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Intracapsular Tonsillectomy in Adults

Not Applicable
Active, not recruiting
Conditions
Tonsillitis Acute
Tonsillitis
Tonsil Disease
Tonsillitis Chronic
Interventions
Procedure: tonsillectomy
Registration Number
NCT03654742
Lead Sponsor
Turku University Hospital
Brief Summary

Comparing the classical extracapsular tonsillectomy (TE) performed with electrosurgery to intracapsular approaches (SIPT) by coblation or microdebrider. The patient group is adults with recurrent or chronic tonsillitis

Detailed Description

Extracapsular tonsillectomy (TE) with monopolar electrosurgery is the most commonly used approach in adult tonsil surgery in Turku University Central Hospital, Finland.

In our study setting we are comparing intracapsular tonsillectomy (subtotal/intracapsular/partial tonsillectomy (SIPT) ) as the intervention group with extracapsular tonsillectomy as the control group.

SIPT is done with either coblation or microdebrider and TE with monopolar electrosurgery.

Indications for surgery are recurrent tonsillitis or chronic tonsillitis. The patient group is adults (16-65 years)

Safety, efficiency and cost-effectiveness are monitored in a prospective, patient-blinded and randomised study setting.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
167
Inclusion Criteria
  • Age 16-65 years
  • Planned tonsil surgery with informed consent
  • Recurrent or chronic tonsillitis
Exclusion Criteria
  • Less than 1 month old, drained quinsy
  • Acute "hot phase" tonsillitis
  • Previous palatine tonsil surgery
  • Suspicion or confirmation of malignancy
  • High dose analgesics consumption
  • Current CPAP-device usage for treatment of OSAS
  • Untreated gastro-esophageal reflux disease
  • Anticoagulative medication
  • Any condition of hemophilia
  • Pregnancy, lactation
  • Current or positive history of malignant disease (if still active follow-up)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
ECTE/ElectrosurgerytonsillectomyExtracapsular tonsillectomy (ECTE) with monopolar electrosurgery
ICTE/CoblatortonsillectomyIntrapsular tonsillectomy (ICTE) with coblator
ICTE/MicrodebridertonsillectomyIntracapsular tonsillectomy (ICTE) with microdebrider
Primary Outcome Measures
NameTimeMethod
Post-operative recovery21 days

Pain post-operatively after discharge as self-reported pain intensity over the past day. Each day is scored with the modified Brief Pain Inventory and recovery is achieved when pain score reaches preset values. Recovery speed defined as pain VAS-score 3 or less at rest; or pain VAS-score 5 or less without regular analgesics use. Daily questionnaire used: Brief Pain Inventory.

Secondary Outcome Measures
NameTimeMethod
Life quality6 months

Quality of life as defined by the questionnaires: Glasgow Benefit Inventory "GBI" at 6 months after operation.

Analgesics use21 days

Need for analgesics postoperatively during 21 days. Measured as number of naprometin tablets/ day and the number of tramadol-paracetamol combination tablets/day.

Post-operative bleeding21 days

Bleeding post-operatively at the ward or at any point during 21 days. Measured as 1-4 (1= bleeding, stopped spontaneously, no contact with staff; 2: Contact with ER, bleeding stopped without intervention; 3: Bleeding, needed intervention (packing, topical adrenalin, electrosurgical hemostasis; 4: Needed OR-time, blood transfusion, ward days

Revision surgery5 years

The need of revision surgery after tonsillectomy, recorded with questionnaire: Nordic Tonsil Surgery Register

Throat problems5 years

Throat problems as described by the Nordic Tonsil Surgery Register at different time points postoperatively

Life Quality6 months

Quality of life as defined by the questionnaires: Tonsillectomy Outcome Inventory 14 "TOI-14" preoperatively and 6 months after operation;

Residual tonsil tissue6 months

Residual tonsil measured right after surgery is completed and at 6 months follow-up.

Trial Locations

Locations (1)

TYKS Korvaklinikka

🇫🇮

Turku, Finland

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