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Meta-Analysis
. 2015 Mar 25;10(3):e0121500.
doi: 10.1371/journal.pone.0121500. eCollection 2015.

Tonsillectomy versus tonsillotomy for sleep-disordered breathing in children: a meta analysis

Hui Wang  1 , Yangyang Fu  2 , Yanmei Feng  1 , Jian Guan  1 , Shankai Yin  1
Affiliations
Meta-Analysis

Tonsillectomy versus tonsillotomy for sleep-disordered breathing in children: a meta analysis

Hui Wang et al. PLoS One. .

Abstract

Objectives: Tonsillotomy has gained popular acceptance as an alternative to the traditional tonsillectomy in the management of sleep-disordered breathing in children. Many studies have evaluated the outcomes of the two techniques, but uncertainty remains with regard to the efficacy and complications of tonsillotomy versus a traditional tonsillectomy. This study was designed to investigate the efficacy and complications of tonsillotomy versus tonsillectomy, in terms of the short- and long-term results.

Methods: We collected data from electronic databases including MEDLINE, EMBASE, and the Cochrane Library. The following inclusion criteria were applied: English language, children, and prospective studies that directly compared tonsillotomy and tonsillectomy in the management of sleep disordered breathing. Subgroup analysis was then performed.

Results: In total, 10 eligible studies with 1029 participants were included. Tonsillotomy was shown to be advantageous over tonsillectomy in short-term measures, such as a lower hemorrhage rate, shorter operation time, and faster pain relief. In long-term follow-up, there was no significant difference in resolution of upper-airway obstructive symptoms, the quality of life, or postoperative immune function between the tonsillotomy and tonsillectomy groups. The risk ratio of SDB recurrence was 3.33 (95% confidence interval = 1.62 6.82, P = 0.001), favoring tonsillectomy at an average follow-up of 31 months.

Conclusions: Tonsillotomy may be advantageous over tonsillectomy in the short term measures and there are no significant difference of resolving obstructive symptoms, quality of life and postoperative immune function. For the long run, the dominance of tonsillotomy may be less than tonsillectomy with regard to the rate of sleep-disordered breathing recurrence.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Search methodology.
Fig 2
Fig 2. Forest plot of included studies demonstrated the risk ratio for the rate of SDB recurrence for tonsillotomy versus tonsillectomy.
A risk ratio > 1 favors tonsillectomy. A: All randomized and non-randomized studies of SDB recurrence were included. B: Only non-randomized studies of SDB recurrence were included.
Fig 3
Fig 3. Forest plot of included studies demonstrated the risk ratio for immune function for tonsillotomy versus tonsillectomy.
A: IgA, B: IgM, C: IgG.
Fig 4
Fig 4. Forest plot of included studies demonstrated the risk ratio for PSG results for tonsillotomy versus tonsillectomy.
Fig 5
Fig 5. Forest plot of included studies demonstrated the risk ratio for operation time for tonsillotomy versus tonsillectomy.
A: All studies were included. B: Studies, with the exception of the Coblation technique, of tonsillotomy versus tonsillectomy.
See this image and copyright information in PMC

References

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