Intracapsular partial tonsillectomy for tonsillar hypertrophy in children.
OBJECTIVE
To review our experience with intracapsular tonsillectomy using powered instrumentation in the management of tonsillar hypertrophy causing obstructive sleep-disordered breathing in children.


METHODS
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.


CONCLUSIONS
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.
Koltai
Peter J
PJ
Section of Pediatric Otolaryngology, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. koltaip@ccf.org
Solares
C Arturo
CA
Mascha
Edward J
EJ
Xu
Meng
M
D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006984:Hypertrophy / Q000473:pathology / Q000601:surgery; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control; D019106:Postoperative Hemorrhage / Q000517:prevention & control; D011336:Probability; D012189:Retrospective Studies; D014068:Tonsillectomy / Q000379:methods*; D014069:Tonsillitis / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome