Novel Tonsillectomy Cuts Pain, Bleeding
But Tonsils Can Grow Back After Surgery
WebMD News Archive
Tonsillectomy: Old and New continued...
Just 3% of the intracapsular surgery patients required emergency room
treatment for pain or dehydration caused by restricted fluid intake due to
pain, compared with 5.4% of patients who had traditional surgery.
But 11 children (0.6%) in the intracapsular tonsillectomy group needed
repeat tonsillectomies when tonsil tissue grew back.
This regrowth rate was in line with earlier reports suggesting that slightly
more than one in 200 children who have the surgery require second
The study is published in the September issue of the journal Archives of
Otolaryngology and Head and Neck Surgery.
Not All ENTs Convinced
Schmidt says the novel surgery should become the standard of care for
children who require tonsil removal because of enlarged tonsils and adenoids.
There is less research on outcomes among children whose indication for surgery
is recurrent infection, or tonsillitis.
Pediatric head and neck surgeon David Darrow, MD, says he is not convinced
that the benefits of intracapsular tonsillectomy outweigh the risk of a second
tonsil surgery, regardless of the surgical indication.
He tells WebMD that he and a colleague recently conducted a similar
comparison of outcomes with the intracapsular surgery and traditional
tonsillectomy at the Norfolk, Va., hospital where he practices.
Children in that study who had the newer surgery also tended to have less
pain and bleeding complications than children who had traditional
tonsillectomies, but Darrow describes the differences as modest.
“Based on the results, my partner and I came to very different conclusions
about this surgery,” he says. “He now does the new surgery routinely, but I was
not convinced that the differences justified the risk of leaving tonsil tissue
behind, so I don’t do it.”
He adds that the newer surgery should never be performed unless parents
fully understand the benefits and risks.
Darrow is a professor of otolaryngology in pediatrics at Eastern Virginia
Medical School. He also chairs the tonsil and adenoids subcommittee for the
American Academy of Otolaryngology.
“Parents may be willing to risk the chance of a second surgery for less
pain, but in the end it is their decision,” he says.