Microdebrider Tonsillotomy vs Electrosurgical Tonsillectomy

Abstract

Objective: To examine whether microdebrider intracapsular tonsillotomy (MT) results in less postoperative pain compared with electrosurgical extracapsular tonsillectomy (ET).Design: Prospective, randomized, double-blind, matched pair, clinical trial.Setting: Specialty care hospital.Patients: Twelve male (48%) and 13 female (52%) children aged 5 to 15 years, with obstructive tonsillar hyperplasia were randomized to have one tonsil removed by MT and the other by ET.Interventions: An angled endoscopic microdebrider was used to perform MT, and ET was performed by standard monopolar cautery technique. Parents and children were blinded to the side of MT and ET. Children rated the pain 0 to 5 by side using the Faces Pain Scale-Revised. Blinded data collection was via telephone daily for 2 weeks by a study nurse.Main Outcome Measures: Primary: postoperative pain as recorded by Faces Pain Scale-Revised; secondary, presence or absence of otalgia and postoperative bleeding.Results: Twenty-two children (88%) had tonsillectomy and adenoidectomy, while 3 children (12%) had tonsillectomy alone. On postoperative days 1 to 9, children reported significantly less pain on the MT side compared with the ET side (paired t test; PϽ.01). By postoperative days 10 to 14, the difference between sides disappeared. Twenty children (80%) reported otalgia, and it was always unilateral. For those children reporting otalgia, there was a 100% correlation between the side of otalgia and the side of ET. There was no posttonsillectomy bleeding among the 25 children.Conclusion: Microdebrider intracapsular tonsillotomy is significantly less painful compared with electrosurgical ET in children undergoing surgical intervention for obstructive tonsillar hypertrophy.

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

“…Initial studies done by Koltai et al21, 22 have suggested that microdebridement is just as effective as traditional techniques in relieving obstructive sleep disordered breathing in children while resulting in less postoperative pain and more rapid recovery. Subsequent studies have reaffirmed these findings 23–28. Although some authors report more intraoperative blood loss,27, 29 the incidence of delayed post operative hemorrhage is significantly less with use of the microdebrider over electrocautery techniques 26, 28.…”

Comparative analysis of physical methods of surgical treatments for patients with chronic tonsillitis

“…В настоящее время существует большое количество научных работ, проспективных исследований и мета-анализов по сравнению эффективности и влияния на качество жизни пациентов тонзиллэктомии с использованием различных физических методов воздействия на лимфоидную ткань миндалин [49][50][51][52][53][54][55][56]. Так, S. Cushing и соавт.…”

Tonsillitis and sore throat in children

“… Dissection with the CO 2 laser [ 222 ] Dissection with hot knife [ 131 ] Dissection with monopolar high frequency current [ 51 ] Dissection with the ultrasound scalpel [ 86 ] Dissection with bipolar radiofrequency coblation [ 160 ] Dissection with bipolar scissors [ 104 ] Dissection with argon gas-assisted monopolar needle [ 99 ] Removal of the excess tissue with the microdebrider [ 137 ] …”