can ablate tissue at 40 to 70 degrees Celsius, compared with the 400 degrees necessary in electrocautery. Coblation also involves less heat reaching surrounding tissues, which means less thermal damage. The literature has yielded mixed results with respect to pain management, with some studies finding that coblation offers better pain control, while others do not show any significant difference between the methods.
The researchers looked prospectively at children aged 2 to 8 years who underwent tonsillectomy—66 with electrocautery and 117 with coblation. They found no significant difference at any of the time points, which included immediately after the procedure, then at five minutes, 15 minutes, 30 minutes and 60 minutes, but pain scores were lower at most time points, including 60 minutes later. Chen acknowledged that there might have been lingering anesthetic effects, and researchers are now planning to look at pain scores over a longer period. Pain after tonsillectomy is an important element to consider, Chen said. “Pain may play a role in delaying transfer of patients from the recovery unit to the floor or eventual discharge.”