title: Comparison of microdebrider subcapsular tonsillectomy to harmonic scalpel and electrocautery total tonsillectomy.
abstract: OBJECTIVE
  The aim of this study was to compare microdebrider subcapsular tonsillectomy (MST) with total tonsillectomies either by harmonic scalpel (TTH) or electrocautery (TTE) in children with obstructive sleep-disordered breathing from tonsillar hypertrophy.
  
  
  METHODS
  Retrospective review of prospectively collected data.
  
  
  METHODS
  Tertiary academic hospital.
  
  
  METHODS
  Eighty consecutive children with obstructive sleep-disordered breathing from tonsillar hypertrophy who underwent MST between January and April of 2003 were compared with a smaller historical cohort of 25 patients who underwent TTEs and TTHs from January to December of 2001.
  
  
  METHODS
  Primary: days to no narcotic pain medicine use and days to solid food intake; secondary: estimated blood loss, surgical time, and postoperative complications.
  
  
  RESULTS
  Fifty-four patients who underwent MSTs and 25 patients who underwent total tonsillectomies met study criteria for a total of 79 patients. The cohorts showed no significant demographic differences between groups. The MST group had a significantly shorter duration of pain medicine use (3.7 +/- 0.5 days) than the TTE (7.0 +/- 0.6 days) or TTH groups (6.8 +/- 0.7 days; P < .001). The MST group (3.5 +/- 0.6 days) and the TTH group (3.6 +/- 0.8 days) achieved solid food intake faster than the TTE group (5.4 +/- 0.7 days; P = 0.004). There was a significantly higher estimated blood loss with the MST group (38.8 +/- 6.1 mL) than the TTH group (19 mL +/- 8.2) and the TTE group (15.1 +/- 7.4 mL; P < .001). TTH (27.3 +/- 3.1 minutes) took longer than MST (20.3 +/- 2.3 minutes) and TTE (21.9 +/- 2.8 minutes; P = .018).
  
  
  CONCLUSIONS
  Microdebrider subcapsular tonsillectomy is valuable in treatment of children with tonsillar hypertrophy because of the decreased pain medicine use and more rapid return to solid food.
authors.affiliation: Department of Otolaryngology, Medical College of Georgia, Augusta, GA 30912, USA.
authors.forename: Charles M
authors.initials: CM
authors.lastname: Mixson
authors.forename: Paul M
authors.initials: PM
authors.lastname: Weinberger
authors.forename: Mitchell B
authors.initials: MB
authors.lastname: Austin
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003646:Debridement / Q000295:instrumentation*; D004564:Electrocoagulation / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D013525:Surgical Instruments; D014068:Tonsillectomy / Q000295:instrumentation*; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000295:instrumentation*