Safety and efficacy of powered intracapsular tonsillectomy in children: a multi-center retrospective case series

Microdebrider Tonsillotomy in Children with Obstructive Tonsillar Hypertrophy

“…In conventional tonsillectomy; lateral pharyngeal muscle is exposed to a temporary super-infection and infected wound healing risk stemming from oral cavity bacteria together with surgical trauma. All these factors are major determinants which cause postoperative pain by most authors [13,14]. Lactic acide and inflamatory mediators (leukotriens, prostaglandines) which are formed after surgical operations stimulate nerve terminals and cause muscle spasms and local ischemia.…”

Tonsillotomy: it's time to clarify the facts

“…In Class I procedures, the follow-up was for the longest B1 week [27], B2 weeks [10,22] [33,49], respectively. The follow-up was not obtainable from one study [51].…”

“…Class II procedures were associated with tonsillar regrowth after a mean and median length of 19 months ''several months after PITA'' [50], or ''usually during the first or second postoperative year'' [33]. Tonsillitis following Class I procedures was reported to have occurred within the first 6 months [26], 1-17 months [25], after 20 months [10], within 4 years [28], or 10-14 years [30].…”

“…In only 15.4 % of all studies, patients older than 8 years of age were excluded for Class I [11,23,26] or Class II procedures [31,35,43]. Insufficient information about the age distribution was provided by two authors [33,50]. Sobol et al [35] excluded children younger than 3 years owing to the higher risk of complications following TE and children older than 7 years to allow the use of one standard pain rating scale for all children.…”

A Review of Tonsillectomy Techniques and Technologies

“…16 Preservation of this margin of tissue, this "biologic dressing," may promote an easier recovery, with lower hemorrhage rates and better recovery of diet and activity reported in comparison with traditional monopolar tonsillectomy techniques. 17,18 The most common extracapsular techniques use a "cold" knife (sharp dissection), monopolar electrocautery, bipolar cautery (or bipolar scissors),or harmonic scalpel. Intracapsular techniques may use the microdebrider, bipolar radiofrequency ablation (which can also be used to remove the entire tonsil), and carbon dioxide laser.…”