Coblation intra-capsular tonsillectomy: A prospective tertiary center trial
There is a growing interest in intra-capsular coblation tonsillectomy (ICT) for the treatment of obstructive sleep apnea (OSA) in children. Literature remains controversial regarding which intra-capsular tonsillectomy (IT) technique is most effective and with least morbidity. Therefore, the aims of...
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| Veröffentlicht in: | International journal of pediatric otorhinolaryngology 2021-11, Vol.150, p.110890-110890, Article 110890 |
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| container_title | International journal of pediatric otorhinolaryngology |
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| creator | Khoueir, Nadim Rassi, Joe Richa, Tony Helou, Diane Khalaf, Michel G. Rassi, Simon |
| description | There is a growing interest in intra-capsular coblation tonsillectomy (ICT) for the treatment of obstructive sleep apnea (OSA) in children. Literature remains controversial regarding which intra-capsular tonsillectomy (IT) technique is most effective and with least morbidity. Therefore, the aims of this study are to objectively measure the post-operative morbidity and the effectiveness of the ICT technique.
107 children undergoing ICT (with or without adenoidectomy) for upper airway obstruction due to tonsillar hypertrophy at a tertiary center university hospital were prospectively enrolled from March 2016 to March 2018. Efficacy of the surgery was assessed by a pre-and post-operative Obstructive Sleep Apnea score (OSA-18). Post-operative morbidity was measured based on the Parent's Post-operative Pain Measure questionnaire (PPPM), type and duration of administered pain medication, time before resuming a full diet and a normal activity, readmission for dehydration and post-operative bleeding incidence.
After a mean follow-up of 21.6 months, OSA-18 mean total score was 78.77 (SD = 15.74) before ICT and 23.7 (SD = 9.25) after surgery, with a significant difference between pre-operative and post-operative scores (p |
| doi_str_mv | 10.1016/j.ijporl.2021.110890 |
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107 children undergoing ICT (with or without adenoidectomy) for upper airway obstruction due to tonsillar hypertrophy at a tertiary center university hospital were prospectively enrolled from March 2016 to March 2018. Efficacy of the surgery was assessed by a pre-and post-operative Obstructive Sleep Apnea score (OSA-18). Post-operative morbidity was measured based on the Parent's Post-operative Pain Measure questionnaire (PPPM), type and duration of administered pain medication, time before resuming a full diet and a normal activity, readmission for dehydration and post-operative bleeding incidence.
After a mean follow-up of 21.6 months, OSA-18 mean total score was 78.77 (SD = 15.74) before ICT and 23.7 (SD = 9.25) after surgery, with a significant difference between pre-operative and post-operative scores (p < 0.001). Mean PPPM scores were low at all evaluation points (5.89, 2.42 and 0.83 at days 2, 5 and 10 respectively). Analgesic use was restricted to acetaminophen in nearly all children for a mean duration of 1.93 days. They resumed a normal diet after 2.42 days and a normal activity (including return to school) after 2.7 days. No hospital readmission nor post-operative hemorrhage were reported.
