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. 2014;43(1):26.
doi: 10.1186/s40463-014-0026-6. Epub 2014 Jul 27.

Tonsillotomy versus tonsillectomy on young children: 2 year post surgery follow-up

Elisabeth Ericsson, Jonas Graf, Inger Lundeborg-Hammarstrom, Elisabeth Hultcrantz

Tonsillotomy versus tonsillectomy on young children: 2 year post surgery follow-up

Elisabeth Ericsson et al. J Otolaryngol Head Neck Surg. 2014.

Abstract

ObjectivesTo study the long-term effect of tonsillotomy and tonsillectomy in young children after two years in comparison to the results after six months.MethodChildren, age 4-5 with Sleep Disordered Breathing (SDB) and tonsil hyperplasia, were randomized to TE (32) or TT (35). TT was performed ad modum Hultcrantz with radiofrequency technique (Ellman). An adenoidectomy with cold steel was performed in the same session for 80% of cases. The patients were assessed prior to surgery, at six and 24 months postoperatively. Effects of surgery were evaluated clinically, through questionnaire (general health/snoring/ENT-infections), Quality of Life (QoL), survey of pediatric obstructive sleep apnea with OSA-18, and children¿s behavior with the Child Behavior Checklist.ResultsAfter two years there was still no difference between the groups with respect to snoring and frequency or severity of upper airway infections. Both TT and TE had resulted in large improvement in short and long term QoL and behavior. Three TT-children and one TE child had been re-operated due to recurrence of obstructive problems, the TE-child and one of the TT-children with adenoidectomy and two of the TT-children with tonsillectomy. Three of the TT-children had tonsil tissue protruding slightly out of the tonsil pouch and twelve TE-children had small tonsil remnants within the tonsil pouches, but with no need for surgery.ConclusionYounger children have a small risk of symptom-recurrence requiring re-surgery within two years after TT. For the majority, the positive effect on snoring, infections, behavior and quality of life remain and is similar to TE.

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Figures

Figure 1
Figure 1
The frequency of snoring after surgery (six months and two years) in comparison with snoring before surgery (Qu) rated by parents. The children reoperated with tonsil surgery are excluded in the two year follow-up.
Figure 2
Figure 2
Assessment of prone to ENT infections children (Qu) were after surgery, six months and two years. The children reoperated with tonsil surgery are excluded in the two year follow-up.
Figure 3
Figure 3
TT=32/TE=32 Change in disease-specific quality of life 6 months and 2 years after. Tonsillotomy and Tonsillectomy. The children reoperated with tonsil surgery are excluded in the two year follow-up.
See this image and copyright information in PMC

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