Intracapsular coblation tonsillectomy versus extracapsular coblation tonsillectomy: a systematic review and a meta-analysis

Daskalakis, Dimitrios; Tsetsos, Nikolaos; Karagergou, Stella; Goudakos, John; Markou, Konstantinos; Karkos, Petros D.

doi:10.1007/s00405-020-06178-2

Cited by 11 publications

(13 citation statements)

References 17 publications

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“…There was a significant difference in late post-operative pain between the groups, with IT being less painful at the late assessment. There was no significant difference in early post-operative pain between the groups [33].…”

Section: Post-operative Complications In Total Tonsillectomy Vs Intracapsular Tonsillectomymentioning

confidence: 68%

“…"Cold" methods, where no heat is used, include cold steel dissection, guillotine, microdebrider, harmonic scalpel, and plasma blade. "Hot" methods include electrocautery (monopolar or bipolar), coblation (radiofrequency-controlled ablation), or laser [2,8,[31][32][33][34][35]. To date, no single technique has been widely accepted as the most superior method for performing the surgery [2,31,36,37].…”

Section: Surgical Techniques and Methods Of Tonsillectomymentioning

confidence: 99%

“…In total tonsillectomy (TT), also known as extra-capsular tonsillectomy, the tonsil and its surrounding capsule are removed completely [32][33][34]. This leaves bare pharyngeal musculature in the tonsillar fossa to heal by secondary intention [35,38].…”

Section: Total Tonsillectomy Vs Intracapsular Tonsillectomymentioning

confidence: 99%

“…This leaves bare pharyngeal musculature in the tonsillar fossa to heal by secondary intention [35,38]. Intracapsular tonsillectomy (IT), also known as partial tonsillectomy, subtotal tonsillectomy, or tonsillotomy, removes the majority of the tonsillar tissue but leaves the capsule surrounding the palatine tonsil intact [33,35,38]. In this technique, the pharyngeal muscle is not exposed and in theory there is less post-operative pain and risk of hemorrhage.…”

Section: Total Tonsillectomy Vs Intracapsular Tonsillectomymentioning

confidence: 99%

“…Post-tonsillectomy pain and hemorrhage in IT versus TT has been examined repeatedly in an effort to determine the "best" technique. There is general agreement that IT has less post-operative hemorrhage than TT [32,33,39]. Unfortunately, there is considerable disparity between the studies available, making direct comparisons challenging.…”

Section: Post-operative Complications In Total Tonsillectomy Vs Intracapsular Tonsillectomymentioning

confidence: 99%

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Considerations in Surgical Management of Pediatric Obstructive Sleep Apnea: Tonsillectomy and Beyond

Uwiera

2021

Children

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Obstructive sleep apnea (OSA) is an increasingly recognized disorder with a reported incidence of 5.7% in children. Tonsillectomy (with or without adenoidectomy) in pediatric OSA in otherwise healthy non-obese children has a success rate of approximately 75%. However, the cure rate reported for all children undergoing tonsillectomy varies from 51% to 83%. This article reviews the history of tonsillectomy, its indications, techniques, various methods, risks, and successes. The article also explores other surgical options in children with residual OSA post-tonsillectomy.

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Section: Post-operative Complications In Total Tonsillectomy Vs Intracapsular Tonsillectomymentioning

confidence: 68%

Section: Surgical Techniques and Methods Of Tonsillectomymentioning

confidence: 99%

Section: Total Tonsillectomy Vs Intracapsular Tonsillectomymentioning

confidence: 99%

Section: Total Tonsillectomy Vs Intracapsular Tonsillectomymentioning

confidence: 99%

Section: Post-operative Complications In Total Tonsillectomy Vs Intracapsular Tonsillectomymentioning

confidence: 99%

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Considerations in Surgical Management of Pediatric Obstructive Sleep Apnea: Tonsillectomy and Beyond

Uwiera

2021

Children

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Postoperative Morbidity of Different Tonsillectomy Techniques: A Systematic Review and Network Meta‐Analysis

