Post-tonsillectomy morbidity and quality of life in pediatric patients with obstructive tonsils and adenoid: microdebrider vs electrocautery.
OBJECTIVE
To prospectively compare outcomes in children over age 2 with obstructive adenotonsillar hypertrophy when tonsillectomy is performed utilizing an intracapsular microdebrider technique versus low-wattage electrocautery technique.


METHODS
Prospective, single-blind, randomized controlled trial at a tertiary care children's hospital.


RESULTS
Among the 300 children, those treated with the microdebrider resumed normal activity faster, with a median recovery of 2.5 days, and stopped taking pain medication sooner, with the median time to the last dose of 4 days. The microdebrider group were 3 times more likely to no longer need pain medications at 3 days postoperatively and 2.5 times less likely to be still needing pain medication 7 days postoperatively. They were twice as likely to be at a normal activity level by 3 days postoperatively and were less likely to still not have attained normal activity and normal diet after 7 days. There was no difference between groups in median days to return to normal diet (3.0 to 3.5 days). At 1-month follow-up, children in the microdebrider group were 5 times more likely to have residual tonsil tissue.


CONCLUSIONS
Intracapsular tonsillectomy in children with obstructive adenotonsillar hypertrophy results in improved peri-operative outcomes. Residual tonsil tissue is more common with use of the microdebrider; however, the incidence of future obstruction or infection is unknown.


METHODS
A-1b.
Derkay
Craig S
CS
Department of Otolaryngology-Head & Neck Surgery, Eastern Virginia Medical School, 825 Fairfax Avenue, Ste. 510, Norfolk, VA 23507-1914, USA. derkaycs@chkd.com
Darrow
David H
DH
Welch
Camille
C
Sinacori
John T
JT
D000233:Adenoidectomy; D000234:Adenoids / Q000473:pathology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003646:Debridement / Q000295:instrumentation*; D004564:Electrocoagulation / Q000295:instrumentation*; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000601:surgery; D008297:Male; D014066:Palatine Tonsil / Q000473:pathology* / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life; D016037:Single-Blind Method; D014068:Tonsillectomy / Q000009:adverse effects / Q000295:instrumentation*; D016896:Treatment Outcome