Comparison of three common tonsillectomy techniques: A prospective randomized, double‐blinded clinical study

Abstract

Postoperative recovery following intracapsular adenotonsillectomy in children with obstructive sleep apnea is significantly earlier with use of either the coblator or microdebrider versus traditional extracapsular tonsillectomy with electrocautery. Microdebrider and coblator were comparable in all other areas except for shorter operative time and less cost for the microdebrider.

Tonsillotomy: it's time to clarify the facts

“…Moreover, there is a risk to injur the pharyngeal muscles owing to the intraoperative bleeding [24]. While the costs of the shaver blade range between $80 [14], $91.20 [48], and $100 [47,48] per operation, the singleuse coblation wand is even more expensive ($140 [52] to $200 [48]). Microdebrider-SIPT has been shown to be advantageous over extracapsular monopolar TE in various outcome measures.…”

“…Operation time is always an issue at institutions with a great number of procedures per year [35] since operating rooms are billed for $5091 per hour [48]. Operation costs were lowest with microdebrider-SIPT ($2205.20), and more expensive with electrocautery TE ($2825.10) and coblation-SIPT ($2837.10), but have not been calculated for the other instruments [48].…”

“…Operation costs were lowest with microdebrider-SIPT ($2205.20), and more expensive with electrocautery TE ($2825.10) and coblation-SIPT ($2837.10), but have not been calculated for the other instruments [48]. While operation time was not stated for seven Class I procedures, one author stated that the procedure took ''less than tonsillectomy 0 s about 2.5 min'' [29].…”

“…Koltai et al [14] only stated that the microdebrider-SIPT takes ''a few minutes longer to perform than total electrocautery tonsillectomy, although the average difference in an informal survey of 20 conservative cases was only 3 min''. Other authors completed the procedures within 10-20 [41,43,47,48,52], 20-30 [32,35,45,46] or more than 30 min [42].…”

“…Antibiotics and steroids were given for at least 5 days [15, 18, 24, 31, 34, 35, 37, 38, 41, 43-45, 47, 48, 52] including intraoperative administration of dexamethasone or a nonspecified steroid [48] in all but three studies [15,24,41]. With one exception [24], all studies analyzed Class II procedures.…”