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Shorter Recovery Time

Sara Scheid MD, FAAP of Capital Region Ear, Nose and Throat is now performing a new  procedure for tonsillectomies: intracapsular tonsillectomy.  Intracapsular tonsillectomy  results in faster recovery time and a return to normal activity and diet.

“The quick recovery time and overall positive results that I have experienced with my patients is extremely encouraging,” said Dr. Scheid.  “Surprisingly, when surgery is done on Thursday most children are ready to go back to school on Monday.”

Over the past seven years, several studies have compared this technique to the traditional electrocautery technique.  Most studies show that patients return to normal diet and activity after two to four days compared to two weeks with the traditional technique.  Children also require significantly less pain medication and are less likely to become dehydrated and require readmission to the hospital.  Studies also        suggest that this procedure is the preferred way to remove tonsils in children under three-years-old.  Since there is less risk of pain,dehydration, and bleeding, most children under three do not require overnight admission postoperatively. 

During this procedure, the tonsil is removed from the outside in, therefore the larger feeding blood vessels are protected between the tonsillar capsule and the  muscle bed.  This results in less risk of post-operative bleeding and allows  children to quickly return to normal activity.  There is also less  damage to the muscle bed itself,  which lessens pain and voice changes.  Initial studies have shown a 3% recurrence rate of the tonsils by leaving a small piece of tonsil in the tonsillar fossa.  Newer techniques are focusing on greater than 95%  removal of the tonsillar tissue with special attention to the superior and inferior poles.  This suggests that a lower recurrence rate is possible. 

“This new technique dramatically reduces the morbidity of this classically painful procedure," said Dr. Scheid. “I concur with the majority of specialists using this technique who feel that the dramatic reduction outweighs the minimal risk of recurrence.”

Initially, this procedure was indicated for children with adenotonsillar hypertrophy and upper airway resistance syndrome, or obstructive sleep apnea.  Now new research shows it is appropriate for patients with chronic tonsillitis too.  Several studies have shown resolution of snoring, upper airway resistance syndrome and obstructive sleep apnea with this technique.  A 2007 study out of Delaware's Dupont Hospital for compared electrocautery tonsillectomy and intracapsular tonsillectomy and found no difference in recurrent infection rate in children followed for two years.