Intracapsular tonsillar reduction (partial tonsillectomy): Reviving a historical procedure for obstructive sleep disordered breathing in children

Peter J. Koltai, C. Arturo Solares, Jeffery A. Koempel, Keiko Hirose, Tom I. Abelson, Paul R. Krakovitz, James Chan, Meng Xu, Edward J. Mascha

Research output: Contribution to journalArticle

115 Scopus citations

Abstract

OBJECTIVE: We sought to reintroduce a historical procedure-intracapsular tonsillar reduction (partial tonsillectomy or tonsillotomy)-for tonsillar hypertrophy causing obstructive sleep disordered breathing (OSDB) in children, as well as to determine whether partial tonsillectomy, compared with conventional (total) tonsillectomy when performed by more than one surgeon, is equally effective for the relief of OSDB while resulting in less pain and more rapid recovery. STUDY DESIGN: We conducted a retrospective case series at a tertiary children's hospital. The charts of children who underwent partial tonsillectomy and total tonsillectomy (1998 through 2002) for postoperative complications were reviewed. The caregivers were surveyed to assess postoperative pain, rapidity of recovery, and effectiveness of surgery for relieving symptoms of OSDB. RESULTS: Two hundred forty-three children underwent partial tonsillectomy and 107 children underwent total tonsillectomy. There were no significant differences in immediate and delayed complications between the groups. Both operations were equally effective in relieving OSDB. Children who had partial tonsillectomy had significantly less postoperative pain and significantly more rapid recovery. CONCLUSION: Intracapsular tonsillar reduction with an endoscopic microdebrider relieves OSDB as effectively as conventional tonsillectomy, but results in less postoperative pain and a more rapid recovery.

Original languageEnglish (US)
Pages (from-to)532-538
Number of pages7
JournalOtolaryngology - Head and Neck Surgery
Volume129
Issue number5
DOIs
StatePublished - Nov 2003

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

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    Koltai, P. J., Solares, C. A., Koempel, J. A., Hirose, K., Abelson, T. I., Krakovitz, P. R., Chan, J., Xu, M., & Mascha, E. J. (2003). Intracapsular tonsillar reduction (partial tonsillectomy): Reviving a historical procedure for obstructive sleep disordered breathing in children. Otolaryngology - Head and Neck Surgery, 129(5), 532-538. https://doi.org/10.1016/S0194-5998(03)00727-7