Kay W Chang1. 1. Division of Pediatric Otolaryngology, Lucile Packard Children's Hospital at Stanford, Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA. KChang@stanfordmed.org <KChang@stanfordmed.org>
Abstract
OBJECTIVE: To compare the postoperative recovery of patients who undergo intracapsular to subcapsular Coblation tonsillectomy. STUDY DESIGN AND SETTING: This was a prospective, randomized, double-blinded study. A total of 69 children, aged 2 to 16 years, were randomized to intracapsular (n = 34) or subcapsular (n = 35) tonsillectomy. The Coblation technique was used with both groups. Outcomes measures were assessed on postoperative day 1 or 2 and 5 or 6. These included child and parental rating of pain with the Wong Faces pain scale, analgesic use, oral intake, and activity level. RESULTS:Intracapsular tonsillectomy patients had similar levels of pain to subcapsular tonsillectomy patients on day 1 or 2. However, at day 5 or 6, intracapsular tonsillectomy patients had significantly less pain than the subcapsular tonsillectomy patients. Intracapsular patients ate more and were more active at both time points. CONCLUSION AND SIGNIFICANCE: Children with obstructive sleep apnea who undergo tonsillectomy demonstrate better postoperative recovery after intracapsular tonsillectomy. The intracapsular versus subcapsular difference may be best appreciated at a delayed time point (day 5 or 6) rather than early (day 1 or 2).
RCT Entities:
OBJECTIVE: To compare the postoperative recovery of patients who undergo intracapsular to subcapsular Coblation tonsillectomy. STUDY DESIGN AND SETTING: This was a prospective, randomized, double-blinded study. A total of 69 children, aged 2 to 16 years, were randomized to intracapsular (n = 34) or subcapsular (n = 35) tonsillectomy. The Coblation technique was used with both groups. Outcomes measures were assessed on postoperative day 1 or 2 and 5 or 6. These included child and parental rating of pain with the Wong Faces pain scale, analgesic use, oral intake, and activity level. RESULTS: Intracapsular tonsillectomy patients had similar levels of pain to subcapsular tonsillectomy patients on day 1 or 2. However, at day 5 or 6, intracapsular tonsillectomy patients had significantly less pain than the subcapsular tonsillectomy patients. Intracapsular patients ate more and were more active at both time points. CONCLUSION AND SIGNIFICANCE: Children with obstructive sleep apnea who undergo tonsillectomy demonstrate better postoperative recovery after intracapsular tonsillectomy. The intracapsular versus subcapsular difference may be best appreciated at a delayed time point (day 5 or 6) rather than early (day 1 or 2).
Authors: Kimberly A Sutters; Danielle Holdridge-Zeuner; Steven Waite; Steven M Paul; Marilyn C Savedra; Brent Lanier; Karla Mahoney; Christine Miaskowski Journal: Pain Med Date: 2012-02-07 Impact factor: 3.750
Authors: Nila Sathe; Sivakumar Chinnadurai; Melissa McPheeters; David O Francis Journal: Otolaryngol Head Neck Surg Date: 2017-01-17 Impact factor: 3.497
Authors: David O Francis; Christopher Fonnesbeck; Nila Sathe; Melissa McPheeters; Shanthi Krishnaswami; Sivakumar Chinnadurai Journal: Otolaryngol Head Neck Surg Date: 2017-01-17 Impact factor: 3.497