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Multicenter Study
. 2008 Feb;28(1):1-6.

Adeno-tonsillar surgery in Italy

G Motta  1 , D Casolino, B Cassiano, S Conticello, E Esposito, F Galletti, V Galli, G Larotonda, P Laudadio, N Mansi, E Mevio, E Mira, G Motta Jr, A Rinaldi Ceroni, V Tarantino, P Tavormina, C Vicini, S Motta, S Aversa, F Berni Canani, V Cappello, P Carra, D Cifarelli, G Cinquegrana, E Consolo, C Ondolo, G Ripa, G Romano
Affiliations
Multicenter Study

Adeno-tonsillar surgery in Italy

G Motta et al. Acta Otorhinolaryngol Ital. 2008 Feb.

Abstract
in English, Italian

Indications to surgery for adeno-tonsillar inflammatory disorders and analysis of the effectiveness of surgical treatment, compared with watchful waiting strategy, continue to be the subject of scientific debate. The present investigation focuses on the surgical activity of 14 Italian Otorhinolaryngological Units between 1999 and 2004. Surgical interventions (adeno-tonsillectomy, adenoidectomy, tonsillectomy) on 26915 children (age range: 2-11 years) were considered. Data on adeno-tonsillar interventions were analysed in relation to other interventions of ENT interest, performed in the same units and in the same period. Adeno-tonsillar interventions accounted for 35.4% of all operations of ENT interest. Adeno-tonsillectomy accounted for 56.6% of overall adeno-tonsillar operations, adenoidectomy 31.6%, tonsillectomy 11.8%. The percentage for the three interventions was homogeneous in the period of the study and in the recruited units. The percentage of children who underwent adeno-tonsillar surgery in paediatric units was higher as compared to general units, as far as concerns the overall number of operations performed. In southern Italy, the number of adeno-tonsillar interventions, in general, and of adeno-tonsillectomy, in particular, was higher compared to that in northern Italy. Results of the present study suggest that environmental factors, cultural issues and local health demands, may influence indications and, therefore, the different incidence of the operations under consideration in the units taking part in the investigation.

Le indicazioni al trattamento chirurgico nella patologia delle tonsille palatine e delle vegetazioni adenoidi continuano a sollecitare un vivace dibattito scientifico. La nostra ricerca ha riguardato l’attività chirurgica di 14 Centri specialistici otorinolaringoiatrici; sono stati presi in considerazione 26.915 pazienti, con età compresa fra i 2 e gli 11 anni, sottoposti ad interventi chirurgici faringei (adeno-tonsillectomia, adenoidectomia e tonsillectomia), nell’arco di tempo compreso fra il 1999 ed il 2004, per una patologia infiammatoria tonsillare e/o adenoidea; i dati relativi a questi pazienti sono stati analizzati tenendo conto degli altri interventi di interesse specialistico, eseguiti negli stessi Centri e nello stesso periodo. Gli interventi faringei costituiscono il 35,4% delle operazioni di competenza specialistica; le adenotonsillectomie incidono sul numero totale di operazioni faringee per il 56,6%, le adenoidectomie per il 31,6% e le tonsillectomie per il 11,8%. L’andamento delle percentuali medie, per i tre interventi, negli anni considerati, è omogeneo; vi è, però, una tendenza alla riduzione delle adenotonsillectomie con un corrispondente aumento degli altri due interventi. Nei Centri che operano in Ospedali Pediatrici il numero percentuale di casi sottoposto ad interventi faringei, in relazione al numero totale di operazioni, è nettamente superiore. Nel meridione d’Italia, il numero degli interventi faringei in generale e quello delle adeno-tonsillectomie in particolare, è più elevato, rispetto al settentrione. I dati raccolti nei singoli Centri, però, si discostano, talora, dalle medie per quanto riguarda sia l’andamento delle percentuali degli interventi negli anni oggetto dello studio, sia l’incidenza reciproca delle tre operazioni faringee studiate. I risultati del nostro studio e le osservazioni riportate in letteratura fanno presumere che fattori socio-ambientali, oltre che indirizzi culturali ed esigenze sanitarie locali, possano influenzare le indicazioni e la diversa incidenza degli interventi studiati.