Russo,

Festa,

Costantino

et al. 2023

The Laryngoscope

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ObjectiveTo compare different tonsillectomy techniques in terms of postoperative bleeding incidence and postoperative pain.MethodsAn arm‐based network analysis was conducted using a Bayesian hierarchical model. The primary and secondary outcomes were postoperative bleeding incidence and mean postoperative pain score.ResultsA total of 6464 patients were included for five different interventions (cold dissection tonsillectomy; extracapsular coblation tonsillectomy; intracapsular coblation tonsillectomy [ICT]; bipolar diathermy tonsillectomy [BDT]; monopolar diathermy tonsillectomy). ICT showed the lowest absolute risk (4.44%) of postoperative bleeding incidence (73.31% chance of ranking first) and the lowest mean postoperative pain score (1.74 ± 0.68) with a 94.0% chance of ranking first, whereas BDT showed both the highest absolute risk of bleeding incidence (10.75%) and the highest mean postoperative pain score (5.67 ± 1.43).ConclusionsICT seems to offer better postoperative outcomes, in terms of reduced risk of bleeding and reduced pain. Further prospective studies are advised to confirm these findings.Level of EvidenceNA Laryngoscope, 2023

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Tonsillectomy Versus Tonsillotomy in Pediatric Sleep‐Disordered Breathing: A Systematic Review and Multi‐subgroup Meta‐analysis

Lao,

Jian,

et al. 2024

The Laryngoscope

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ObjectivesTo evaluate the potential of tonsillotomy (TT) as an alternative to tonsillectomy (TE) for treating children with obstructive sleep‐disordered breathing (oSDB).Data SourcesTwo independent reviewers searched PubMed, the Cochrane Library, Embase, and additional sources to identify controlled studies comparing TT versus TE in pediatric patients with oSDB.Review MethodsWe evaluated post‐surgery symptom relief, and short‐ and long‐term postoperative benefits for children. Fixed‐effect meta‐analysis, sensitivity analysis, and subgroup analysis were conducted.ResultsIn our analysis of 32 studies with 9,430 children, the analysis revealed TT group had a similar therapeutic effect on improvement of OSA‐18 as TE group (MD = 5.20, 95% CI: −32.67 to 43.07, p = 0.96). In terms of short‐term outcome, the days to return to normal diet for TT group were shorter than that for TE group (MD = −2.49, 95%CI: −3.57 to −1.28; p < 0.001), less analgesics use (MD = −3.19, 95% CI = −3.44 to −2.93, p < 0.001), and lower postoperative secondary bleeding (RR = 0.33; 95%CI: 0.23 to 0.47; p < 0.001). But the risk of reoperation (OR = 8.28; 95%CI: 2.66 to 12.64; p < 0.001), oSDB recurrence (OR = 2.16; 95%CI: 1.20–3.86; p = 0.01), and postoperative infection (OR = 1.82; 95%CI: 1.34 to 2.47; p < 0.001) in TT group was significantly higher than that in TE group.ConclusionsTonsillotomy reduces postoperative pain and bleeding, speeding up recovery for children with oSDB, and improving their quality of life. Yet, the risk of recurrent infections from residual tonsil tissue, which may require reoperation, calls for a careful evaluation of the procedure's short‐term gains against its long‐term risks.Level of EvidenceNA Laryngoscope, 2024

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Intracapsular coblation tonsillectomy versus extracapsular coblation tonsillectomy: a systematic review and a meta-analysis

Cited by 11 publications

References 17 publications

Considerations in Surgical Management of Pediatric Obstructive Sleep Apnea: Tonsillectomy and Beyond

Considerations in Surgical Management of Pediatric Obstructive Sleep Apnea: Tonsillectomy and Beyond

Postoperative Morbidity of Different Tonsillectomy Techniques: A Systematic Review and Network Meta‐Analysis

Tonsillectomy Versus Tonsillotomy in Pediatric Sleep‐Disordered Breathing: A Systematic Review and Multi‐subgroup Meta‐analysis

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