Pediatric coblation total tonsillectomy: intracapsular or extracapsular?

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.