Intracapsular Partial Tonsillectomy for Tonsillar Hypertrophy in Children

• Published in: The Laryngoscope 2002-08, Vol.112 (S100), p.17-19
• Main Authors: Koltai, Peter J., Solares, C. Arturo, Mascha, Edward J., Xu, Meng
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Case-Control Studies; Child; Child, Preschool; Female; Follow-Up Studies; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics; Humans; Hypertrophy - pathology; Hypertrophy - surgery; Intracapsular tonsillectomy; Male; Medical sciences; microdebrider; Non tumoral diseases; obstructive sleep apnea; Otorhinolaryngology. Stomatology; Pain Measurement; Pain, Postoperative - prevention & control; pediatric; Postoperative Hemorrhage - prevention & control; Probability; Retrospective Studies; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the upper aerodigestive tract; tonsillar hypertrophy; tonsillectomy; Tonsillectomy - methods; Tonsillitis - diagnosis; Tonsillitis - surgery; tonsillotomy; Treatment Outcome; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology
• ISSN: 0023-852X; 1531-4995
• DOI: 10.1002/lary.5541121407

Objective To review our experience with intracapsular tonsillectomy using powered instrumentation in the management of tonsillar hypertrophy causing obstructive sleep‐disordered breathing in children. Study Design Retrospective case series. Methods Intracapsular tonsillectomy, a form of partial tonsillectomy performed with an endoscopic microdebrider, preserves the tonsillar capsule as a barrier to exposure of the pharyngeal muscles. Results in 150 children who underwent this procedure were compared with those in 162 children who had standard tonsillectomy. Results Children who underwent intracapsular tonsillectomy had significantly less pain throughout the recovery period than those who had standard tonsillectomy. There was no significant difference between the two groups in intraoperative blood loss, and no episodes of immediate postoperative bleeding occurred in either group. Six patients who had the standard operation and one patient who had the intracapsular procedure had delayed hemorrhage requiring hospital readmission. Five children in the standard group and one in the intracapsular group were readmitted because of dehydration. Thus, in all, 11 readmissions were necessary among children who underwent standard tonsillectomy, whereas 2 were required among those who had intracapsular tonsillectomy. Conclusion Intracapsular tonsillectomy is as effective as standard tonsillectomy in relieving obstructive sleep‐disordered breathing but produces less postoperative pain and fewer episodes of delayed hemorrhage and dehydration.