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Intracapsular tonsillectomy versus extracapsular tonsillectomy: a safety comparison

Published online by Cambridge University Press:  29 September 2021

J Naidoo Open the ORCID record for J Naidoo [Opens in a new window]  and
K Schlemmer Open the ORCID record for K Schlemmer [Opens in a new window]
J Naidoo*
Affiliation:
Busamed Hillcrest Private Hospital, Durban, South Africa
K Schlemmer
Affiliation:
Busamed Hillcrest Private Hospital, Durban, South Africa Department of Otorhinolaryngology, Head and Neck Surgery, University of Kwa-Zulu Natal, South Africa Department of Speech-Language Pathology Audiology, University of Pretoria, South Africa
*
Author for correspondence: Dr J Naidoo, Janani Suite 109A, Hillcrest Private Hospital, 471 Kassier Road, Assagay, Durban, Kwa-Zulu Natal3610, South Africa E-mail: janani@drjnaidoo.com
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Abstract

Objective

Post-tonsillectomy haemorrhage remains a significant complication despite modifications of technique and instrumentation. Intracapsular tonsillectomy spares the capsule as a protective barrier for underlying blood vessels and musculature. Its efficacy in children with sleep-disordered breathing has been established, along with lowered rates of haemorrhage and pain, but research pertaining to adults and for recurrent infections has been limited.

Method

This retrospective study, encompassing 730 patients, compared post-operative haemorrhage rates between extracapsular (n = 379) and intracapsular tonsillectomy (n = 351) across all ages and indications using CoblationTM technology.

Results

A significant difference in post-operative haemorrhage rate was observed between extracapsular and intracapsular tonsillectomy techniques (2.1 vs 0.3 per cent; p = 0.025). In addition, an age of 18 years or older was also found to be an independent risk factor for post-operative haemorrhage (p = 0.01).

Conclusion

CoblationTM intracapsular tonsillectomy was shown to be safe and effective across all ages and indications, with a low risk of bleeding and revision surgery.

Keywords

TonsillectomyTonsillitisSleep Apnea SyndromesAirway ObstructionPostoperative HemorrhageAdenoidsPalatine Tonsils
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 8 , August 2022 , pp. 720 - 725
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr J Naidoo takes responsibility for the integrity of the content of the paper

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