Longitudinal outcomes with intracapsular tonsillectomy, a single surgeon's experience

Abstract

Purpose: To assess the risk of tonsillar regrowth and post-operative complications associated with intracapsular tonsillectomy (IT) when performed by a single surgeon using a standardized technique.

Materials and methods: The current study was conducted as a retrospective chart review of all IT performed by a single surgeon between November 11, 2009 and July 22, 2020 at the Cleveland Clinic and the Cleveland Clinic Beachwood Family Health and Surgery Center . Data collection included patient demographics, surgical data, post operative results, complications, and available long-term follow-up data.

Results: There were 221 ITs performed between November 2009 and July 2020. The post operative bleeding rate was 3.5 %. A single adult patient required re-operation for bleeding. Rate of tonsillar regrowth was 3.9 % (n = 7) and 1.1 % (n = 2) required re-operation (total tonsillectomy). No patients in the current study developed post-operative dehydration or had excessive post-operative pain requiring an emergency department visit or hospitalization.

Conclusions: The current study demonstrated similar rates of post operative bleeding after IT when compared to established rates following TT. The current study's regrowth rate was 3.9 % with a low 1.1 % rate of re-operation. This study adds to a growing body of literature supporting the use of IT due to lower complication rates when compared to TT, including post-operative bleeding, dehydration, and pain, with minimal rate of re-operation for bleeding or regrowth.

Keywords: Cobalator; Intracapsular; Microdebrider; Sleep apnea; Tonsillar regrowth; Tonsillectomy.