(1033) Revision Surgery Following Intracapsular Tonsillotomy in Pediatric Patients, a Six-Year Retrospective

Introduction: Intracapsular tonsillotomy and adenoidectomy (ICT) leaves residual tonsillar tissue, allowing for regrowth, potentially requiring revision surgery (RS). Predicting the need for RS would help to characterize appropriate patients for this technique.

Methods: This is a retrospective cohort-study. We collected medical history, indications for and complications of ICT, and symptoms of tonsillar regrowth from all patients with tonsillar regrowth from 2019 through 2025 at Children’s Hospital of Colorado. Our primary outcome was need for RS. For patients that required RS, we identified the technique and any complications. Preliminary analyses included descriptive statistics and two-sided Fisher’s exact tests.

Results: Twenty pediatric patients with tonsillar regrowth following ICT were included (n=20), 16 (80%) of whom were symptomatic and 10 (50%) of whom required RS, most often extracapsular. ICT indications included obstructive sleep apnea (OSA), sleep-disordered breathing (SDB), and recurrent tonsillitis. Prematurity, atopy, and obesity were the most common additional conditions. Following RS, five (50%) patients suffered complications, two of which required ED admission or surgical intervention. We found a non-significant association between RS and symptomatic tonsillar regrowth (p=0.087). No associations were found between RS and OSA/SDB (p=1.00), ICT complications (p = 0.58), prematurity (p=0.21), atopy (p=1.00), or obesity (p=1.00).

Conclusions: These preliminary data suggest symptomatic tonsillar regrowth may be predictive of need for RS. The high rate of complications following RS suggests these patients are more complex, though there was no association between RS and patient factors suggestive of medical complexity, e.g. patient history.