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Intracapsular Tonsillectomy and Adenoidectomy Is Associated With Higher Rates of Postoperative Fever: Prospective
Roee Noy1,2, Roni Barzilai1,2, Emad Elias Khoury1,2
1Department of Otolaryngology-Head and Neck Surgery, Rambam Health Care Campus, Haifa, Israel.
Summary
Powered intracapsular tonsillectomy and adenoidectomy (PITA) is linked to increased postoperative fever in children compared to cold adenotonsillectomy. Parents should be informed about fever risks and management following PITA procedures.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Surgical Outcomes
Background:
- Postoperative fever is a common concern in pediatric tonsillectomy.
- Limited data exists on the influence of surgical technique on fever incidence.
Purpose of the Study:
- To compare the incidence of postoperative fever in children undergoing cold adenotonsillectomy versus powered intracapsular tonsillectomy and adenoidectomy (PITA).
Main Methods:
- Prospective cohort study of 82 children undergoing tonsillectomy with or without adenoidectomy.
- Surgical techniques included cold adenotonsillectomy and PITA (coblation or microdebrider).
- Primary outcome: high postoperative fever (>37.9°C) within 1 week; secondary outcomes: hemorrhage, pain, diet resumption, halitosis, referrals, readmissions.
Main Results:
- The 1-week postoperative fever rate was 24.4%.
- PITA was associated with significantly higher rates of fever (OR: 4.81) and physician referrals compared to cold adenotonsillectomy.
- PITA demonstrated lower pain scores and faster return to a normal diet.
Conclusions:
- PITA is associated with an increased risk of postoperative fever in pediatric patients.
- Informed parental counseling regarding fever potential and management is crucial for PITA procedures.
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