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A Comparison of Techniques

Richard Schmidt, MD; Amanda Herzog; Steven Cook, MD; Robert O’Reilly, MD; Ellen Deutsch, MD; James Reilly, MD

Arch Otolaryngol Head Neck Surg. 2007;133(9):925-928.

Objective  To compare the postoperative complications of intracapsular tonsillectomy using a microdebrider with traditional electrodissection tonsillectomy.

Design  Retrospective chart review.

Setting  Tertiary care pediatric referral center.

Patients  The medical records of 2944 patients undergoing tonsillectomy with or without adenoidectomy at our institution between January 1, 2002, and May 31, 2005, were reviewed.

Main Outcome Measures  Incidence of delayed postoperative hemorrhage, return to the hospital or emergency department for pain or dehydration, and the need for revision surgery.

Results  There were 1731 patients in the intracapsular tonsillectomy group and 1212 in the traditional electrodissection tonsillectomy group. The incidence of delayed hemorrhage was 1.1% in the intracapsular tonsillectomy group and 3.4% in the traditional electrodissection tonsillectomy group (P < .001). For delayed hemorrhage requiring treatment in the operating room for control, the incidence was 0.5% in the intracapsular tonsillectomy group and 2.1% in the traditional electrodissection tonsillectomy group (P < .001). Treatment in the emergency department or hospital for pain or dehydration was necessary in 3.0% of the intracapsular tonsillectomy group and in 5.4% of the traditional electrodissection tonsillectomy group (P = .002). Eleven patients (0.64%) in the intracapsular tonsillectomy group required revision tonsillectomy.

Conclusion  Intracapsular tonsillectomy has a lower incidence of postoperative hemorrhage and pain leading to hospital-based evaluation compared with traditional electrodissection tonsillectomy.

Author Affiliations: Division of Pediatric Otolaryngology, Alfred I. duPont Hospital for Children, Wilmington, Delaware.

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