Comparison of microdebrider subcapsular tonsillectomy to harmonic scalpel and electrocautery total tonsillectomy.
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.
Mixson
Charles M
CM
Department of Otolaryngology, Medical College of Georgia, Augusta, GA 30912, USA.
Weinberger
Paul M
PM
Austin
Mitchell B
MB
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*