Chan Kenny H, Friedman Norman R, Allen Gregory C, Yaremchuk Kathleen, Wirtschafter Ari, Bikhazi Nadim, Bernstein Joseph M, Kelley Peggy E, Lee Kelvin C
Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, The Children's Hospital, Denver, USA.
Arch Otolaryngol Head Neck Surg. 2004 Nov;130(11):1303-7. doi: 10.1001/archotol.130.11.1303.
To determine the efficacy of intracapsular tonsillectomy using low-temperature plasma excision for improving the quality of the postoperative experience and for treating obstructive symptoms through 12 months postoperatively.
Prospective, randomized, controlled, single-blind study.
Multiple private or institutional otolaryngology clinics.
Fifty-five children (aged 3-12 years) with obstructive tonsillar hypertrophy.
Patients were randomly assigned and blinded to undergo either intracapsular tonsillectomy using low-temperature plasma excision (n = 27) or total tonsillectomy using conventional electrosurgery (n = 28).
Operative data, 14-day recovery variables, and obstructive symptoms were prospectively collected through 12 months.
During the first 14 days, significantly fewer children in the intracapsular group reported nausea (P = .01) or lost weight (P = .003). The intracapsular group had a significantly faster resolution of pain (P = .01), had an earlier return to a normal diet (P = .004), ceased taking pain medication sooner (P = .002), and returned to normal activity sooner (P = .04). Postoperatively, the intracapsular group had more residual tonsil tissue than the total tonsillectomy group (P = .002 for the 3- and 12-month visits). However, the incidence of recurring obstructive symptoms, pharyngitis, and antibiotic use was similar in both treatment groups during the 12 months.
Postoperative morbidity normally associated with traditional (total) tonsillectomy was significantly reduced after intracapsular tonsillectomy using low-temperature plasma excision. The residual tonsillar tissue associated with this technique was of no clinical consequence.
确定采用低温等离子体切除术进行囊内扁桃体切除术在改善术后体验质量以及治疗术后12个月内的阻塞性症状方面的疗效。
前瞻性、随机、对照、单盲研究。
多家私立或机构性耳鼻喉科诊所。
55名患有阻塞性扁桃体肥大的儿童（年龄3至12岁）。
患者被随机分组并设盲，分别接受低温等离子体切除术进行囊内扁桃体切除术（n = 27）或采用传统电外科手术进行全扁桃体切除术（n = 28）。
前瞻性收集手术数据、14天恢复变量以及阻塞性症状，持续12个月。
在术后的前14天，囊内扁桃体切除术组中报告恶心（P = 0.01）或体重减轻（P = 0.003）的儿童明显较少。囊内扁桃体切除术组的疼痛缓解明显更快（P = 0.01），恢复正常饮食更早（P = 0.004），更早停止服用止痛药（P = 0.002），更早恢复正常活动（P = 0.04）。术后，囊内扁桃体切除术组的残余扁桃体组织比全扁桃体切除术组更多（3个月和12个月随访时P = 0.002）。然而，在12个月期间，两个治疗组的复发性阻塞性症状、咽炎和抗生素使用的发生率相似。
采用低温等离子体切除术进行囊内扁桃体切除术后，通常与传统（全）扁桃体切除术相关的术后发病率显著降低。与该技术相关的残余扁桃体组织无临床影响。
