Intracapsular Tonsillectomy- Let's Start a Revolution!

PROGRAM DESCRIPTION: Tonsillectomy is one of the most commonly performed surgeries in children. Currently over 300,000 tonsillectomies are performed on children in the United States annually. While previously the main indication for tonsillectomy was chronic tonsillitis, the majority of tonsillectomies are now performed for sleep disordered breathing and obstructive sleep apnea.

Since Koltai described the approach and potential merits of intracapsular tonsillectomy in 2002, the procedure has steadily gained popularity in the United States and across the world as an alternative to traditional extracapsular tonsillectomy.

The advantages of intracapsular tonsillectomy are documented across numerous retrospective and prospective clinical studies as well as randomized control trials. A meta-analysis of randomized control trials concluded that intracapsular tonsillectomy demonstrates a reduced incidence of postoperative hemorrhage, reduced need for analgesics, more rapid rate of return to normal diet, and fewer days returning to normal activity.

Despite these clear advantages and the increasing number of senior pediatric otolaryngologists advocating for a paradigm shift towards intracapsular tonsillectomy, the current incidence of intracapsular tonsillectomy being performed in the United States is approximately 20% as determined by a national survey of pediatric otolaryngologists conducted by the speakers.

In order to increase the adoption of intracapsular tonsillectomy, general otolaryngologists and pediatric otolaryngologists already in practice need further instruction and guidance on the technique.

The goals of this expert series course are; to provide guidance into the perioperative management of patients undergoing intracapsular tonsillectomy; introduce the technique of intracapsular tonsillectomy; and to provide expert guidance on the nuances of the intracapsular tonsillectomy technique. By the end of the course, the general otolaryngologist and pediatric otolaryngologist should feel more comfortable with the technique of intracapsular tonsillectomy.