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John P. Bent, MD; Max M. April, MD; Robert F. Ward, MD; Alexander Sorin, MD; Brian Reilly, MS; Gregg Weiss, MS

Arch Otolaryngol Head Neck Surg. 2004;130:1197-1200.

Objectives  (1) To assess the safety and efficacy of outpatient intracapsular tonsillectomy, which has been recently described as a less invasive means of treating obstructive tonsillar hypertrophy, in children younger than 3 years; and (2) to challenge the standard dictum that children younger than 3 years should be admitted to the hospital after tonsil and adenoid surgery.

Design  Retrospective cohort study via medical chart review and telephone interview.

Setting  Pediatric otolaryngology group practice with academic affiliation.

Patients  Children with symptomatic tonsillar and adenoid hypertrophy (n = 226) who underwent microdebrider-assisted intracapsular tonsillectomy between September 1, 2000, and October 1, 2002.

Methods  Comparison of study group (children <3 years old, n = 38; mean age, 30.3 months; 20 boys and 18 girls) with control group (children 3 years, n = 188), measuring pain, oral intake, analgesic requirements, complications, need for readmission, and relief of symptoms.

Results  There were no statistically significant differences in pain, oral intake, or analgesic requirements. All children, regardless of age, were discharged home within 4 hours of surgery. No child in either group required readmission, and there were no complications related to the time of discharge. Younger children experience equivalent symptomatic improvement.

Conclusion  Children younger than 3 years may undergo intracapsular tonsillectomy as outpatients without sacrificing safety or efficacy.

From the New York Otolaryngology Institute, New York, NY. Dr April has a royalty agreement with Medtronic/Xomed.

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