title: Partial tonsillectomy with scalpel in children with obstructive tonsillar hypertrophy.
abstract: OBJECTIVE
  To compare postoperative pain of partial tonsillectomy (PT) with scalpel and total classical tonsillectomy (TT).
  
  
  METHODS
  Prospective, randomized study at a tertiary care institution. Ninety-six children who were diagnosed with obstructive tonsillar hypertrophy were included to the study. Children's tonsils were removed totally (Group TT) by classical dissection tonsillectomy or partially (Group PT) using scalpel and tissue scissors. The parents were instructed to fill out a form daily for nine postoperative days; recording total amount of analgesics administered that day and a Visual Analog Scale (VAS) each day assessing child's life quality and daily activities.
  
  
  RESULTS
  Eighty-one children (2-14 years old) who completed the study were included in the analysis. Total tonsillectomy group (Group TT) consisted of 41 patients and partial tonsillectomy group (Group PT) consisted of 40 patients. There was no difference between two groups' operative parameters such as operation time [21.3 min (PT) and 22.3 min (TT)] and blood loss [44.2 ml (PT) and 46.0 ml (TT)] (p>0.05). PT group received significantly less dosage of analgesics per day; 1.18+/-1.27 vs. 2.00+/-1.45 (p<0.005). Total used analgesic dose in PT group were also lower than TT group (10.7+/-7.13 vs. 18.02+/-6.99 doses). When each day's analgesic use was compared separately a significant difference was found (p<0.05) in all days except 9th postoperative day (p>0.05). There was no difference in the pain scores between two techniques (p>0.05).
  
  
  CONCLUSIONS
  Unlike tonsillectomy, PT aims to remove the tonsilla palatina subtotally. It is especially performed in children with obstructive tonsils. PT with scalpel is an inexpensive and safe method necessitating only standard surgical instruments. It causes less postoperative pain than classical dissection tonsillectomy.
authors.affiliation: Department of Otolaryngology, KTU Medical School, Trabzon, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Korkmaz
authors.forename: Devrim
authors.initials: D
authors.lastname: Bektas
authors.forename: Bengu
authors.initials: B
authors.lastname: Cobanoglu
authors.forename: Refik
authors.initials: R
authors.lastname: Caylan
mesh_terms: D000293:Adolescent; D000402:Airway Obstruction / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006984:Hypertrophy; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000188:drug therapy; D014066:Palatine Tonsil / Q000473:pathology*; D014068:Tonsillectomy / Q000379:methods*