Radiofrequency tonsillotomy versus bipolar scissors tonsillectomy for the treatment of OSAS in children: A prospective study

Morinière, S.; Roux, Alexandre; Bakhos, D.; Trijolet, J.-P.; Pondaven, S.; Pinlong, E.; Lescanne, E.

doi:10.1016/j.anorl.2012.06.002

Cited by 28 publications

(24 citation statements)

References 22 publications

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“…Regarding postoperative infections, there were only 3 cases out of 64 that reported tonsillitis, counting less than 1 episode per year, which were easily controlled with just one antibiotic cycle. These outcomes are similar to the studies previously mentioned [2,3,4,9,10,16,18] showing that radiofrequency tonsils reduction is an effective and safe technique overall, and also in our series.…”

Section: Discussionsupporting

confidence: 80%

“…Besides reduction in morbidity, partial tonsillectomy offers improvement in quality of life and satisfaction [12,17]. In terms of outcomes, total and partial techniques seem to be equally effective [4,5,[8][9][10][11][14][15][16]18] and safe [2,3,15,16]. Several instruments are available to perform partial techniques, being the radiofrequency ones very popular.…”

Section: Introductionmentioning

confidence: 99%

“…Hence several authors support a reduction of tonsils volume instead of extracapsular tonsillectomy [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. In fact, a shift from tonsillectomy to tonsillotomy already happened in Sweden, where the majority of children presenting tonsils obstructive symptoms are submitted to tonsillotomy [19].…”

Section: Introductionmentioning

confidence: 99%

“…In tonsils hypertrophy causing upper airway obstruction, partial techniques present several advantages, such as minimum intraoperative hemorrhage, shorter duration of surgery, lower postoperative hemorrhage, lower postoperative pain, lower swallowing and speaking difficulties [3][4][5][6][7]9,[13][14][15][16]18]. Besides reduction in morbidity, partial tonsillectomy offers improvement in quality of life and satisfaction [12,17].…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness and Safety of Radiofrequency Tonsils Reduction in Pediatric Obstructive Sleep Apnea

Jardim¹,

Marinho²,

Araujo³

et al. 2017

JOENTR

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Objective: Adenotonsillectomy is a well-accepted option for treatment of pediatric obstructive sleep apnea (OSA). This study pretends to evaluate the effectiveness and safety of radiofrequency tonsils reduction in surgical treatment of pediatric OSA. Study design:Retrospective study evaluating tonsils reduction after surgical treatment of pediatric OSA patients submitted to radiofrequency tonsils reduction and adenoidectomy. Subjects and methods:A retrospective cohort study, including children diagnosed with: OSA, tonsils hypertrophy (Brodsky scale > 2/2) and apnea-hypopnea index (AHI) > 1 (when polysomnography was made, n=50) who were submitted to radiofrequency tonsils reduction associated with classic adenoidectomy between 2011 and 2013 in CUF Descobertas Hospital (Lisbon). Children with recurrent tonsillitis (meeting criteria for tonsillectomy by AAO-HNS guidelines) were excluded. Outcomes measured: 1) variation in pre and postoperative tonsils size (Brodsky scale), maintenance of roncopathy, maintenance or suspicion of apnea (effectiveness outcomes); 2) postoperative hemorrhage, tonsillitis during postoperative follow up (safety outcomes). Data was collected by consulting clinical charts and by telephonic interviews made by an ENT physician. Statistical analysis was made with STATA 13.Results: A population of 64 children was obtained with 22 months of median follow up. The mean age was 4 yo with 56% males. 81.25% had a preoperative Brodsky scale of at least 3/3, and 64% had moderate or severe degree of OSA. A reduction of at least 2 grades between pre and postoperative Brodsky scale was found in 75.41% and the reduction wasn't associated with the follow up time. Postoperative absence of roncopathy and apnea was reported in 93% and 100% of cases, respectively. Postoperative frequency of hemorrhage was 0% and only 3 patients (4.68%) reported tonsillitis episodes. Conclusion:In our series, radiofrequency tonsils reduction proved to be an effective and safe technique in tonsils reduction, and therefore, in OSA pediatric surgical treatment.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effectiveness and Safety of Radiofrequency Tonsils Reduction in Pediatric Obstructive Sleep Apnea

Jardim¹,

Marinho²,

Araujo³

et al. 2017

JOENTR

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“…However, a study reported by Morinière et al [8] showed no statistically significant difference between the 2 groups in terms of mean operating time.…”

Section: Discussionmentioning

confidence: 90%

Cold Dissection Tonsillectomy and Radiofrequency Tonsil Ablation: A Prospective Comparative Study