Intra-capsular tonsillectomy by coblation is an effective and safe procedure that provides rapid post-operative recovery with minimal analgesic requirements, thus deserving a wider application in treating upper airway obstruction due to tonsillar hypertrophy in children.</description><identifier>ISSN: 0165-5876</identifier><identifier>EISSN: 1872-8464</identifier><identifier>DOI: 10.1016/j.ijporl.2021.110890</identifier><identifier>PMID: 34411867</identifier><language>eng</language><publisher>Ireland: Elsevier B.V</publisher><subject>Adenoidectomy ; Child ; Coblation ; Humans ; Morbidity ; Obstructive sleep apnea ; Pain, Postoperative - etiology ; Palatine Tonsil ; Pediatric population ; Prospective Studies ; Surgery ; Tonsillectomy ; Tonsillectomy - adverse effects</subject><ispartof>International journal of pediatric otorhinolaryngology, 2021-11, Vol.150, p.110890-110890, Article 110890</ispartof><rights>2021 Elsevier B.V.</rights><rights>Copyright © 2021 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c362t-d9e7d4d76fc74b237cffa1737c2c2abadbd6147ffdfb781ce685cb7c1242ea6e3</citedby><cites>FETCH-LOGICAL-c362t-d9e7d4d76fc74b237cffa1737c2c2abadbd6147ffdfb781ce685cb7c1242ea6e3</cites><orcidid>0000-0002-7151-1102 ; 0000-0001-5663-3374</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ijporl.2021.110890$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34411867$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Khoueir, Nadim</creatorcontrib><creatorcontrib>Rassi, Joe</creatorcontrib><creatorcontrib>Richa, Tony</creatorcontrib><creatorcontrib>Helou, Diane</creatorcontrib><creatorcontrib>Khalaf, Michel G.</creatorcontrib><creatorcontrib>Rassi, Simon</creatorcontrib><title>Coblation intra-capsular tonsillectomy: A prospective tertiary center trial</title><title>International journal of pediatric otorhinolaryngology</title><addtitle>Int J Pediatr Otorhinolaryngol</addtitle><description>There is a growing interest in intra-capsular coblation tonsillectomy (ICT) for the treatment of obstructive sleep apnea (OSA) in children. Literature remains controversial regarding which intra-capsular tonsillectomy (IT) technique is most effective and with least morbidity. Therefore, the aims of this study are to objectively measure the post-operative morbidity and the effectiveness of the ICT technique.
107 children undergoing ICT (with or without adenoidectomy) for upper airway obstruction due to tonsillar hypertrophy at a tertiary center university hospital were prospectively enrolled from March 2016 to March 2018. Efficacy of the surgery was assessed by a pre-and post-operative Obstructive Sleep Apnea score (OSA-18). Post-operative morbidity was measured based on the Parent's Post-operative Pain Measure questionnaire (PPPM), type and duration of administered pain medication, time before resuming a full diet and a normal activity, readmission for dehydration and post-operative bleeding incidence.
After a mean follow-up of 21.6 months, OSA-18 mean total score was 78.77 (SD = 15.74) before ICT and 23.7 (SD = 9.25) after surgery, with a significant difference between pre-operative and post-operative scores (p < 0.001). Mean PPPM scores were low at all evaluation points (5.89, 2.42 and 0.83 at days 2, 5 and 10 respectively). Analgesic use was restricted to acetaminophen in nearly all children for a mean duration of 1.93 days. They resumed a normal diet after 2.42 days and a normal activity (including return to school) after 2.7 days. No hospital readmission nor post-operative hemorrhage were reported.
Intra-capsular tonsillectomy by coblation is an effective and safe procedure that provides rapid post-operative recovery with minimal analgesic requirements, thus deserving a wider application in treating upper airway obstruction due to tonsillar hypertrophy in children.</description><subject>Adenoidectomy</subject><subject>Child</subject><subject>Coblation</subject><subject>Humans</subject><subject>Morbidity</subject><subject>Obstructive sleep apnea</subject><subject>Pain, Postoperative - etiology</subject><subject>Palatine Tonsil</subject><subject>Pediatric population</subject><subject>Prospective Studies</subject><subject>Surgery</subject><subject>Tonsillectomy</subject><subject>Tonsillectomy - adverse effects</subject><issn>0165-5876</issn><issn>1872-8464</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1LAzEQhoMotlb_gcgeveyaZLPJ1oMgxS8seNFzyCazkJL9MEkL_fembPXoaTLwzMybB6FrgguCCb_bFHYzDt4VFFNSEILrJT5Bc1ILmteMs1M0T1iVV7XgM3QRwgZjInBVnaNZyRghNRdz9L4aGqeiHfrM9tGrXKsxbJ3yWRz6YJ0DHYduf589ZqMfwphau4Msgo9W-X2moU_vLHqr3CU6a5ULcHWsC_T1_PS5es3XHy9vq8d1rktOY26WIAwzgrdasIaWQretIiJVqqlqlGkMJ0y0rWkbURMNvK50IzShjILiUC7Q7bQ3JfreQoiys0GDc6qHYRskrXjJqBC4TiibUJ3CBw-tHL3tUnBJsDxolBs5aZQHjXLSmMZujhe2TQfmb-jXWwIeJgDSP3cWvAzaQq_BWJ8USTPY_y_8ANm1h6U</recordid><startdate>202111</startdate><enddate>202111</enddate><creator>Khoueir, Nadim</creator><creator>Rassi, Joe</creator><creator>Richa, Tony</creator><creator>Helou, Diane</creator><creator>Khalaf, Michel G.