Endoscope-Assisted Tonsillotomy (Partial Intracapsular Tonsillectomy): How We Do It

Uzomefuna, Vincent; Glynn, Fergal

doi:10.5402/2012/713901

Cited by 4 publications

(2 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…If indicated, endoscopic adenoidectomy can be performed with the necessary hemostasis under endoscopic control, in contrast to blind curettage of adenoid tissue (endoscopic adenotonsillectomy). [31][32][33] Transoral endoscopic examination of the nasopharynx at the end of adenoidectomy is a useful technique because it allows the surgeon to detect any remnants of adenoid tissue and any bleeding points that can be treated endoscopically under visual guidance. In addition, it may reduce symptomatic regrowth of the adenoids in the postoperative period.…”

Section: Discussionmentioning

confidence: 99%

Comparative Study of Various Techniques Tonsillectomy

Garibyan,

Gevorkyan,

Chahoyan

et al. 2024

JBSMFS

View full text Add to dashboard Cite

Objective: The purpose of the study was to compare intraoperative factors and postoperative outcomes between the image-guided acute dissection technique and the endoscopic image-guided acute dissection technique. Material and methods: The study was conducted in 153 patients (81 men and 72 women, average age 26.4 years) who underwent tonsillectomy (2018-2023). Patients were randomly assigned 2 group 52% percent of patients(group1) underwent tonsillectomy with acute dissection technique under visual control, and 48% of patients (group 2) underwent tonsillectomy with acute dissection technique under endoscopic visualization using a 4.0 mm 0° endoscope (Karl Storz, Tuttlingen, Germany). Indications for tonsillectomy were hypertrophy of the tonsils in 82 patients, recurrent tonsillitis in 23 patients and focal infection of the tonsils in 48 patients. Tonsillectomy was performed under general anesthesia using an oral speculum specifically designed for tonsillectomy. All patients were assessed and compared for postoperative pain, bleeding, recurrence, or tonsil tissue growth in the immediate and late postoperative period. The removed adenoid is sent for histology. Clinical diagnosis: Chronic decompensated tonsillitis. Pathohistological diagnosis: Within the limits of the examined material, the histological picture corresponds to chronic tonsillitis, hypertrophy of nasopharyngeal adenoid tissue. Results: There were no serious intra- or postoperative complications. Bleeding points were identified in 47 patients (31 patients group1 and 16 patients group 2). The source of bleeding was observed in the central deep part of the adenoids - in 18 patients, in the lateral parts of the adenoids - in 16 patients, adenoids on both sides in 13. Remnants of adenoid tissue were found in 23 patients, (17 patients group 1 and 6 patients group 2). Remnants of adenoid tissue were removed using bipolar diathermy under image guidance. The operation time for endoscopic tonsillectomy is shorter than for traditional procedures. Conclusions: The visibility provided Tonsillectomy by endoscopic techniques improves the ease and precision of surgery. Clinical significance determines the need for further testing of already proposed means and methods.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparative Study of Various Techniques Tonsillectomy

Garibyan,

Gevorkyan,

Chahoyan

et al. 2024

JBSMFS

View full text Add to dashboard Cite

show abstract

“…5 With the use of an endoscope during tonsillectomy, thin blood vessels and cords are easily identified, and separation along the tonsillar capsule is facilitated, which may not only help prevent postoperative hemorrhage but also minimize postoperative pain. 8 At our department (Otolaryngology Department, Yamagata Prefectural Shinjo Hospital), supervising surgeons have used 4-mm rigid endoscopes to teach tonsillectomy to specialist trainees in real time since 2013. After extraction of the palatine tonsils, the endoscope is brought close to the tonsillar bed to closely monitor the state of hemostasis and other conditions, and the exposure of the tonsillar bed after tonsillectomy is assessed in detail.…”

Section: Introductionmentioning

confidence: 99%

Observation of Posttonsillectomy Wounds Using Endoscopy and Examination of the Postoperative Course by Wound Type

Yoshida

Furukawa

Nagase

2022

International Journal of Practical Otolaryngology

View full text Add to dashboard Cite

Palatine tonsillectomy is a surgical procedure that novice otolaryngologists should master early and is taught at many medical institutions. Unfortunately, however, the transoral procedure cannot provide a large enough field of view to doctors other than the one performing the operation. Therefore, it is difficult to share the surgical field and provide real-time teaching. Dissection of the wrong layer can cause postoperative bleeding and pain. Our department uses a 70-degree, 4-mm rigid endoscope for palatine tonsillectomy, which makes it possible for preceptors to teach tonsillectomy in real time and to evaluate the condition of the postoperative wound in detail. We classified the postoperative state after tonsillectomy into three stages, based on the degree of residual subcapsular connective tissue. We assessed the association between the amount of residual subcapsular connective tissue and the underlying disease that required indication for tonsillectomy, the postoperative course, and the operation time in 33 patients who had undergone palatine tonsillectomy at our institution between May 2017 and November 2020. We found that the more the subcapsular connective tissue that remained, the less the postoperative pain and bleeding. This association suggests that conserving the subcapsular connective tissue is important. Bringing the endoscope closer to the surgical field to observe the field without blind areas enables adequate hemostasis and easy sharing of the surgical field; therefore, this method is also effective for teaching tonsillectomy to surgical trainees.

show abstract