Intracapsular versus extracapsular dissection tonsillectomy for adults: A systematic review

Amin, Nikul; Lakhani, Raj

doi:10.1002/lary.28435

Cited by 21 publications

(27 citation statements)

References 41 publications

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“…These mainly include postoperative bleeding, postoperative infections and pain. The study participants will be recruited from a group of patients that would usually be operated on at our clinics according to common practice without any research setting, so the study itself does not add any risk for the participants as the novel TT seems to have fewer complications than the traditional TE [ 23 ]. In case of complications, participants are instructed to contact their respective clinic and their care is arranged by the study hospitals according to good clinical practice.…”

Section: Methods: Participants Interventions and Outcomesmentioning

confidence: 99%

Total or partial tonsillar resection (tonsillectomy or tonsillotomy) to change the quality of life for adults with recurrent or chronic tonsillitis: study protocol for a randomised controlled trial

Laajala

Tokola

Autio

et al. 2021

Trials

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Background Tonsillar surgery has been used for decades to treat recurrent and chronic tonsillitis in adults. Recurrent and chronic tonsillitis result in disturbing symptoms, treatment costs, sick leave, and impaired quality of life (QoL). Theoretically, removing all or part of the altered pathological palatal lymphoid tissue alleviates the symptoms and enhances the QoL. Whether this is true with total or partial tonsillar resection (tonsillectomy (TE) and tonsillotomy (TT), respectively) has not been reported in a randomised trial yet. Methods We conduct a multicentre, partly blinded, randomised, 6-month, parallel-group clinical study including 285 adult participants referred to surgical treatment for chronic or recurrent tonsillitis. The participants will either have TE, TT or watchful waiting (WW). The primary outcome will be the difference between the mean disease-specific Tonsillectomy Outcome Inventory-14 (QoL questionnaire) scores at 6 months. Comparison is made firstly between the combined TE+TT and WW groups (superiority analysis), and secondly between the TE and TT groups (non-inferiority analysis). Discussion This study will add significant new information to the effects and harms of TE and TT procedures in the treatment of adults with chronic or recurrent tonsillitis. Trial registration ClinicalTrials.gov: NCT04657549

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Section: Methods: Participants Interventions and Outcomesmentioning

confidence: 99%

Total or partial tonsillar resection (tonsillectomy or tonsillotomy) to change the quality of life for adults with recurrent or chronic tonsillitis: study protocol for a randomised controlled trial

Laajala

Tokola

Autio

et al. 2021

Trials

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“…While surgical instruments might influence the postoperative hemorrhage rate, the surgery technique is important as well. A systemic review [ 15 ] revealed that intracapsular dissection tonsillectomy has a lower secondary postoperative hemorrhage rate than extracapsular techniques. All patients in our study received extracapsular dissection tonsillectomy.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Post-Tonsillectomy Hemorrhage between Monopolar and Plasma Blade Techniques

Chen

2021

JCM

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The plasma blade is an innovative device that was recently introduced for performing tonsillectomy. While one of the benefits of the plasma blade is limited thermal damage, the effects of plasma blades on postoperative hemorrhage have not been thoroughly investigated. Patients who underwent tonsillectomy in our institution between January 2013 and September 2018 were retrospectively enrolled in the study. A total of 1214 patients were enrolled in the study, with 759 participants who underwent monopolar tonsillectomy and 455 participants who underwent plasma blade tonsillectomy. In total, 14 bleeding events occurred in the monopolar group, and 10 events occurred in the plasma blade group. The odds ratio for postoperative bleeding in the plasma blade group was 1.20 (95% CI 0.52 to 2.72). After adjusting for potential confounders, the adjusted odds ratio was 1.34 (95% CI 0.58 to 3.07). In conclusion, there is no significant difference in post-tonsillectomy hemorrhage rates between the traditional monopolar technique and plasma blade technique. Plasma blade tonsillectomy can be considered as safe as traditional monopolar tonsillectomy.

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“…The authors reported excellent symptom control, with similar trends for obstructive and infective conditions. 25 …”

Section: Discussionmentioning

confidence: 99%

Subtotal intracapsular tonsillectomy may be the first choice for tonsillectomy in children

et al. 2021

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Objective To investigate the effect and prognosis of subtotal intracapsular tonsillectomy. Methods All children (n=162) with tonsillar hypertrophy and chronic tonsillitis were randomly divided into two groups: tonsillectomy (n=75) and subtotal intracapsular tonsillectomy (n=87). Tonsillectomy: the tonsillar tissue was completely removed along with the tonsillar capsule. Subtotal intracapsular tonsillectomy: 80% to 90% of the tonsils and the complete epithelium of the tonsillar crypts were removed without damaging the tonsillar capsule. The Face, Legs, Activity, Cry, and Consolability (FLACC) and parents’ postoperative pain measure (PPPM) scales were used to evaluate postoperative pain, and the obstructive sleep apnea (OSA)-18 questionnaire was used to assess the children’s postoperative quality of life. The patients were followed-up for 2 years. Results 1. The FLACC and PPPM scales indicated that the children’s postoperative pain after subtotal intracapsular tonsillectomy was significantly less than that of children undergoing tonsillectomy. 2. The OSA-18 scale scores indicated that subtotal intracapsular tonsillectomy significantly improved the children’s quality of life. 3. Two years after subtotal intracapsular tonsillectomy, no patients required reoperation. Conclusion Subtotal intracapsular tonsillectomy may be the first choice for tonsillar hypertrophy and chronic tonsillitis patients.

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Intracapsular versus extracapsular dissection tonsillectomy for adults: A systematic review

Cited by 21 publications

References 41 publications

Total or partial tonsillar resection (tonsillectomy or tonsillotomy) to change the quality of life for adults with recurrent or chronic tonsillitis: study protocol for a randomised controlled trial

Total or partial tonsillar resection (tonsillectomy or tonsillotomy) to change the quality of life for adults with recurrent or chronic tonsillitis: study protocol for a randomised controlled trial

Comparison of Post-Tonsillectomy Hemorrhage between Monopolar and Plasma Blade Techniques

Subtotal intracapsular tonsillectomy may be the first choice for tonsillectomy in children

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