</creator><creator>Rassi, Simon</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7151-1102</orcidid><orcidid>https://orcid.org/0000-0001-5663-3374</orcidid></search><sort><creationdate>202111</creationdate><title>Coblation intra-capsular tonsillectomy: A prospective tertiary center trial</title><author>Khoueir, Nadim ; Rassi, Joe ; Richa, Tony ; Helou, Diane ; Khalaf, Michel G. ; Rassi, Simon</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c362t-d9e7d4d76fc74b237cffa1737c2c2abadbd6147ffdfb781ce685cb7c1242ea6e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adenoidectomy</topic><topic>Child</topic><topic>Coblation</topic><topic>Humans</topic><topic>Morbidity</topic><topic>Obstructive sleep apnea</topic><topic>Pain, Postoperative - etiology</topic><topic>Palatine Tonsil</topic><topic>Pediatric population</topic><topic>Prospective Studies</topic><topic>Surgery</topic><topic>Tonsillectomy</topic><topic>Tonsillectomy - adverse effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Khoueir, Nadim</creatorcontrib><creatorcontrib>Rassi, Joe</creatorcontrib><creatorcontrib>Richa, Tony</creatorcontrib><creatorcontrib>Helou, Diane</creatorcontrib><creatorcontrib>Khalaf, Michel G.</creatorcontrib><creatorcontrib>Rassi, Simon</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of pediatric otorhinolaryngology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Khoueir, Nadim</au><au>Rassi, Joe</au><au>Richa, Tony</au><au>Helou, Diane</au><au>Khalaf, Michel G.</au><au>Rassi, Simon</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Coblation intra-capsular tonsillectomy: A prospective tertiary center trial</atitle><jtitle>International journal of pediatric otorhinolaryngology</jtitle><addtitle>Int J Pediatr Otorhinolaryngol</addtitle><date>2021-11</date><risdate>2021</risdate><volume>150</volume><spage>110890</spage><epage>110890</epage><pages>110890-110890</pages><artnum>110890</artnum><issn>0165-5876</issn><eissn>1872-8464</eissn><abstract>There is a growing interest in intra-capsular coblation tonsillectomy (ICT) for the treatment of obstructive sleep apnea (OSA) in children. Literature remains controversial regarding which intra-capsular tonsillectomy (IT) technique is most effective and with least morbidity. Therefore, the aims of this study are to objectively measure the post-operative morbidity and the effectiveness of the ICT technique.
107 children undergoing ICT (with or without adenoidectomy) for upper airway obstruction due to tonsillar hypertrophy at a tertiary center university hospital were prospectively enrolled from March 2016 to March 2018. Efficacy of the surgery was assessed by a pre-and post-operative Obstructive Sleep Apnea score (OSA-18). Post-operative morbidity was measured based on the Parent's Post-operative Pain Measure questionnaire (PPPM), type and duration of administered pain medication, time before resuming a full diet and a normal activity, readmission for dehydration and post-operative bleeding incidence.
After a mean follow-up of 21.6 months, OSA-18 mean total score was 78.77 (SD = 15.74) before ICT and 23.7 (SD = 9.25) after surgery, with a significant difference between pre-operative and post-operative scores (p < 0.001). Mean PPPM scores were low at all evaluation points (5.89, 2.42 and 0.83 at days 2, 5 and 10 respectively). Analgesic use was restricted to acetaminophen in nearly all children for a mean duration of 1.93 days. They resumed a normal diet after 2.42 days and a normal activity (including return to school) after 2.7 days. No hospital readmission nor post-operative hemorrhage were reported.
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| subjects | Adenoidectomy Child Coblation Humans Morbidity Obstructive sleep apnea Pain, Postoperative - etiology Palatine Tonsil Pediatric population Prospective Studies Surgery Tonsillectomy Tonsillectomy - adverse effects |
| title | Coblation intra-capsular tonsillectomy: A prospective tertiary center trial |
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