Application and Demonstration of Endoscope-assisted Low-temperature Plasma Radiofrequency Ablation Resection of Tonsils

1. Basis for Project Initiation 1.1 Chronic tonsillitis is a common health issue that can significantly impact the patient's quality of life.

Chronic tonsillitis is a common condition in the field of otolaryngology, primarily caused by recurrent episodes of acute tonsillitis that persist and fail to heal, leading to degeneration and necrosis of epithelial cells within the gland. This results in the retention of pathogenic microorganisms and inflammatory exudates, causing blockage of the crypt drainage, which then leads to secondary infections and eventually evolves into chronic inflammation[1]. Clinically, it manifests mainly with symptoms such as frequent colds, discomfort during swallowing, a sensation of something foreign in the throat, dryness in the throat, bad breath, paroxysmal coughing, headaches, and more. In severe cases, it can cause difficulty in breathing, sleep apnea, and even lead to complications like acute nephritis, rheumatic arthritis, heart disease, and scarlet fever, significantly impacting both the physical and mental health of patients, severely affecting their quality of daily life.

1.2 Traditional tonsillectomy is associated with significant trauma and numerous complications, whereas the low-temperature plasma knife causes minimal trauma and offers excellent hemostatic effects.

For chronic tonsillitis patients with recurrent acute tonsillitis, peritonsillar abscess, excessive hypertrophy of tonsils, repeated acute attacks, sleep apnea and neighboring organs involved, surgical treatment is often used in clinic. The surgical methods of tonsillectomy mainly include two categories: one is cold instrument surgery, including traditional tonsillectomy and extrusion; The second is hot instrument surgery, including the application of laser, high-frequency electrotome, low temperature plasma radio frequency surgery. Due to the abundant blood supply of the tonsil, traditional surgery is prone to cause damage and bleeding of arteries and accompanying veins and venous plexus, which affects the surgical field of view and leads to poor hemostatic effect of the wound during the operation, thus prolonging the operation time and affecting the prognosis. Studies have shown that in the process of traditional tonsillectomy, tissues around the knife edge need to be drawn into the sheath, which excessively stretches the tonsils, causing damage to some normal tissues and increasing postoperative pain. In addition, due to insufficient visual field, over-deep resection is likely to result in incomplete intraoperative hemostasis and residual, which is likely to lead to primary postoperative hemorrhage and excessive postoperative pharyngeal activity. It will promote postoperative complications, which is not conducive to postoperative recovery .

With the development of minimally invasive technology, low-temperature plasma radiofrequency ablation has been widely used in various soft tissue surgeries in otorhinolaryngology in recent years, showing advantages such as less trauma, quick postoperative recovery and good prognosis . The application of low-temperature plasma knife in tonsillectomy integrates the functions of surgical cutting, hemostasis and suction, which can clearly separate the tonsil envelope and surrounding tissues, and at the same time draw out blood to clean the wound, thus shortening the operation time and reducing the amount of intraoperative blood loss [15]. The surgical field of view is clear, the damage to the surrounding large blood vessels and muscle tissue is small, and the mechanical damage caused by traditional dissection can be avoided. At the same time, the mucosal tissue of the pharyngeal cavity can be preserved to the maximum extent, which has little impact on the function of the pharyngeal cavity and is conducive to the guarantee of treatment safety. In addition, low-temperature incision wound is more orderly, and can immediately form a protein false film to cover the wound, reduce the stimulation of nerve endings, and help reduce the degree of postoperative pain, so as to promote the early recovery of patients, comprehensively improve the prognosis and improve the quality of life of patients .