New procedure cuts tonsillectomy pain

Mason was diagnosed with failure to thrive. Kids with the disorder can't take in enough calories needed for weight gain and growth. At 8 months he had to rely on a feeding tube to eat.

Mason grew healthier, but the feeding tube damaged his tonsils. Dr. Mitchell Austin decided to take them out using a new device that cuts with ions.

"The ions create heat at a very localized, fixed point," said Dr. Austin, Nemours Children's Clinic.

The tool generates four times less heat than traditional cutting devices, leaving a smaller scar on the throat.

"Lesser depth of burn versus a deeper burn," said Dr. Austin.

Just a few millimeters less damage can cut recovery time in half.

"They're eating in a week instead of two weeks. They're taking probably five or seven days less of stronger narcotic pain medications, and their moms feel better that their child is in less pain requiring less pain medicine," said Dr. Austin.

Mason was eating 24 hours after the operation.

"You would not look at him and know he had surgery the day before," said Mason's mom, Carla McRae.

And just two weeks post-op, he was back to being a typical 2-year-old. Hopefully a sign his troubles are behind him.

The most common and traditional method of tonsil removal uses a scalpel.

Web Extra Information: Less Painful Tonsillectomy

A TIME-TESTED SURGERY:

Tonsil removals, or tonsillectomies, are one of the most common procedures performed on children, says the American Academy of Otolaryngology - Head and Neck Surgery. It's also one of the oldest types of surgery. The first report of a tonsillectomy was made by the Roman surgeon Celsus in 30 AD and was performed with a scalpel. Today, tonsillectomies are most often recommended for children with sleeping disorders related to enlarged tonsils and chronic tonsil infections, although infections are now more treatable with antibiotics. DOES YOUR CHILD NEED A TONSILLECTOMY?

Although tonsillectomies have been performed for centuries, physicians are just now beginning to agree on indications for the surgery. The two main problems that call for tonsil removal are obstructive sleep apnea syndrome (OSAS) and chronic tonsillitis. OSAS happens when obstruction of a child's airway leads to abnormal breathing during sleep and sleep disruption. Symptoms include snoring, pauses in breathing, snorts and gasps during sleep.

The American Academy of Pediatrics says only about 2 percent of children have true obstructive sleep apnea. Tonsillitis is an infection of the tonsils, and the American Academy of Otolaryngology says children should have their tonsils removed if they have three or more tonsil or adenoid infections per year.

Despite the number of successful tonsillectomies performed every year, some parents avoid having the procedure done on their children out of fear. A recent study conducted to ease this fear found things like social and behavioral problems, anxiety, depression and social immaturity actually improved significantly in children after they underwent the procedure. PROCEDURE OPTIONS:

Since the first procedure with a scalpel, tonsillectomy methods have evolved and branched out into many different types. Cold knife dissection is removal of the tonsils using a scalpel and is still one of the most common methods practiced today.

Electrocautery burns the tonsil tissue and cauterizes blood vessels to reduce blood loss. Some tonsillectomy devices seem to stem from science fiction. A harmonic scalpel uses ultrasonic energy to vibrate its blade so fast that it simultaneously cuts and coagulates tonsil tissue. Some otolaryngologists use carbon dioxide lasers to vaporize and remove tonsil tissues.

The procedure lasts 15 to 20 minutes, is performed under local anesthesia and enables the patient to go back to school or work the next day. All of these procedures can be used to treat chronic tonsil infections, but a different technique can be used to treat enlarged, but not chronically infected tonsils. Radiofrequency ablation, or somnoplasty, transfers radiofrequency energy to tonsil tissue through probes.

It can be performed under light sedation or local anesthesia and shrinks the size of the tonsils by scarring them. Patients can immediately resume normal activities after the procedure.

LOWER TEMPERATURES MADE POSSIBLE:

Coblation tonsillectomy involves using radiofrequency waves and relatively low temperatures to break down tissue and remove the tonsils. The procedure can be performed in 15 minutes and most children who undergo the surgery are back to school in one week. "I think it's statistically significant that lower temperature technologies in tonsillectomy reduce pain, shorten the need for pain medicine usage and usually return the child back to a more active state earlier," Mitchell Austin, M.D., a pediatric otolaryngologist at Nemours Children's Clinic in Orlando, Fla.