Tonsillectomy and Adenoidectomy - Pediatric Clinics of North America

Pediatric Clinics of North America, Journal Year: 2022, Volume and Issue: 69(2), P. 247 - 259

Published: March 22, 2022

Language: Английский

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Coblation intracapsular tonsillectomy in children: A prospective study of 1257 consecutive cases with long‐term follow‐up

Clinical Otolaryngology, Journal Year: 2021, Volume and Issue: 46(6), P. 1184 - 1192

Published: April 28, 2021

Intracapsular tonsillectomy (ICT) is increasingly adopted by paediatric centres worldwide due to its association with reduced pain, fast recovery and low risks of post-operative complications. Questions still surround role in patients recurrent tonsillitis, as well tonsillar regrowth requiring revision surgery.Prospective consecutive case series from March 2013 April 2020.Tertiary ENT referral centre.Paediatric undergoing Coblation ICT, or without adenoidectomy, for obstructive and/or infective indications.Health-Related Quality Life (HRQL), analgesia requirement, haemorrhage rates, time return normal diet activity school/nursery, parental satisfaction. We report surgery rates identify predictive factors surgery.A total 1257 (median age 4.2 years) underwent a median direct implied follow-up 101.5 1419 days, respectively. noted significantly improved HRQL scores across all domains. Median requirement was six no required theatre haemorrhage. The majority were eating within 24 hours returned activity/school week post-operatively. Revision 2.6% cases, mainly symptoms regrowth. Being under two years old at initial (OR 5.10), having severe OSA 4.43) comorbidities 2.98) increased the risk needing surgery.Long-term data demonstrate efficacy safety ICT range indications.

Language: Английский

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Effect of Race, Ethnicity, and Language on Adenotonsillectomy Outcomes in Pediatric Otolaryngology

Otolaryngology, Journal Year: 2025, Volume and Issue: unknown

Published: March 25, 2025

Disparities have been described across racial and socioeconomic groups in adenotonsillectomy access surgical outcomes, but little is known about the impact of language. We studied effect race, ethnicity, language on frequency postoperative rates visits to emergency department, hospital admissions, return operating room. hypothesized that non-white, Hispanic, patients speaking a non-English would higher department visits, readmissions, Retrospective cohort analysis. Tertiary care academic center. Demographic encounter data were abstracted from hospital's warehouse for who underwent over 12 years (May 2011-June 2023). Continuous variables compared using Kruskal-Wallis test or Mann-Whitney U as indicated. Categorical Fisher's exact test. Our study included 7945 patients. Non-white had 30-day visit than white (8.6% vs 6.8%; P = .003) comparable admissions room rates. Hispanic other ethnic (8.0%, 8.6%) non-Hispanic (6.8%; .026). Patients Spanish different (8.7%, 10.6%) English-speaking (7.3%; .038). Rates admission similar race groups. Higher present our patient population racial, ethnic, linguistic cohorts.

Language: Английский

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Intracapsular Tonsillectomy With Monopolar Cautery—A Cost‐Effective Surgical Technique

OTO Open, Journal Year: 2025, Volume and Issue: 9(2)

Published: April 1, 2025

Abstract Objective To illustrate improved posttonsillectomy hemorrhage rates with a novel cost‐effective monopolar intracapsular tonsillectomy (ICT) technique. Study Design Retrospective cohort. Setting Single physician's experience at Midwest private practice. Methods A single surgeon's chart review of 576 pediatric patients who underwent in the last 20 years was completed. In total, 331 cases were treated ICT performed bovie electrocautery technique, as opposed to more widely used microdebrider or coblator techniques. 246 traditional extracapsular (ECT) technique using electrocautery. Results Of ICTs performed, one postoperative requiring intervention identified, resulting an bleed rate 0.3%. ECTs 9 bleeds ECT 3.7%. this cohort, relative risk developing 12 times higher than ( P = .018). Every 30 prevented tonsil (number needed treat [NNT] 29.8). Potential savings cautery is $1.5 $1.6 million for every 10,000 that transition from Conclusion resulted significantly decreased compared surgeon and much lower cost

Language: Английский

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An overview of management strategies for pediatric obstructive sleep apnea following adenotonsillectomy

Expert Review of Respiratory Medicine, Journal Year: 2025, Volume and Issue: unknown

Published: May 8, 2025

Persistent obstructive sleep apnea (OSA) following adenotonsillectomy is a frequently encountered challenge for clinicians including pediatricians, neurologists, otolaryngologists and specialists, if untreated poses severe health risks to children. This article evaluates the etiology pathophysiology of persistent pediatric OSA. It also discusses conditions that predispose some children OSA reviews different diagnostic modalities various options management A PubMed search was performed using terms in combinations: apnea, positive airway pressure, hypoglossal nerve stimulator, myofunctional therapy, nasal surgery, CPAP tolerance, obesity, Down syndrome, monteleukast, frenulectomy, bariatric drug induced endoscopy, cine MRI. commonly seen Understanding anatomic physiologic mechanisms at play important formulate specific strategies. have higher degree suspicion after an with neurological comorbidities obesity.

Language: Английский

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Efficacy of endoscopic powered intracapsular tonsillectomy and adenoidectomy for pediatric obstructive sleep apnea: A retrospective case-control study

Auris Nasus Larynx, Journal Year: 2022, Volume and Issue: 50(3), P. 383 - 388

Published: Sept. 7, 2022

Language: Английский

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A prospective, randomized, single‐blind study comparing coblation and monopolar extracapsular tonsillectomy

Laryngoscope Investigative Otolaryngology, Journal Year: 2022, Volume and Issue: 7(3), P. 707 - 714

Published: March 29, 2022

Abstract Objective The aim of this study was to compare intraoperative blood loss, postoperative pain, post‐tonsillectomy hemorrhage (PTH), and medical costs associated with extracapsular tonsillectomy between coblation monopolar electrocautery in children. Materials methods This included 293 patients aged 6–15 years planned undergo tonsillectomy. Data on estimated pain score, operation time, PTH, the cost disposable equipment were collected. Results Coblation significantly lower mean scores than technique days 1 ( p <.001) 2 = 0.02). However, score similar groups at all other time points. group had a shorter compared (11.09 ± 7.53 vs. 17.12 4.29 min, <.001). Intraoperative loss not different .43).The (US$ 28.18 US$ 430.48, PTH occurred 17 (5.80%) required second surgery. Secondary 6.16% (9/146) 0.68% (1/147) groups, respectively higher tonsillitis tonsillar hypertrophy (12.37% 2.55%, .002), difference significant among subgroups. Of pole, middle portion, upper pole involved 15 (88.24%), (11.76%), 0 cases, respectively. Conclusions novel are except 2. offers advantages over method less operative decreased secondary cost. Level Evidence: NA.

Language: Английский

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When Should We Recommend Intracapsular Tonsillectomy in Pediatric Patients?

The Laryngoscope, Journal Year: 2024, Volume and Issue: 134(8), P. 3423 - 3424

Published: March 28, 2024

Language: Английский

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Intracapsular versus Extracapsular Tonsil Surgery: comparison of Postoperative Haemorrhage outcomes in the Australasian setting

International Journal of Pediatric Otorhinolaryngology, Journal Year: 2024, Volume and Issue: 186, P. 112147 - 112147

Published: Oct. 28, 2024

Language: Английский

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Coblation intracapsular tonsillectomy in a paediatric tertiary centre: Revision surgery rates over a nine-year period

International Journal of Pediatric Otorhinolaryngology, Journal Year: 2024, Volume and Issue: 181, P. 111942 - 111942

Published: April 8, 2024

Language: Английский

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