Pediatric coblation total tonsillectomy: intracapsular or extracapsular?

Abstract

Objectives: To compare the results of coblation intracapsular total tonsillectomy (CITT) with those of conventional coblation extracapsular total tonsillectomy (CETT) in the treatment of tonsillar hypertrophy in children with regards to efficacy and complications.

Methods: Ninety children with adenotonsillar hyperplasia underwent tonsillectomy ± adenoidectomy (48 CITT and 42 CETT). Intraoperative situation was observed and recorded. Patients were reexamined regarding recovery condition and tonsil regrowth, and were followed for at least one year.

Results: Significant differences were observed in four clinical features when the CITT group was compared with the CETT group: intraoperative bleeding score, intraoperative tonsillar fossa score, color of white membrane one day postoperatively, and visual analogue scale (VAS) value one week postoperatively (p < .05). There were statistical correlations between intraoperative bleeding score and age, course of disease, surgery method, number of acute tonsillitis attacks per year, and intraoperative tonsillar fossae score (p < .05). Two significant differences were noted when the tonsil hypertrophy group was compared with the chronic tonsillitis group: color of white membrane at one day and one week postoperatively (p < .05). No regrowth of tonsil was found.

Conclusions: Compared with conventional extracapsular tonsillectomy, CITT has the advantages of decreased pain and bleeding, and promote healing of wounds. No tonsillar regrowth was observed after at least one year of follow-up.

Chinese abstract

目的：比较低温消融囊内全扁导体切除术（CITT）与传统的低温消融囊外全扁桃体切除术（CETT）在治疗儿童扁桃体肥大的疗效和并发症方面的结果。

方法：90例腺体增生儿童患者接受了扁桃体切除术±腺样体切除术（48例CITT和42例CETT）。观察并记录了术中情况。对病人进行了关于恢复状况和扁桃体再生的检查, 随访至少1年。

结果：当比较CITT组与CETT组时, 观察到四个临床特征方面的显著差异：术间出血评分、术间扁桃体窝评分、手术一天后的白膜颜色以及术后1周的视力模拟量表（VAS）值（p < 0.05）。术中出血评分与年龄、病程、手术方法、每年急性扁桃体炎发病次数以及术间扁桃体窝评分之间有统计学相关性（p < 0.05）。当扁桃体肥大组与慢性扁桃体炎组比较时, 注意到两个显着差异：术后1天和1周时白膜的颜色（p < 0.05）。没有发现扁桃体的再生。

结论：与传统的囊外扁桃体切除术相比, CITT具有减轻疼痛和出血, 促进伤口愈合的优点。随访至少一年后, 未观察到扁桃体再生。

Keywords:

• Intracapsular tonsillectomy
• coblation
• tonsillectomy
• pediatric
• surgical safety

Acknowledgements

Author contributions: YXL and QLG designed the study, performed all the surgeries and prepared the manuscript. YXL reviewed the patients and performed data analysis. ZW, BZ, CL, and JQL participated in patient management.

The authors have no funding, financial relationships, or conflicts of interest to disclose.

Disclosure statement

No potential conflict of interest was reported by the authors.