Comparative study Between intracapsular microdebrider tonsillectomy and extracapsular conventional surgical tonsillectomy

Document Type : Original Article

Authors

1 Assistant professor of Otorhinolaryngology, Faculty of medicine-Beni-Suef University

2 Professor of Otorhinolaryngology Faculty of medicine – Beni-Suef University

3 Police Academy hospital

4 Lecturer of Otorhinolaryngology Faculty of medicine - Beni-Suef University

Abstract

Aim and objectives: Evaluation of the efficacy of intracapsular microdebrider tonsillectomy in comparison to extracapsular conventional surgical tonsillectomy regarding timing, postoperative pain, amount of blood loss, tonsillar fossa healing and complications. Methods: Controlled, prospective, and comparative study was done on 25 patients (14 female and 11 male) aged from 4-12 years old. Those patients received intracapsular microdebrider tonsillectomy on the left side and conventional extracapsular surgical tonsillectomy on the right side. Results: Intracapsular microdebrider tonsillectomy had a significant less pain post tonsillectomy, there was a great difference between the two sides. On our study we did the two techniques on the same person, and this helped us to know the difference between the two techniques in pain on the same body mass index, while we found that no statistically difference between the two techniques in timing, volume of blood loss during operation, wound healing, and complications Conclusions: Intracapsular microdebrider tonsillectomy was comfortable, safe, and effective procedure, we motivate other surgeons to add to our experience with microdebrider intracapsular tonsillectomy.

Keywords

Main Subjects


  1. Harounian, J., Schaefer, E., Schubart, J. and Carr, M. (2016): Pediatric adenotonsillectomy and postoperative hemorrhage: Demographic and geographic variation in the US: International Journal of Pediatric Otorhinolaryngology; 87: 50 54.
  2. Vicini, C., Eesa, M., Hendawy, E. and Pari, M. (2015): Powered intracapsular tonsillotomy vs. conventional extracapsular tonsillectomy for pediatric OSA: A retrospective study about efficacy, complications, and quality of life: International journal of pediatric otorhinolaryngology; 79(7): 1106-1110.
  3. Maddern, R. (2002): Electrosurgery for tonsillectomy: The laryngoscope; 112(S100): 11-13.
  4. Solares, A., Koempel, A., Hirose, K. and Abelson, I. and Reilly, S. (2005): Safety and efficacy of powered intracapsular tonsillectomy in children: a multi-center retrospective case series: International journal of pediatric otorhinolaryngology; 69(1): 21- 26.
  5. Sorin, A., Bent, P., April, M. and Ward, F. (2004): Complications of Microdebrider‐Assisted Powered Intracapsular Tonsillectomy and Adenoidectomy: The Laryngoscope; 114(2):297-300.
  6. Koltai, J., Solares, A., Mascha, J. and Xu, M. (2002): Intracapsular partial tonsillectomy for tonsillar hypertrophy in children: The Laryngoscope; 112(S100): 17- 19.
  7. Wong, D. and Baker, C. (1988): Pain in children: comparison of assessment scales: Pediatr Nurs; 14(1): 9-17.
  8. Derkay, C., Darrow, D., Welch, C. and Sinacori, J. (2006): Post tonsillectomy morbidity and quality of life in pediatric patients with obstructive tonsils and adenoid: microdebrider vs electrocautery: Otolaryngology—Head and Neck Surgery; 134(1): 114-120.
  9. Bitar, M. and Rameh, C. (2008): Microdebrider-assisted partial tonsillectomy: short-and long-term outcomes: European archives of oto-rhinolaryngology; 265(4): 459-463.
  10. Mixson, M., Weinberger, M. and Austin, B. (2007): Comparison of microdebrider subcapsular tonsillectomy to harmonic scalpel and electrocautery total tonsillectomy: American journal of otolaryngology; 28(1): 13-17.
  11. Wilson, Y., Merer, D. and Moscatello, A. (2009): Comparison of three common tonsillectomy techniques: A prospective randomized, double‐ blinded clinical study: The Laryngoscope; 119(1): 162-170.
  12. Sobol, S., Wetmore, R., Marsh, R. and Stow, J. and Jacobs, I. (2006): Postoperative recovery after microdebrider intracapsular or monopolar electrocautery tonsillectomy: a prospective, randomized, single-blinded study: Archives of Otolaryngology–Head & Neck Surgery; 132(3): 270-274.
  13. Koltai, J., Solares, A., Koempel, A. and Hirose, K. and Abelson, T. (2003): Intracapsular tonsillar reduction (partial tonsillectomy): reviving a historical procedure for obstructive sleep disordered breathing in children: Otolaryngology-Head and Neck Surgery; 129(5): 532-538.
  14. Lister, M., Cunningham, M., Benjamin, B. and Williams, M. and Tirrell, A. and Schaumberg, D. and Hartnick, C. (2006): Microdebrider tonsillotomy vs electrosurgical tonsillectomy: a randomized, double-blind, paired control study of postoperative pain: Archives of Otolaryngology–Head and Neck Surgery; 132(6): 599-604.
  15. Cohen, M., Getz, A., Isaacson, G. and Gaughan, J. and Szeremeta, W. (2007): Intracapsular vs. extracapsular tonsillectomy: a comparison of pain: The Laryngoscope; 117(10):1855-1858.
  16. Rubinstein, B. and Derkay, C. (2017): Rethinking surgical technique and priorities for pediatric tonsillectomy: American journal of otolaryngology; 2(38): 233-236.
  17. Schmidt, R., Herzog, A., Cook, S. and O’Reilly, R. and Deutsch, E. and Reilly, J. (2007): Complications of tonsillectomy: a comparison of techniques: Archives of Otolaryngology– Head and Neck Surgery; 133(9): 925-928.
  18. Doshi, H., Rosow, D., Ward, R. and April, M. (2011): Age-related tonsillar regrowth in children undergoing powered intracapsular tonsillectomy: International journal of pediatric otorhinolaryngology; 75(11):1395-1398.
  19. Eviatar, E., Kessler, A., Shlamkovitch, N. and Vaiman, M. and Zilber, D. and Gavriel, H. (2009): Tonsillectomy vs. partial tonsillectomy for OSAS in children—10 years post-surgery follow-up: International journal of pediatric otorhinolaryngology; 73(5): 637-640.