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Figures

Fig. 1
Fig. 1
Adeno-tonsillar interventions (% with SD) related to overall number of specialistic operations in the same years. A) Overall values. B) Data from General Units. C) Data from Paediatric Units. AT = Adeno-Tonsillectomy; A = Adenoidectomy; T = Tonsillectomy; PU = Paediatric Units; GU = General Units.
Fig. 1
Fig. 1
Adeno-tonsillar interventions (% with SD) related to overall number of specialistic operations in the same years. A) Overall values. B) Data from General Units. C) Data from Paediatric Units. AT = Adeno-Tonsillectomy; A = Adenoidectomy; T = Tonsillectomy; PU = Paediatric Units; GU = General Units.
Fig. 1
Fig. 1
Adeno-tonsillar interventions (% with SD) related to overall number of specialistic operations in the same years. A) Overall values. B) Data from General Units. C) Data from Paediatric Units. AT = Adeno-Tonsillectomy; A = Adenoidectomy; T = Tonsillectomy; PU = Paediatric Units; GU = General Units.
Fig. 2
Fig. 2
Percentage with standard deviation of adeno-tonsillar interventions related to overall number of these operations in the same years. A) Overall values. B) Data from General Units. C) Data from Paediatric Units. AT = Adeno-Tonsillectomy; A = Adenoidectomy; T = Tonsillectomy
Fig. 2
Fig. 2
Percentage with standard deviation of adeno-tonsillar interventions related to overall number of these operations in the same years. A) Overall values. B) Data from General Units. C) Data from Paediatric Units. AT = Adeno-Tonsillectomy; A = Adenoidectomy; T = Tonsillectomy
Fig. 2
Fig. 2
Percentage with standard deviation of adeno-tonsillar interventions related to overall number of these operations in the same years. A) Overall values. B) Data from General Units. C) Data from Paediatric Units. AT = Adeno-Tonsillectomy; A = Adenoidectomy; T = Tonsillectomy
Fig. 3
Fig. 3
Incidence of adeno-tonsillar interventions in General and Paediatric Units. Data reported refer to: A) overall number of specialistic operations; B) overall number of adeno-tonsillar interventions. AT = Adeno-Tonsillectomy; A = Adenoidectomy; T = Tonsillectomy; PU = Paediatric Units; GU = General Units.
Fig. 3
Fig. 3
Incidence of adeno-tonsillar interventions in General and Paediatric Units. Data reported refer to: A) overall number of specialistic operations; B) overall number of adeno-tonsillar interventions. AT = Adeno-Tonsillectomy; A = Adenoidectomy; T = Tonsillectomy; PU = Paediatric Units; GU = General Units.
Fig. 4
Fig. 4
Percentage of adeno-tonsillar interventions, with standard deviation, related to overall number of operations of specialistic interest performed in the recruited Units of northern and southern Italy. A) Data from northern Italy Units. B) Data from southern Italy Units. AT = Adeno-Tonsillectomy; A = Adenoidectomy; T = Tonsillectomy.
Fig. 4
Fig. 4
Percentage of adeno-tonsillar interventions, with standard deviation, related to overall number of operations of specialistic interest performed in the recruited Units of northern and southern Italy. A) Data from northern Italy Units. B) Data from southern Italy Units. AT = Adeno-Tonsillectomy; A = Adenoidectomy; T = Tonsillectomy.
Fig. 5
Fig. 5
Incidence of adeno-tonsillar interventions performed in recruited Units of northern and southern Italy. Data reported refer to: A) overall number of specialistic operations; B) overall number of adeno-tonsillar interventions. AT = Adeno-Tonsillectomy; A = Adenoidectomy; T = Tonsillectomy; N = northern Italy; S = southern Italy.
Fig. 5
Fig. 5
Incidence of adeno-tonsillar interventions performed in recruited Units of northern and southern Italy. Data reported refer to: A) overall number of specialistic operations; B) overall number of adeno-tonsillar interventions. AT = Adeno-Tonsillectomy; A = Adenoidectomy; T = Tonsillectomy; N = northern Italy; S = southern Italy.
Fig. 6
Fig. 6
Percentage of adeno-tonsillar interventions, with standard deviation, related to overall number of these operations in the same years, performed in recruited Units of northern and southern Italy. A) Data from northern Italy Units. B) Data from southern Italy Units. AT = Adeno-Tonsillectomy; A = Adenoidectomy; T = Tonsillectomy
Fig. 6
Fig. 6
Percentage of adeno-tonsillar interventions, with standard deviation, related to overall number of these operations in the same years, performed in recruited Units of northern and southern Italy. A) Data from northern Italy Units. B) Data from southern Italy Units. AT = Adeno-Tonsillectomy; A = Adenoidectomy; T = Tonsillectomy
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