The efficacy of carbon dioxide laser applications in tonsillectomy: systematic review.

BACKGROUND: Tonsillectomy is a common surgical procedure used to treat chronic tonsillitis, obstructive sleep apnoea, recurrent or chronic tonsillitis and Peritonsillar abscesses. Traditional methods like cold steel dissection and electrocautery are effective but often associated with significant bleeding, pain, and prolonged recovery. Carbon dioxide (CO₂) laser-assisted tonsillectomy offers a precise, haemostatic alternative with potential advantages in reducing surgical trauma. PURPOSE: This systematic review evaluates the clinical efficacy and safety of CO₂ laser tonsillectomy compared to conventional surgical techniques. METHODS: A comprehensive search of PubMed, Embase, Scopus, and the Cochrane Library was conducted following PRISMA 2020 guidelines. Ten studies comparing CO₂ laser tonsillectomy with traditional approaches were included. Key outcomes assessed were intraoperative blood loss, postoperative pain, operative time, healing, complications, and patient satisfaction. RESULTS: CO₂ laser tonsillectomy showed reduced intraoperative bleeding and, in many cases, lower postoperative pain and faster recovery. Operative times were sometimes longer, and partial tonsillotomy carried a risk of symptom recurrence. The laser method was especially beneficial for adults and patients unsuitable for general anaesthesia. CONCLUSIONS: CO₂ laser tonsillectomy is a safe and effective alternative to traditional methods, particularly in select patient groups. While it offers advantages in recovery and haemostasis, further research is needed to confirm long-term outcomes and optimize surgical protocols.