Efficacy of Powered Intracapsular Tonsillectomy: A Single-Blinded Prospective Study

TL;DR

This study compares a less invasive tonsillectomy method with the traditional one, finding it may reduce pain and medication use without increasing risks.

Contribution

The first prospective, single-blind trial comparing powered intracapsular tonsillectomy with conventional extracapsular tonsillectomy.

Findings

PIT showed a trend toward lower postoperative pain scores on days two to four.

PIT significantly reduced analgesic consumption compared to cTE.

No postoperative bleeding occurred in either group, indicating safety.

Abstract

Background

Powered intracapsular tonsillectomy (PIT) is considered a less invasive alternative to conventional extracapsular tonsillectomy (cTE), potentially reducing postoperative pain and complications. However, most prior studies have been retrospective.

Objective

This study aimed to assess the clinical utility of PIT in comparison to cTE through a single-blind, randomized controlled trial.

Methods

In this prospective trial (registered with the WHO International Clinical Trials Registry Platform, ID: JPRN-UMIN000043776), patients undergoing PIT (n = 6) or cTE (n = 5) were evaluated. The primary outcome was postoperative pain measured by the FACES Pain Rating Scale (FRS). Secondary outcomes included analgesic use, dietary intake, and postoperative bleeding.

Results

The PIT group showed a trend toward lower FRS scores on postoperative days two to four (p = 0.053) and significantly reduced analgesic consumption (p < 0.001). No significant differences were found in dietary intake. No postoperative bleeding occurred in either group.

Conclusion

PIT was associated with significantly lower analgesic use and a trend toward reduced postoperative pain, with no increased risk of bleeding. PIT may be a safe and minimally invasive alternative to cTE, potentially facilitating earlier postoperative dietary advancement.

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