Partial (intracapsular) tonsillectomy is enjoying somewhat of a revival offering the potential for less postoperative pain and bleeding whilst relieving the obstructive element. The authors look at 303 patients, 82 of whom had partial tonsillectomy using coblation. They measured pre and post immunoglobulin levels in both groups and found no significant levels pre and post surgery or between the two groups. Partial tonsillectomy appeared to be quicker and most interestingly there were no postoperative bleeds in this group. Five patients in the partial group had tonsillar regrowth (6.1%) of which two went on to total tonsillectomy. All five had tonsillitis following the partial tonsillectomy. This small study seems to support data emerging that partial intracapsular tonsillectomy effectively deals with obstructive symptoms while potentially offering dramatic reductions in postoperative haemorrhage. The down side remains the potential for regrowth, tonsillitis and further surgery. More developments to follow I’m sure!

Long term outcome of tonsillar regrowth after partial tonsillectomy in children with obstructive sleep apnea.
Zhang Q, Li D, Wang H.
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Ravi Thevasagayam

Clinical Lead, Department of ENT, Sheffield Children’s Hospital, Sheffield, S10 2TH, UK.

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