In this episode of BackTable ENT, Dr. Shah interviews pediatric otolaryngologist Dr. Kevin Huoh about intracapsular tonsillectomy, including the postoperative benefits of the procedure and his personal techniques.

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SHOW NOTES

First, Dr. Huoh explains the principle behind intracapsular tonsillectomy. This technique involves removing the tonsil but leaving the capsule intact to protect muscles of the pharyngeal wall and lateral vessels. When he performs this procedure on patients, he notices that their recovery period is less painful and their lower risk of hemorrhages when compared to extracapsular tonsillectomy patients. According to the literature, there is only 3% risk of tonsil regrowth, but he considers regrowth a safer complication than tonsillar hemorrhage. His postoperative recovery regimen includes Tylenol or Motrin for 24 hours, and his patients can start on a regular diet immediately after surgery. Then, he and Dr. Shah discuss differences between American and European guidelines on intracapsular tonsillectomy.

Next, Dr. Huoh explains the type of equipment he uses and his intracapsular tonsillectomy technique. He encourages surgeons to follow their tonsillar regrowth rate, as this data can inform surgeons on whether they are removing enough tissue during the procedure. Additionally, he also emphasizes that it is never too late to learn a new procedure like intracapsular tonsillectomy. He finds it easy to add on an intracapsular tonsillectomy as a minor procedure if he is already taking a patient to the OR for another surgery because of the minimal risks of the procedure. Finally, Dr. Shah and Dr. Huoh discuss tonsillectomies in adults and children with recurrent peritonsillar abscesses.

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RESOURCES

Smith + Nephew Coblation Technology for Adenotonsillectomy

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