Intracapsular Tonsillectomy vs Extracapsular Tonsillectomy- factors Influencing Decision Making in Parents

Sunday, October 18, 2026

11:48 AM - 11:54 AM PT

Location: 409AB

Presenting Author(s)

Ryan A. Dewan, BS

Medical Student
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Buffalo, New York, United States

Co-Author(s)

Alexa F. Ibrahim, BA

Medical Student
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Oyster Bay, NY, United States
AK

Abraham A. Kassem, BS

Research Associate
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Department of Otolaryngology, Head and Neck Surgery, United States
Chinelo F. Eruchalu, BS

Medical Student
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo
Buffalo, New York, United States
JS

Joshua Sorrentino, BS

Medical Student
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, United States

Senior Author(s)

MC

Michele M. Carr, DDS MD MEd PhD

Professor
Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Dept of Otolaryngology
Buffalo, New York, United States

Introduction: Extracapsular tonsillectomy (ECT) and intracapsular tonsillectomy (ICT) are widely performed pediatric surgeries, yet little is known about the factors parents consider when choosing between these techniques. This study aimed to identify decision-making priorities and advice sources influencing parental decision selection of ECT versus ICT.

Methods: This cross-sectional survey study was conducted from July-November 2025 at a children’s hospital. Parents of children who underwent ECT or ICT completed surveys including demographics, decision-making factors, and advice sources. Responses on 5-point Likert scales (1=strongly disagree/not important; 5=strongly agree/very important) were compared between groups using Welch’s t-tests and Chi-square or Fisher’s exact tests.

Results: Among 241 respondents, 116 (48.1%) selected ECT and 125 (51.9%) selected ICT. Respondents were primarily mothers (n=187, 77.6%), predominantly White (n=185, 76.8%) and over half held at least a bachelor's degree (n=135, 56.0%). Children undergoing ICT were older than those undergoing ECT (6.95 ± 2.92 vs 5.54 ± 2.66 years, p<.001). Compared with ECT, parents selecting ICT rated bleeding risk (4.53 vs 3.59), length of healing time (4.34 vs 3.66), and expected postoperative pain (4.17 vs 3.58) as more important decision factors (all p<.001). Concern for tonsil regrowth was rated as more important among parents selecting ECT (4.01 vs 3.51, p>.001). Surgical choice was not associated with parent education, patient gender, or parent race (all p>.05). Advice sources were similar between groups, with the child’s other parent, pediatricians, and otolaryngologists rated most influential.

Conclusions: Parents prioritized different surgical factors when selecting ICT versus ECT. Recognizing these priorities may streamline preoperative counseling and improve shared decision-making.