Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2017 Mar;156(3):456-463.
doi: 10.1177/0194599816683916. Epub 2017 Jan 17.

Comparative Effectiveness of Partial versus Total Tonsillectomy in Children

Nila Sathe  1 , Sivakumar Chinnadurai  2 , Melissa McPheeters  1 , David O Francis  2
Affiliations
Review

Comparative Effectiveness of Partial versus Total Tonsillectomy in Children

Nila Sathe et al. Otolaryngol Head Neck Surg. 2017 Mar.

Abstract

Objective To assess the effectiveness of partial versus total tonsillectomy in children. Data Sources MEDLINE, EMBASE, and Cochrane Library from January 1980 to June 2016. Review Methods Two investigators independently screened studies and extracted data. Investigators independently assessed risk of bias and strength of evidence of the literature. Heterogeneity precluded quantitative analysis. Results In 16 eligible randomized controlled trials (RCTs), definitions of "partial" tonsillectomy varied. In addition to comparing partial with total tonsil removal, 11 studies compared surgical techniques (eg, coblation). In studies comparing the same technique, return to normal diet or activity was faster with partial removal (more favorable outcomes in 4 of 4 RCTs). In studies with differing surgical techniques, return to normal diet and activity was faster with partial versus total tonsillectomy (more favorable outcomes in 5 of 6 studies). In 3 of 4 RCTs, partial tonsillectomy was associated with more throat infections than total tonsillectomy. Differences between groups were generally not statistically significant for obstructive symptom persistence, quality of life, or behavioral outcomes. Across all studies, 10 (6%) of roughly 166 children had tonsillar regrowth after partial tonsillectomy. Conclusions Data do not allow firm conclusions regarding the comparative benefit of partial versus total removal; however, neither surgical technique nor extent of surgery appears to affect outcomes markedly. Partial tonsillectomy conferred moderate advantages in return to normal diet/activity but was also associated with tonsillar regrowth and symptom recurrence. Effects may be due to confounding given differences in populations and surgical approaches/techniques. Heterogeneity and differences in the operationalization of "partial" tonsillectomy limited comparative analyses.

Keywords: adenotonsillectomy; tonsillectomy; tonsillotomy.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Disposition of studies identified for this review
*Numbers do not tally as studies could be excluded for multiple reasons. Abbreviations: n = Number.
See this image and copyright information in PMC

References

    1. Boss EF, Marsteller JA, Simon AE. Outpatient tonsillectomy in children: demographic and geographic variation in the United States, 2006. J Pediatr. 2012;160:814–9. - PubMed
    1. Cullen KA, Hall MJ, Golosinskiy A. Ambulatory surgery in the United States, 2006. Natl Health Stat Report. 2009:1–25. - PubMed
    1. Parker NP, Walner DL. Trends in the indications for pediatric tonsillectomy or adenotonsillectomy. Int J Pediatr Otorhinolaryngol. 2011;75:282–5. - PubMed
    1. Patel HH, Straight CE, Lehman EB, et al. Indications for tonsillectomy: a 10 year retrospective review. Int J Pediatr Otorhinolaryngol. 2014;78:2151–5. - PubMed
    1. Koltai PJ, Solares CA, Mascha EJ, et al. Intracapsular partial tonsillectomy for tonsillar hypertrophy in children. Laryngoscope. 2002;112:17–9. - PubMed

Publication types