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Otolaryngol Head Neck Surg. 2006 Jan;134(1):114-20.

Post-tonsillectomy morbidity and quality of life in pediatric patients with obstructive tonsils and adenoid: microdebrider vs electrocautery.

Author information

1
Department of Otolaryngology-Head & Neck Surgery, Eastern Virginia Medical School, 825 Fairfax Avenue, Ste. 510, Norfolk, VA 23507-1914, USA. derkaycs@chkd.com

Abstract

OBJECTIVE:

To prospectively compare outcomes in children over age 2 with obstructive adenotonsillar hypertrophy when tonsillectomy is performed utilizing an intracapsular microdebrider technique versus low-wattage electrocautery technique.

STUDY DESIGN AND SETTING:

Prospective, single-blind, randomized controlled trial at a tertiary care children's hospital.

RESULTS:

Among the 300 children, those treated with the microdebrider resumed normal activity faster, with a median recovery of 2.5 days, and stopped taking pain medication sooner, with the median time to the last dose of 4 days. The microdebrider group were 3 times more likely to no longer need pain medications at 3 days postoperatively and 2.5 times less likely to be still needing pain medication 7 days postoperatively. They were twice as likely to be at a normal activity level by 3 days postoperatively and were less likely to still not have attained normal activity and normal diet after 7 days. There was no difference between groups in median days to return to normal diet (3.0 to 3.5 days). At 1-month follow-up, children in the microdebrider group were 5 times more likely to have residual tonsil tissue.

CONCLUSIONS:

Intracapsular tonsillectomy in children with obstructive adenotonsillar hypertrophy results in improved peri-operative outcomes. Residual tonsil tissue is more common with use of the microdebrider; however, the incidence of future obstruction or infection is unknown.

EBM RATING:

A-1b.

PMID:
16399190
DOI:
10.1016/j.otohns.2005.10.039
[Indexed for MEDLINE]

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