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Management of Periodic Fever, Aphthous Stomatitis, Pharyngitis, Adenitis with Intracapsular Tonsillectomy
Uche C Ezeh1, Philip J Kahn2, Max M April1
1Division of Pediatric Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, New York, U.S.A.
The Laryngoscope
|August 19, 2023
Summary
Intracapsular tonsillectomy with adenoidectomy (ITA) effectively treated pediatric patients with periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome, resolving symptoms without complications.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Immunology
Background:
- Periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome is a common autoinflammatory disorder in children.
- Surgical intervention, specifically tonsillectomy, is a recognized treatment for refractory PFAPA syndrome.
- Intracapsular tonsillectomy with adenoidectomy (ITA) offers a potentially less invasive surgical approach compared to total tonsillectomy.
Observation:
- This study retrospectively analyzed 2 pediatric patients diagnosed with PFAPA syndrome.
- Both patients presented with recurrent febrile episodes and were candidates for surgical management.
- ITA was performed using a microdebrider, with close postoperative follow-up.
Findings:
- The ITA procedure was highly efficacious in both pediatric patients.
- Neither patient experienced postoperative complications.
- Symptomatic resolution of PFAPA was sustained for over 1 year post-surgery in both cases.
Implications:
- ITA represents a safe and effective surgical treatment option for PFAPA syndrome in children.
- This minimally invasive approach may reduce the risks associated with total tonsillectomy.
- Further research with larger cohorts and longer follow-up periods is warranted to validate ITA as a standard treatment for PFAPA.
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