Bipolar Tonsillotomy Shows Faster Recovery and Lower Morbidity than Cold Dissection Tonsillectomy: A Comparative Study in Pediatric Patients

Abstract This prospective observational study compared postoperative outcomes between bipolar tonsillotomy (TT) and cold dissection tonsillectomy (TE) in 368 pediatric patients (198 TE, 170 TT) undergoing tonsil surgery between April 2023 and August 2025 for sleep-disordered breathing or recurrent tonsillitis. Postoperative pain (Visual Analog Scale), oral intake, complications, and OSA-18 scores were assessed with multivariate logistic regression analysis adjusting for age and gender. Mean follow-up was 6 months. TT demonstrated significantly better short-term outcomes across multiple domains. Pain duration was 43% shorter (4.2 vs. 7.4 days, p 0.05). Reoperation was required in 7.05% of TT patients during follow-up. These findings demonstrate that bipolar tonsillotomy offers substantial advantages over tonsillectomy in pediatric patients, including reduced postoperative morbidity, faster recovery, and comparable improvement in sleep-disordered breathing symptoms, representing a safe and effective alternative for selected pediatric patients, particularly those with sleep-disordered breathing.