Comparison of microdebrider subcapsular tonsillectomy to harmonic scalpel and electrocautery total tonsillectomy

Charles M. Mixson, Paul M. Weinberger, Mitchell B. Austin

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Objective: The aim of this study was to compare microdebrider subcapsular tonsillectomy (MST) with total tonsillectomies either by harmonic scalpel (TTH) or electrocautery (TTE) in children with obstructive sleep-disordered breathing from tonsillar hypertrophy. Design: Retrospective review of prospectively collected data. Setting: Tertiary academic hospital. Patients: Eighty consecutive children with obstructive sleep-disordered breathing from tonsillar hypertrophy who underwent MST between January and April of 2003 were compared with a smaller historical cohort of 25 patients who underwent TTEs and TTHs from January to December of 2001. Main outcome measures: Primary: days to no narcotic pain medicine use and days to solid food intake; secondary: estimated blood loss, surgical time, and postoperative complications. Results: Fifty-four patients who underwent MSTs and 25 patients who underwent total tonsillectomies met study criteria for a total of 79 patients. The cohorts showed no significant demographic differences between groups. The MST group had a significantly shorter duration of pain medicine use (3.7 ± 0.5 days) than the TTE (7.0 ± 0.6 days) or TTH groups (6.8 ± 0.7 days; P < .001). The MST group (3.5 ± 0.6 days) and the TTH group (3.6 ± 0.8 days) achieved solid food intake faster than the TTE group (5.4 ± 0.7 days; P = 0.004). There was a significantly higher estimated blood loss with the MST group (38.8 ± 6.1 mL) than the TTH group (19 mL ± 8.2) and the TTE group (15.1 ± 7.4 mL; P < .001). TTH (27.3 ± 3.1 minutes) took longer than MST (20.3 ± 2.3 minutes) and TTE (21.9 ± 2.8 minutes; P = .018). Conclusion: Microdebrider subcapsular tonsillectomy is valuable in treatment of children with tonsillar hypertrophy because of the decreased pain medicine use and more rapid return to solid food.

Original languageEnglish (US)
Pages (from-to)13-17
Number of pages5
JournalAmerican Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume28
Issue number1
DOIs
StatePublished - Jan 1 2007

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Electrocoagulation
Tonsillectomy
Hypertrophy
Sleep Apnea Syndromes
Medicine
Pain
Eating
Narcotics
Operative Time
Tertiary Care Centers
Demography
Outcome Assessment (Health Care)
Food

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Comparison of microdebrider subcapsular tonsillectomy to harmonic scalpel and electrocautery total tonsillectomy. / Mixson, Charles M.; Weinberger, Paul M.; Austin, Mitchell B.

In: American Journal of Otolaryngology - Head and Neck Medicine and Surgery, Vol. 28, No. 1, 01.01.2007, p. 13-17.

Research output: Contribution to journalArticle

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abstract = "Objective: The aim of this study was to compare microdebrider subcapsular tonsillectomy (MST) with total tonsillectomies either by harmonic scalpel (TTH) or electrocautery (TTE) in children with obstructive sleep-disordered breathing from tonsillar hypertrophy. Design: Retrospective review of prospectively collected data. Setting: Tertiary academic hospital. Patients: Eighty consecutive children with obstructive sleep-disordered breathing from tonsillar hypertrophy who underwent MST between January and April of 2003 were compared with a smaller historical cohort of 25 patients who underwent TTEs and TTHs from January to December of 2001. Main outcome measures: Primary: days to no narcotic pain medicine use and days to solid food intake; secondary: estimated blood loss, surgical time, and postoperative complications. Results: Fifty-four patients who underwent MSTs and 25 patients who underwent total tonsillectomies met study criteria for a total of 79 patients. The cohorts showed no significant demographic differences between groups. The MST group had a significantly shorter duration of pain medicine use (3.7 ± 0.5 days) than the TTE (7.0 ± 0.6 days) or TTH groups (6.8 ± 0.7 days; P < .001). The MST group (3.5 ± 0.6 days) and the TTH group (3.6 ± 0.8 days) achieved solid food intake faster than the TTE group (5.4 ± 0.7 days; P = 0.004). There was a significantly higher estimated blood loss with the MST group (38.8 ± 6.1 mL) than the TTH group (19 mL ± 8.2) and the TTE group (15.1 ± 7.4 mL; P < .001). TTH (27.3 ± 3.1 minutes) took longer than MST (20.3 ± 2.3 minutes) and TTE (21.9 ± 2.8 minutes; P = .018). Conclusion: Microdebrider subcapsular tonsillectomy is valuable in treatment of children with tonsillar hypertrophy because of the decreased pain medicine use and more rapid return to solid food.",
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