Aktuelle Studienlage zur Tonsillotomie

Abstract

TT is predominantly indicated for tonsillar hyperplasia, with or without tonsillitis. Restrictions related to age or surgical instruments are not reported in the literature data. Data concerning operation time, intraoperative bleeding, and outcome favor TT over TE. The median values for regrowth (3.0 %), postoperative tonsillitis (2.85 %), and secondary TE (1.37 %) emphasize the high success rate of TT. Further research utilizing a uniform terminology is mandatory to clarify the benefit of TT over TE in the long term and to resolve sleep-related breathing disorders resulting from tonsillar hyperplasia or tonsillitis.

Time to Functional Recovery After Laser Tonsillotomy Performed Under Local Anesthesia vs Conventional Tonsillectomy With General Anesthesia Among Adults

“…A randomized clinical trial by Ericcson et al comparing radiofrequency tonsillotomy performed under general anesthesia with tonsillectomy found a significantly faster resumption of normal activities with tonsillotomy (mean [SD], 6.4 [2.3] days) compared with tonsillectomy (10.6 [2.8] days); lower pain on postoperative days 1, 3, 5, and 10; lower analgesic medication requirements; and fewer postoperative hemorrhage events. Other studies have also found lower bleeding rates with tonsillotomy vs tonsillectomy …”

“…Other studies have also found lower bleeding rates with tonsillotomy vs tonsillectomy. [27][28][29][30] On the basis of direct surgical considerations, we believe that the differences in functional recovery, postoperative pain, and complications may be exclusively attributed to the less invasive nature of tonsillotomy. The postoperative wound after tonsillotomy may be comparable to a serious abrasion, whereas after tonsillectomy, tissue damage is more extensive, exposes the underlying constrictor muscle, and includes large blood vessels.…”

Tonsillenchirurgie: Einfluss des Tonsillenspatels auf den Pharynxdurchmesser

“…Klinisch lässt sich das am reduzierten Blutungsrisiko und der schnelleren Wundheilung erkennen. Derzeit spricht viel dafür, dass der Ersatz der Tonsillektomie durch die Tonsillotomie bei selektiver Indikationsstellung nicht nachteilig für das Ergebnis bei deutlich geringerer postoperativer Morbidität ist [11]. Trotz dieses Vorteils dürfen die Berichte über tödlich verlaufende Blutungskomplikationen nicht ignoriert werden [9].…”