Complications of tonsillectomy: a comparison of techniques

Abstract

Objective: To compare the postoperative complications of intracapsular tonsillectomy using a microdebrider with traditional electrodissection tonsillectomy.

Design: Retrospective chart review.

Setting: Tertiary care pediatric referral center.

Patients: The medical records of 2944 patients undergoing tonsillectomy with or without adenoidectomy at our institution between January 1, 2002, and May 31, 2005, were reviewed.

Main outcome measures: Incidence of delayed postoperative hemorrhage, return to the hospital or emergency department for pain or dehydration, and the need for revision surgery.

Results: There were 1731 patients in the intracapsular tonsillectomy group and 1212 in the traditional electrodissection tonsillectomy group. The incidence of delayed hemorrhage was 1.1% in the intracapsular tonsillectomy group and 3.4% in the traditional electrodissection tonsillectomy group (P < .001). For delayed hemorrhage requiring treatment in the operating room for control, the incidence was 0.5% in the intracapsular tonsillectomy group and 2.1% in the traditional electrodissection tonsillectomy group (P < .001). Treatment in the emergency department or hospital for pain or dehydration was necessary in 3.0% of the intracapsular tonsillectomy group and in 5.4% of the traditional electrodissection tonsillectomy group (P = .002). Eleven patients (0.64%) in the intracapsular tonsillectomy group required revision tonsillectomy.

Conclusion: Intracapsular tonsillectomy has a lower incidence of postoperative hemorrhage and pain leading to hospital-based evaluation compared with traditional electrodissection tonsillectomy.