Less pain, bleeding with newer tonsil surgery

NEW YORK (Reuters Health) - People who have their tonsils removed using an "intracapsular" technique -- which removes at least 90 percent of tonsil tissue, but spares the tonsil capsule -- seem to experience less bleeding and pain after surgery compared with those who have their tonsils out using the traditional tonsil removal surgery, new research suggests.

The findings stem from a look back at the medical charts of 2,944 patients who underwent tonsillectomy with or without removal of the adenoids (tissue at the back of the throat) at one center from January 2002 through May 2005. The patients included 1,731 who had the newer intracapsular tonsillectomy procedure and 1,212 who had traditional tonsillectomy.

Among those in the traditional tonsillectomy group, 3.4 percent had delayed bleeding (more than 24 hours after surgery) and 2.1 percent required treatment in the operating room for bleeding, compared with 1.1 percent and 0.5 percent among those in the intracapsular tonsillectomy group, Dr. Richard Schmidt, from Alfred I. duPont Hospital for Children in Wilmington, Delaware, and colleagues report.

Three percent of patients who had intracapsular tonsillectomy and 5.4 percent of those who had traditional tonsillectomy needed emergency room treatment for pain or dehydration, which often occurs after tonsil surgery when pain restricts fluid intake.

However, 11 patients who had intracapsular tonsillectomies and none of those who had traditional tonsillectomies needed revision tonsillectomies.

"The ideal tonsillectomy," the authors write, "would have minimal or no risks and be completely effective. Although the risks for intracapsular tonsillectomy are lower than those for traditional tonsillectomy, the procedure is not always effective," they conclude.

SOURCE: Otolaryngology--Head and Neck Surgery, September 2007.