title: Powered intracapsular tonsillotomy vs. conventional extracapsular tonsillectomy for pediatric OSA: A retrospective study about efficacy, complications and quality of life.
abstract: OBJECTIVE
  To compare the results of powered intracapsular tonsillectomy and adenoidectomy (PITA) with that of conventional extracapsular tonsillectomy and adenoidectomy (ECTA) in treatment of pediatric obstructive sleep apnea (OSA) as regard efficacy, complications including postoperative pain and bleeding, and quality of life.
  
  
  METHODS
  Four hundred fifty children with adenotonsillar hyperplasia (with age range from 3 to 14 years) underwent tonsillectomy ± adenoidectomy (251 PITA and 199 ECTA) from January 2012 till October 2014 for OSA. Outcome measures included Obstructive Sleep Apnea Survey (OSA-18), the number of cases treated for post tonsillectomy bleeding with particular regard to the number of cases that needed readmission, the need for analgesics, the visual analog scale (VAS) for post-operative pain, the perceived satisfaction assessed by post tonsillectomy quality of life questionnaire (QOL).
  
  
  RESULTS
  OSA-18 scores proved that both PITA and ECTA were equally effective in curing upper airway obstructive symptoms as reflected by the targeted questionnaire. Postoperative bleeding was significantly lower in the PITA group (P<0.01). Postoperative pain and number of needed analgesic doses were significantly lower in the PITA group (P=0.01, P<0.01, respectively). Satisfaction and quality of life were significantly higher in the PITA group (P<0.01).
  
  
  CONCLUSIONS
  PITA is proved to be effective in treating pediatric OSA with less morbidity, less complications in terms of postoperative bleeding mainly with better satisfaction and lower incidence of regrowth.
authors.affiliation: Department of Special Surgery, ENT and Oral Surgery Unit, G.B. Morgagni - L. Pierantoni Hospital, University of Pavia in Forlì, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Vicini
authors.affiliation: Department of Otolaryngology, Head-Neck Surgery, University of Zagazig, Zagazig, Egypt. Electronic address: dr.eesaorl@gmail.com.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Eesa
authors.affiliation: Department of Otolaryngology, Head-Neck Surgery, University of Zagazig, Zagazig, Egypt.
authors.forename: Ehsan
authors.initials: E
authors.lastname: Hendawy
authors.affiliation: Department of Special Surgery, ENT and Oral Surgery Unit, G.B. Morgagni - L. Pierantoni Hospital, University of Pavia in Forlì, Italy.
authors.forename: Milena
authors.initials: M
authors.lastname: Pari
authors.affiliation: Department of Special Surgery, ENT and Oral Surgery Unit, G.B. Morgagni - L. Pierantoni Hospital, University of Pavia in Forlì, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: D'Agostino
authors.affiliation: King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia.
authors.forename: Saleh
authors.initials: S
authors.lastname: AlGhamdi
authors.affiliation: Department of Special Surgery, ENT and Oral Surgery Unit, G.B. Morgagni - L. Pierantoni Hospital, University of Pavia in Forlì, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Meccariello
mesh_terms: D000233:Adenoidectomy; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D010149:Postoperative Pain / Q000453:epidemiology; D017060:Patient Satisfaction; D019106:Postoperative Hemorrhage / Q000453:epidemiology; D011788:Quality of Life; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000601:surgery*; D014068:Tonsillectomy / Q000295:instrumentation / Q000379:methods*; D064232:Visual Analog Scale
keywords: Microdebrider; Tonsillectomy; Tonsillotomy