Randomized, controlled, multisite study of intracapsular tonsillectomy using low-temperature plasma excision.
OBJECTIVE
To determine the efficacy of intracapsular tonsillectomy using low-temperature plasma excision for improving the quality of the postoperative experience and for treating obstructive symptoms through 12 months postoperatively.


METHODS
Prospective, randomized, controlled, single-blind study.


METHODS
Multiple private or institutional otolaryngology clinics.


METHODS
Fifty-five children (aged 3-12 years) with obstructive tonsillar hypertrophy.


METHODS
Patients were randomly assigned and blinded to undergo either intracapsular tonsillectomy using low-temperature plasma excision (n = 27) or total tonsillectomy using conventional electrosurgery (n = 28).


METHODS
Operative data, 14-day recovery variables, and obstructive symptoms were prospectively collected through 12 months.


RESULTS
During the first 14 days, significantly fewer children in the intracapsular group reported nausea (P = .01) or lost weight (P = .003). The intracapsular group had a significantly faster resolution of pain (P = .01), had an earlier return to a normal diet (P = .004), ceased taking pain medication sooner (P = .002), and returned to normal activity sooner (P = .04). Postoperatively, the intracapsular group had more residual tonsil tissue than the total tonsillectomy group (P = .002 for the 3- and 12-month visits). However, the incidence of recurring obstructive symptoms, pharyngitis, and antibiotic use was similar in both treatment groups during the 12 months.


CONCLUSIONS
Postoperative morbidity normally associated with traditional (total) tonsillectomy was significantly reduced after intracapsular tonsillectomy using low-temperature plasma excision. The residual tonsillar tissue associated with this technique was of no clinical consequence.
Chan
Kenny H
KH
Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, The Children's Hospital, Denver, USA. chan.kennyh@tchden.org
Friedman
Norman R
NR
Allen
Gregory C
GC
Yaremchuk
Kathleen
K
Wirtschafter
Ari
A
Bikhazi
Nadim
N
Bernstein
Joseph M
JM
Kelley
Peggy E
PE
Lee
Kelvin C
KC
D002648:Child; D002675:Child, Preschool; D004598:Electrosurgery / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D010149:Postoperative Pain / Q000453:epidemiology; D020127:Recovery of Function; D014068:Tonsillectomy / Q000379:methods*