Intra-Capsular Tonsillotomy by Ultrasonic Method

Today’s physicians are paying more attention to enlarged tonsils, realizing that this upper airway obstruction leads to obstructive sleep disordered breathing in children, the cause of a myriad of behavioral and health problems. The conventional treatment for this medical condition is complete removal of the tonsils (total tonsillectomy) by a variety of surgical procedures (cold dissection, electrocautery, microbipolar, and harmonic scalpel). In their search for a less invasive, but equally effective technique, a team of ear, nose, and throat specialists revisited an old procedure, tonsillotomy, or partial tonsillectomy, but in this case, performed with contemporary technology. The procedure involves a reduction in the tonsil size, partially shaving them away using an endoscopic microdebrider, a very small, high-speed device that shaves soft tissue. The partial tonsillectomy eliminates the obstructive portion of the tonsil while preserving the tonsillar capsule. The capsule integrity is maintained, and a natural biologic dressing is left in place over the pharyngeal muscles, preventing them from injury, inflammation, and infection. The procedure results in less post-operative pain, a more rapid recovery, and perhaps fewer delayed complications [1].