Powered intracapsular tonsillectomy: for pediatric tonsillar hypertrophy

摘要

Objective: To introduce a new technique, "intracapsular" tonsillectomy for the management of tonsillar hypertrophy causing obstructive sleep disordered breathing in children. Design: Retrospective case series, comparing 150 children who had intracapsular tonsillectomy (Group 1) with 162 children who had standard tonsillectomies (Group 2). Method: Intracapsular tonsillectomy is a form of "partial" tonsillectomy performed with an endoscopic microdebrider. It is based on the principle of preserving the tonsillar capsule as a barrier to exposure of the pharyngeal musculature, preventing their injury and inflammation. Results: Children with intracapsular tonsillectomy (Group 1) had significantly less post-operative pain throughout their recovery compared with the children who had standard tonsillectomy (Group 2). There was one episode of delayed hemorrhage in Groups 1 and 6 episodes of delayed hemorrhage in Group 2. Conclusion: Intracapsular tonsillectomy is equally effective in relieving obstructive sleep disordered breathing as standard tonsillectomy, but results in less post-operative pain and less delayed hemorrhage.