Intracapsular versus subcapsular coblation tonsillectomy.

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).