Intracapsular or extracapsular tonsillectomy?

 
 

What is the best way to remove tonsils?...

An important distinction is whether an intra-capsular or extra capsular tonsillectomy is performed. So what is the difference between the two procedures? The tonsil has a fibrous capsule that separates it from the other tissues of the throat. In a traditional (extracapsular) tonsillectomy, the capsule of the tonsil is removed with the tonsil. With an intracapsular tonsillectomy, the tonsil capsule is left behind. Why does this matter, you may ask? Larger blood vessels are located outside the tonsil capsule. They subdivide into much smaller blood vessels within the tonsil itself. This means that if an intra-capsular tonsillectomy is performed, these larger blood vessels not exposed in the same way, and the risk of heavy bleeding is reduced. This has been confirmed in a number of studies comparing the two techniques. Research has also revealed that the intra-capsular technique is less painful to recover from. Intracapsular tonsillectomy is usually performed using coblation. This involves using an instrument that allows the tonsils to be carefully dissolved away. One small drawback of intra-capsular tonsillectomy is that small amounts of tonsil tissue are occasionally left behind. In about 2% of cases, this can regrow and require further surgery if it becomes problematic.