Intracapsular and Extracapsular Tonsillectomy and Adenoidectomy in Pediatric Obstructive Sleep Apnea

Abstract

Both ETA and ITA are effective modalities to treat OSAS, with comparable surgical outcomes on short-term follow-up. However, when comorbid diagnoses of both asthma and obesity exist, OSAS is likely to be refractory to treatment with ITA compared with ETA.

The safety and efficacy of powered intracapsular tonsillectomy in children: A meta‐analysis

“…In particular, the degrees of improvement after PITA in AHI and OSA‐18 scores were similar improvement with conventional tonsillectomy. Our results were supported with those of previous studies . Considering that there were reduced AHI score, and symptomatic relief of snoring and obstructive symptoms after PITA, the tonsillar regrowth was not likely clinically significant.…”

“…Data from the included studies were extracted using standardized methods and were checked by two independent reviewers. The outcomes compared between the two groups were as follows: operative time (the time from mouth gag placement to removal); operative blood loss (the total amount of fluid in the suction bottle, including the tonsillar tissue removed by the microdebrider and excluding the saline used for PITA and extracapsular tonsillectomy (ET)); postoperative pain (pain score after leaving the operation room); postoperative analgesic requirements (doses of postoperative opioids or nonopioid analgesics); time to resumption of a normal diet and activity (abated discomfort from swallowing and the number of days until resumption of normal activity); sleep disturbance (questionnaire); postoperative AHI score (AHI score followed up postoperatively); pre‐ and post‐treatment change of AHI score (the degree of postoperative improvement in the AHI score compared with preoperative AHI score); postoperative bleeding control (incidence of postoperative bleeding control in the operative room); hospitalization (incidence of postoperative pain or dehydration); and tonsil regrowth (incidence of postoperative tonsil remnant or regrowth). The outcomes analyzed were derived from comparisons between the pre‐ and post‐treatment AHI values during the follow‐up period 4 to 6 months after PITA.…”

The relationship between allergic status and adenotonsillar regrowth: a retrospective research on children after adenotonsillectomy

“…tonsillotomy) and extracapsular (i.e. traditional) tonsillectomy41 were acceptable for tonsillar resection in our series. All surgical procedures were performed in a single-stage by the same surgical team to ensure consistency of treatment strategies.…”

Postoperative characteristics of combined pharyngoplasty and tonsillectomy versus tonsillectomy in children with obstructive sleep apnea syndrome

“…3,4 OSA in children is primarily attributed to adenotonsillar hypertrophy, 5 and as such, tonsillectomy with or without adenoidectomy (T&A) is currently the most common treatment for children with OSA. 6 The standard procedure for adenotonsillectomy includes the removal of the palatal tonsils and adenoids.…”