Endoscope-Assisted Tonsillotomy (Partial Intracapsular Tonsillectomy): How We Do It

Vincent Uzomefuna,Fergal Glynn

doi:10.5402/2012/713901

Abstract

Objective. To describe our technique of performing tonsillotomy that increases visibility by providing a better view of the tonsils and related structures through the use of a 30-degree scope. Method. Patients had tonsillotomy with microdebrider with the aid of a 30-degree endoscope for both visualization and on-screen projection and magnification. Result. The endoscope-assisted technique provides a more detailed exposure of pharyngeal structures and their relationships with the tonsils. It is easier to clearly visualize the upper and lower poles. The magnification with the endoscope makes it easier to appreciate anatomic details and identify/deal selectively with minute bleeding points. Conclusion. The use of 30-degree endoscope in tonsillotomy provides better visualization of the upper and lower tonsil poles and may make the procedure easier for the surgeon and safer for the patient.

Highlights

Tonsillotomy was initially practiced in the 19th century and has been revived in the early 1990s [1]
After years of heated arguments among surgeons of the last century, tonsillotomy was eventually abandoned in favor of tonsillectomy as a result of changes in the understanding of the pathophysiology of some diseases such as rheumatism, scarlet fever, and chronic heart disease, which were thought to originate from the “diseased” remnants of tonsil tissue [2, 3]
A 30-degree endoscope is introduced through the oral cavity, followed by a quick general inspection of the oropharynx and nasopharynx including the tonsils, adenoids, choanal aperture, and surrounding structures (Figure 2)

Summary

Objective

To describe our technique of performing tonsillotomy that increases visibility by providing a better view of the tonsils and related structures through the use of a 30-degree scope. Patients had tonsillotomy with microdebrider with the aid of a 30-degree endoscope for both visualization and on-screen projection and magnification. The endoscope-assisted technique provides a more detailed exposure of pharyngeal structures and their relationships with the tonsils. It is easier to clearly visualize the upper and lower poles. The magnification with the endoscope makes it easier to appreciate anatomic details and identify/deal selectively with minute bleeding points. The use of 30-degree endoscope in tonsillotomy provides better visualization of the upper and lower tonsil poles and may make the procedure easier for the surgeon and safer for the patient

Introduction

ISRN Otolaryngology

Findings

Conclusions