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A Prospective, Randomized, Single-blinded Study

Steven E. Sobol, MD, MSc; Ralph F. Wetmore, MD; Roger R. Marsh, PhD; Joanne Stow, RN; Ian N. Jacobs, MD

Arch Otolaryngol Head Neck Surg. 2006;132:270-274.

Objective  To prospectively assess the postoperative recovery in patients randomly selected to receive either microdebrider intracapsular tonsillectomy (MT) or monopolar electrocautery tonsillectomy (ET).

Design  A prospective, randomized, single-blinded study.

Setting  Tertiary care children's hospital.

Patients  A total of 74 patients between the ages of 3 and 7 years undergoing adenotonsillectomy for obstruction were randomly assigned to the MT and ET groups.

Main Outcome Measures  Families were blinded to the technique used and given a checklist to fill out daily quantifying pain, activity, diet, and the number of doses of pain medication given over a 10-day period. Other variables assessed included the time of surgery and intraoperative blood loss.

Results  The average time of surgery was 16.9 minutes for ET compared with 20.9 minutes for MT (P<.001). The average blood loss was 30 mL for ET compared with 45 mL for MT (P = .01). Resumption of near-normal dietary intake was achieved 1.7 days earlier in patients receiving MT compared with ET (P = .04). There was no significant difference in the number of days taken for the resolution of pain or resumption of normal activity between the 2 groups.

Conclusions  Microdebrider tonsillectomy takes over 4 minutes longer to perform compared with ET and has slightly higher intraoperative blood loss. There appears to be a slight advantage in the resumption of normal dietary intake with MT but no significant difference in the number of days taken for the resolution of pain or resumption of normal activity.

Author Affiliations: Department of Otolaryngology–Head and Neck Surgery, Emory University School of Medicine, Atlanta, Ga (Dr Sobol); and Division of Pediatric Otolaryngology, The Children's Hospital of Philadelphia, and University of Pennsylvania School of Medicine (Drs Wetmore, Marsh, and Jacobs and Ms Stow), Philadelphia.

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