Clinical Trials of Tonsillectomy and Adenoidectomy

Jl, Paradise

doi:10.1097/00007611-197608000-00030

Cited by 23 publications

(5 citation statements)

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“…16,18,19 The study was approved annually by the hospital's Human Rights Committee. Subjects were recruited from among hospital outpatients and children referred by community practitioners or directly by parents.…”

Section: Methodsmentioning

confidence: 99%

“…Two parallel, randomized controlled trials were conducted at the Children's Hospital of Pittsburgh, Pittsburgh, Pa, from April 1980 to April 1994 as an extension of a previously instituted study of indications for tonsillectomy and adenoidectomy. 16,18,19 The study was approved annually by the hospital's Human Rights Committee. Subjects were recruited from among hospital outpatients and children referred by community practitioners or directly by parents.…”

Section: Methodsmentioning

confidence: 99%

“…Details have previously been reported regarding initial evaluation of subjects, study exclusion criteria (children with overt or submucous palatal clefts were specifically excluded), and procedures regarding informed consent and surgery. 16,17,19,20 To be eligible for the present trials, children were required to be age 3 to 15 years, not have undergone previous tympanostomy tube placement, and have ex-perienced (1) at least 3 episodes of acute otitis media during the preceding 6 months, or at least 4 episodes during the preceding 12 months including at least 1 episode during the preceding 6 months, with at least 1 of the episodes having been documented with a recorded description of symptoms and tympanic membrane findings or confirmed by tympanometry, tympanocentesis, or myringotomy; or (2) middleear effusion in 1 or both ears extending over at least 180 days during the preceding year and documented by at least 2 clinical observations at least 6 months apart, the most recent by a study-team clinician and/or confirmed by tympanometry.…”

Section: Methodsmentioning

confidence: 99%

“…2 Notwithstanding the widespread performance of adenoid-tonsil surgery to reduce the occurrence of otitis media, the efficacy of such surgery under various clinical circumstances has remained in doubt, largely because most reported clinical trials have important limitations. [15][16][17] Previously we reported results of clinical trials of adenoidectomy in a group of children we considered severely affected because they had undergone tympanostomy tube placement for persistent and/or recurrent otitis media and, after tubal extrusion, had again developed otitis media. 17 However, those trials did not address either the efficacy of adenoidectomy in children with persistent or recurrent otitis media who had not previously undergone tube placement or the relative efficacy in such children of adenoidectomy compared with T&A.…”

mentioning

confidence: 99%

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Adenoidectomy and Adenotonsillectomy for Recurrent Acute Otitis Media

Paradise¹,

Bluestone²,

Colborn³

et al. 1999

JAMA

138

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DENOIDECTOMY AND ADENOtonsillectomy (T&A) are the most commonly performed major surgical operations among US children; in 1994 an estimated 140 000 US children younger than 15 years underwent adenoidectomy, and an estimated 286 000 underwent T&A. 1 In many, if not most, of the children undergoing adenoidectomy and in many of the children undergoing T&A, the primary or secondary surgical diagnosis has been otitis media. 2 Based on early recommendations 3-5 and also on more recent studies, 6-9 adenoidectomy has generally been considered the component of tonsil and adenoid surgery that is efficacious in reducing the occurrence of otitis media. Standard textbooks of pediatrics 10,11 and otolaryngology 12,13 as well as current guidelines of the American Academy of Otolaryngology-Head and Neck Surgery 14 recommend adenoidectomy, but not tonsillectomy, for this purpose. Nonetheless, many practicing otolaryngologists recommend T&A for children with persis-

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Adenoidectomy and Adenotonsillectomy for Recurrent Acute Otitis Media

Paradise¹,

Bluestone²,

Colborn³

et al. 1999

JAMA

138

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“…Beginning in late-1970s, Paradise and colleagues published a series of reports and randomized controlled trial results showing that only those children severely affected by throat infections benefitted from the removal of the tonsils, while moderate to minimally affected children merely showed modest benefit that may not outweigh the risk of surgery. These studies also revealed the self-limiting nature of throat infections [4–8]. Along with numerous studies questioning the efficacy of tonsillectomy, gradual decline in tonsillectomy rate was noted.…”

Section: Discussionmentioning

confidence: 99%

Tonsillectomy as prevention and treatment of sleep-disordered breathing: a report of 23 cases

Woo

Choi²

2016

Maxillofac Plast Reconstr Surg

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BackgroundThe paradigm of tonsillectomy has shifted from a treatment of recurrent throat infection to one of multi-discipline management modalities of sleep-disordered breathing (SDB). While tonsillectomy as a treatment for throat problems has been performed almost exclusively by otorhinolaryngologists, tonsillectomy as a part of the armamentarium for the multifactorial, multidisciplinary therapy of sleep-disordered breathing needs a new introduction to those involved in treating SDB patients. This study has its purpose in sharing a series of tonsillectomies performed at the Seoul National University Dental Hospital for the treatment and prevention of SDB in adult patients.MethodsTotal of 78 patients underwent tonsillectomy at the Seoul National University Dental Hospital from 1996 to 2015, and 23 of them who were operated by a single surgeon (Prof. Jin-Young Choi) were included in the study. Through retrospective chart review, the purpose of tonsillectomy, concomitant procedures, grade of tonsillar hypertrophy, surgical outcome, and complications were evaluated.ResultsTwenty-one patients diagnosed with SDB received multiple surgical procedures (uvulopalatal flap, uvulopalatopharyngoplasty, genioglossus advancement genioplasty, tongue base reduction, etc.) along with tonsillectomy. Two patients received mandibular setback orthognathic surgery with concomitant tonsillectomy in anticipation of postoperative airway compromise. All patients showed improvement in symptoms such as snoring and apneic events during sleep.ConclusionsWhen only throat infections were considered, tonsillectomy was a procedure rather unfamiliar to oral and maxillofacial surgeons. With a shift of primary indication from recurrent throat infections to SDB and emerging technological and procedural breakthroughs, simpler and safer tonsillectomy has become a major tool in the multidisciplinary treatment modality for SDB.

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