Kumar¹,

Padiyar²,

Kumar³

2018

Dubai Med J

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Background: Over the last few years, various techniques have been proposed for performing tonsillectomy in an attempt to lower the morbidity of this surgery. However, controversy still exists regarding the optimal technique involving the least postoperative morbidity. More recently, temperature-controlled radiofrequency has been introduced as a much more effective and safe device for tonsil reduction. Objective: To compare the effectiveness of conventional tonsillectomy versus radiofrequency tonsil ablation with respect to duration of surgery, amount of intraoperative bleeding, recovery time, and postsurgical pain. Materials and Methods: 60 patients were randomly divided into two groups. One group underwent conventional cold ablation tonsillectomy while radiofrequency tonsillectomy was performed in the second group. Duration of surgery, amount of intraoperative bleeding, recovery time, and postsurgical pain (using the Wong-Baker FACES Pain Rating Scale®) were measured. All patients were followed for 24 months. Results: Comparing the radiofrequency tonsillectomy group to the cold dissection tonsillectomy group, the mean duration of surgery was 6.92 versus 18 min, the amount of intraoperative bleeding was 2.75 versus 39.88 mL, and the difference on the postoperative pain scale between the two groups was statistically significant (p < 0.005). There was no recurrence of tonsillitis episodes in either of the 2 groups during the 2-year follow-up period. Conclusion: After adequate training, the radiofrequency technique is beneficial to both the surgeon and the patient, including the possibility to excise tissue and coagulate bleeding vessels with the same device. Postoperative morbidity and complications are lower as compared to the conventional cold dissection technique.

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Tonsillectomy Versus Tonsillotomy in Pediatric Sleep‐Disordered Breathing: A Systematic Review and Multi‐subgroup Meta‐analysis

Lao,

Jian,

et al. 2024

The Laryngoscope

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ObjectivesTo evaluate the potential of tonsillotomy (TT) as an alternative to tonsillectomy (TE) for treating children with obstructive sleep‐disordered breathing (oSDB).Data SourcesTwo independent reviewers searched PubMed, the Cochrane Library, Embase, and additional sources to identify controlled studies comparing TT versus TE in pediatric patients with oSDB.Review MethodsWe evaluated post‐surgery symptom relief, and short‐ and long‐term postoperative benefits for children. Fixed‐effect meta‐analysis, sensitivity analysis, and subgroup analysis were conducted.ResultsIn our analysis of 32 studies with 9,430 children, the analysis revealed TT group had a similar therapeutic effect on improvement of OSA‐18 as TE group (MD = 5.20, 95% CI: −32.67 to 43.07, p = 0.96). In terms of short‐term outcome, the days to return to normal diet for TT group were shorter than that for TE group (MD = −2.49, 95%CI: −3.57 to −1.28; p < 0.001), less analgesics use (MD = −3.19, 95% CI = −3.44 to −2.93, p < 0.001), and lower postoperative secondary bleeding (RR = 0.33; 95%CI: 0.23 to 0.47; p < 0.001). But the risk of reoperation (OR = 8.28; 95%CI: 2.66 to 12.64; p < 0.001), oSDB recurrence (OR = 2.16; 95%CI: 1.20–3.86; p = 0.01), and postoperative infection (OR = 1.82; 95%CI: 1.34 to 2.47; p < 0.001) in TT group was significantly higher than that in TE group.ConclusionsTonsillotomy reduces postoperative pain and bleeding, speeding up recovery for children with oSDB, and improving their quality of life. Yet, the risk of recurrent infections from residual tonsil tissue, which may require reoperation, calls for a careful evaluation of the procedure's short‐term gains against its long‐term risks.Level of EvidenceNA Laryngoscope, 2024

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Radiofrequency tonsillotomy versus bipolar scissors tonsillectomy for the treatment of OSAS in children: A prospective study

Abstract: Radiofrequency tonsillotomy is a safe technique for the treatment of obstructive tonsillar hypertrophy in children with good results on OSAS and a reduction of postoperative pain.

Cited by 28 publications

References 22 publications

Effectiveness and Safety of Radiofrequency Tonsils Reduction in Pediatric Obstructive Sleep Apnea

Effectiveness and Safety of Radiofrequency Tonsils Reduction in Pediatric Obstructive Sleep Apnea

Cold Dissection Tonsillectomy and Radiofrequency Tonsil Ablation: A Prospective Comparative Study

Tonsillectomy Versus Tonsillotomy in Pediatric Sleep‐Disordered Breathing: A Systematic Review and Multi‐subgroup Meta‐analysis

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