Randomized, Controlled, Multisite Study of Intracapsular Tonsillectomy Using Low-Temperature Plasma Excision | Otolaryngology | JAMA Otolaryngology–Head & Neck Surgery | JAMA Network
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Steward  DLWelge  JAMyer  CM Do steroids reduce morbidity of tonsillectomy?  Laryngoscope 2001;1111712- 1718PubMedGoogle ScholarCrossref
Telian  SAHandler  SDFleisher  GRBaranak  CCWetmore  RFPotsic  WP The effect of antibiotic therapy on recovery after tonsillectomy in children: a controlled study.  Arch Otolaryngol Head Neck Surg 1986;112610- 615PubMedGoogle ScholarCrossref
Koltai  PJSolares  CAMascha  EJXu  M Intracapsular partial tonsillectomy for tonsillar hypertrophy in children.  Laryngoscope 2002;11217- 19PubMedGoogle ScholarCrossref
Koltai  PJSolares  CAKoempel  JA  et al.  Intracapsular tonsillar reduction (partial tonsillectomy).  Otolaryngol Head Neck Surg 2003;129532- 538PubMedGoogle ScholarCrossref
Hultcrantz  ELinder  AMarkstrom  A Tonsillectomy or tonsillotomy?  Int J Pediatr Otorhinolaryngol 1999;51171- 176PubMedGoogle ScholarCrossref
Densert  ODesai  HEliasson  A  et al.  Tonsillotomy in children with tonsillar hypertrophy.  Acta Otolaryngol 2001;121854- 858PubMedGoogle ScholarCrossref
Willging  JPWiatrak  BJ Harmonic scalpel tonsillectomy in children: a randomized prospective study.  Otolaryngol Head Neck Surg 2003;128318- 325PubMedGoogle ScholarCrossref
Lee  KCAltenau  MMBarnes  DR  et al.  Incidence of complications for subtotal ionized field ablation of the tonsils.  Otolaryngol Head Neck Surg 2002;127531- 538PubMedGoogle ScholarCrossref
Friedman  MLoSavio  PIbrahim  HRamakrishnan  V Radiofrequency tonsil reduction: safety, morbidity, and efficacy.  Laryngoscope 2003;113882- 887PubMedGoogle ScholarCrossref
Belloso  AChidambaram  AMorar  PTimms  MS Coblation tonsillectomy versus dissection tonsillectomy.  Laryngoscope 2003;1132010- 2013PubMedGoogle ScholarCrossref
Bhattacharyya  NKepnes  LJ Clinical effectiveness of coblation inferior turbinate reduction.  Otolaryngol Head Neck Surg 2003;129365- 371PubMedGoogle ScholarCrossref
Bäck  LJHytonen  MLMalmberg  HOYlikoski  JS Submucosal bipolar radiofrequency thermal ablation of inferior turbinates: a long-term follow-up with subjective and objective assessment.  Laryngoscope 2002;1121806- 1812PubMedGoogle ScholarCrossref
Temple  RHTimms  MS Paediatric coblation tonsillectomy.  Int J Pediatr Otorhinolaryngol 2001;61195- 198PubMedGoogle ScholarCrossref
Timms  MSTemple  RH Coblation tonsillectomy: a double blind randomized controlled study.  J Laryngol Otol 2002;116450- 452PubMedGoogle ScholarCrossref
Uribe  JW Electrothermal chondroplasty.  Clin Sports Med 2002;21675- 685PubMedGoogle ScholarCrossref
Woloszko  JStalder  KRBrown  IG Plasma characteristics of repetitively-pulsed electrical discharges in saline solutions used for surgical procedures.  IEEE Trans Plasma Sci 2002;301376- 1383Google ScholarCrossref
Chinpairoj  SFeldman  MDSaunders  JCThaler  ER A comparison of monopolar electrosurgery to a new multipolar electrosurgical system in a rat model.  Laryngoscope 2001;111213- 217PubMedGoogle ScholarCrossref
Shah  UKGalinkin  JChiavacci  RBriggs  M Tonsillectomy by means of plasma-mediated ablation.  Arch Otolaryngol Head Neck Surg 2002;128672- 676PubMedGoogle ScholarCrossref
Wong  DLBaker  CM Pain in children.  Pediatr Nurs 1988;149- 17PubMedGoogle Scholar
Linder  AMarkstrom  AHultcrantz  E Using the carbon dioxide laser for tonsillotomy in children.  Int J Pediatr Otorhinolaryngol 1999;5031- 36PubMedGoogle ScholarCrossref
Koltai  PJKalathia  ASStanislaw  PHeras  HA Power-assisted adenoidectomy.  Arch Otolaryngol Head Neck Surg 1997;123685- 688PubMedGoogle ScholarCrossref
Original Article
November 2004

Randomized, Controlled, Multisite Study of Intracapsular Tonsillectomy Using Low-Temperature Plasma Excision

Arch Otolaryngol Head Neck Surg. 2004;130(11):1303-1307. doi:10.1001/archotol.130.11.1303

Objective  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.

Design  Prospective, randomized, controlled, single-blind study.

Setting  Multiple private or institutional otolaryngology clinics.

Patients  Fifty-five children (aged 3-12 years) with obstructive tonsillar hypertrophy.

Intervention  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).

Main Outcome Measures  Operative data, 14-day recovery variables, and obstructive symptoms were prospectively collected through 12 months.

Results  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.

Conclusions  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.