Intracapsular tonsillectomy improves children's postoperative behavior measures

Abstract

Background

Tonsillectomy represents one of the most frequently performed surgical interventions in pediatric otolaryngology (Bohr and Shermetaro, 2023) [1]. The selection of surgical technique plays a crucial role in determining multiple aspects of postoperative recovery, including pain management, healing trajectory, and behavioral adaptation (Karam et al., 2022; Lin et al., 2024). This investigation sought to evaluate the differential impacts of coblation intracapsular tonsillectomy (CIT) versus traditional cold dissection total tonsillectomy (TT) on postoperative behavioral patterns in pediatric patients.

Objective

This study aimed to conduct a comprehensive comparison of postoperative behavioral outcomes between pediatric patients undergoing CIT versus TT procedures.

Methods

The investigation prospectively enrolled 163 pediatric patients, aged 2–15 years, scheduled for tonsillectomy. Subjects underwent either CIT or TT procedures according to standardized protocols. Postoperative assessment utilized two validated instruments: the Parental Postoperative Pain Management (PPPM) questionnaire and the Wong-Baker Faces Pain Scale. Parents completed these assessments daily from postoperative day (POD) 1 through 7.

Results

Analysis revealed consistently superior behavioral outcomes in the CIT group compared to the TT cohort. Initial evaluations on POD 1 demonstrated advantages for the CIT technique across all measured parameters, with two reaching statistical significance. By POD 7, the behavioral differences between groups had become more pronounced, with seven parameters showing statistically significant advantages in the CIT group. Composite behavioral scores similarly demonstrated significant superiority in the CIT cohort.

Conclusions

The postoperative period following tonsillectomy presents substantial challenges for pediatric patients and their families, characterized by notable behavioral modifications. Our findings demonstrate that CIT procedures are associated with markedly improved behavioral outcomes compared to conventional TT approaches. These results provide compelling evidence supporting the preferential use of CIT when considering the behavioral impact of tonsillectomy in pediatric populations. This data contributes valuable insights to inform surgical decision-making in pediatric tonsillectomy cases.