Powered intracapsular tonsillotomy vs. conventional extracapsular tonsillectomy for pediatric OSA: A retrospective study about efficacy, complications and quality of life

Improvement in symptoms of obstructive sleep apnoea in children following tonsillectomy versus tonsillotomy: a systematic review and meta‐analysis

“…33,34 This is thought to be due to the intact capsule providing a barrier 'dressing' between the operative field and the pharyngeal muscles, thereby decreasing inflammation and preventing muscle injury. 2,6 This leads to reduced postoperative oropharyngeal pain, encouraging oral intake and stimulating recovery. 1 The reduction in peri-and postoperative haemorrhage is thought to be due to the preservation of the larger primary tonsillar vessels, with only the smaller tonsillar arterioles, apparently less prone to the dreaded late postoperative haemorrhage, disrupted by the intracapsular surgery.…”

“…2,5 Given that the objective in treating this problem revolves around debulking oropharyngeal obstruction rather than complete removal of lymphoid tissue, it is thought that intracapsular tonsillectomy provides an effective, less painful and potentially safer alternative to extracapsular tonsillectomy. 1,2,5,6 This systematic review and meta-analysis aims to examine improvements in OSA-18 score, as a measure of subjective quality of life, following surgery in paediatric patients treated for OSA with both tonsillectomy and tonsillotomy surgical techniques. It is hoped that this will provide evidence as to whether tonsillotomy is as effective a technique for treating OSA, in the light of its favourable postoperative characteristics.…”

Complications of turbinate reduction surgery in combination with tonsillectomy in pediatric patients

“…Finally, surgical technique and instrumentation cannot be accounted for using the current database. Because intracapsular tonsillectomy has a different safety profile than extracapsular tonsillectomy, it is possible that surgical technique was a confounding variable that we were not able to control . A study examining complications of combined procedures based on surgical technique requires a single institution experience rather than a national database for analysis and would be a valuable addition to the literature.…”

Effectiveness and Safety of Radiofrequency Tonsils Reduction in Pediatric Obstructive Sleep Apnea

“…Hence several authors support a reduction of tonsils volume instead of extracapsular tonsillectomy [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. In fact, a shift from tonsillectomy to tonsillotomy already happened in Sweden, where the majority of children presenting tonsils obstructive symptoms are submitted to tonsillotomy [19].…”

“…Besides reduction in morbidity, partial tonsillectomy offers improvement in quality of life and satisfaction [12,17]. In terms of outcomes, total and partial techniques seem to be equally effective [4,5,[8][9][10][11][14][15][16]18] and safe [2,3,15,16].…”