The effect of tonsillotomy on chronic recurrent tonsillitis in children

Foki, Elisabeth; Seemann, Rudolf; Stelter, Klaus; Lill, Claudia

doi:10.1080/00016489.2017.1322712

Cited by 16 publications

(10 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…20 While there are several reasons for this, one reason is to avoid surgery on children with the associated complications of ET including postoperative hemorrhage and pain. If IT in future studies continues to be shown to be effective in treating chronic tonsillitis as some studies have concluded already, 29,31 the indications for surgical treatment of chronic tonsillitis may expand.…”

Section: Paradigm Shift Implicationsmentioning

confidence: 99%

Current Status and Future Trends: Pediatric Intracapsular Tonsillectomy in the United States

2020

View full text Add to dashboard Cite

Objectives 1) To assess the current status of pediatric intracapsular tonsillectomy in the United States, and 2) To apply lessons from the scientific literature and adoption of surgical innovation to predict future trends in pediatric intracapsular tonsillectomy. Methods This was a cross‐sectional survey study and literature review. An anonymous survey was sent to all members of the American Society of Pediatric Otolaryngology (ASPO) to determine current practices in pediatric tonsillectomy. Statistical analysis was performed to compare differences in individuals who perform intracapsular tonsillectomy as opposed to extracapsular tonsillectomy. A literature analysis of the adoption of new technological advancements and innovative surgical techniques was then performed. Results The survey was sent to 540 pediatric otolaryngologists with a response rate of 42%. Of all respondents, 20% currently perform intracapsular tonsillectomy. The primary reason cited for not performing the procedure was concern for tonsillar regrowth. Time in practice, practice setting, and fellowship status was not associated with an increased incidence of intracapsular tonsillectomy. Conclusions Only 20% of pediatric otolaryngologist respondents in the United States perform intracapsular tonsillectomy. Based on the documented advantages of intracapsular tonsillectomy over extracapsular tonsillectomy and an analysis of adoption of novel surgical techniques, we predict a paradigm shift in the specialty toward intracapsular tonsillectomy. Level of Evidence 3 Laryngoscope, 131:S1–S9, 2021

show abstract

Section: Paradigm Shift Implicationsmentioning

confidence: 99%

Current Status and Future Trends: Pediatric Intracapsular Tonsillectomy in the United States

2020

View full text Add to dashboard Cite

show abstract

“…Despite the merits of PIT, there was still concern about regrowth and reinfection after the procedure. One study has reported regrowth after PIT, especially in cases of acute tonsillitis [25]. The authors concluded that very young children with tonsillar tissues that are yet to reach the maximal size are at a greater risk of tonsil regrowth for a minimum of 4 weeks and up to 1 year postoperatively.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of Powered Intracapsular Tonsillectomy in Pediatric Patients with Tonsil Problem, Including Recurrent Tonsillitis: A Single Surgeon’s Experience

Kim¹,

Li²,

Park³

et al. 2020

ORL

View full text Add to dashboard Cite

Introduction: Powered intracapsular tonsillectomy (PIT) is a technique that protects the tonsillar capsule by using a microdebrider, resulting in faster wound-healing and reduced suffering. Many studies have found PIT to be effective, particularly in pediatric patients with obstructive sleep apnea (OSA). However, previous studies have not included patients with a history of recurrent tonsillitis. Objective: The aim of this study was to determine the efficacy of PIT in pediatric patients even with a history of recurrent tonsillitis, and therefore, we want to expand the indication for PIT and reveal its safety. Methods: A total of 886 pediatric patients underwent PIT between February 2013 and March 2016. All patients rated their postoperative pain using a visual analog scale (VAS) and completed the Korean obstructive sleep apnea (KOSA)-18 questionnaire for assessment of their quality of life (QOL). There were 539 males and 347 females. Their mean age was 6.2 years (range 2–14 years). The majority (77.7%) underwent the operation for OSA, and the rest (22.3%) had a history of recurrent tonsillitis. To compare the efficacy of PIT with traditional tonsillectomy, we selected 191 patients who underwent extracapsular tonsillectomy (ECT), a conventional technique, during the same time period. The median follow-up period was 16.7 months. During the follow-up period, instances of delayed bleeding and recurrent pharyngitis were monitored. Results: In comparison to the patients who underwent ECT, the PIT group showed significantly fewer cases of postoperative bleeding (p = 0.027). Thirteen patients in the PIT group (1.5%) visited the hospital during the follow-up period for pharyngitis, while 8 in the ECT group (4.2%) visited for pharyngitis. The mean postoperative pain score, as assessed by a VAS, was 4.6 ± 3.2, and pain improved within an average of 2.9 days after surgery in the PIT group. The mean KOSA-18 score for the QOL of the patients was 65.9 preoperatively and 35.6 postoperatively in the PIT group. Conclusions: Pediatric tonsillectomy using PIT is valid for reducing postoperative pain and improving the QOL of OSA patients. PIT is also effective and safe for patients with a history of recurrent tonsillitis.

show abstract

“…Similar findings have been published in other studies [18][19][20], reflecting an increased awareness of upper airway obstruction. TT is mostly performed because of obstructive symptoms, although a few studies have shown that TT can be beneficial also for children and young adults with recurrent tonsillitis [21,22].…”

Section: Discussionmentioning

confidence: 99%

Changing trends in pediatric tonsil surgery

Sakki

Mäkinen

Roine

et al. 2019

International Journal of Pediatric Otorhinolaryngology

View full text Add to dashboard Cite

A B S T R A C TObjectives: We analyzed trends in tonsil surgery over a 10-year period in a single tertiary care hospital and evaluated the effects of these changes on use of hospital services and healthcare costs. Methods: This was a retrospective cohort study based on data from databases at the Department of Otorhinolaryngology, Helsinki University Hospital, Helsinki, Finland. Children under 16 years of age with tonsillectomy (TE) or tonsillotomy (TT) performed during 2007-2016 were included in the study. Results: In 10 years, 4979 tonsil surgeries were performed on 4951 children: TE in 3170 (64%) and TT in 1781 (36%) children. The total number of tonsil surgeries stayed nearly constant. TT operations commenced in the study hospital in 2009 and from 2012 onwards have been more common than TE procedures. Altogether 279 patients visited the emergency department because of complications; TE patients had 9.0 visits/100 surgeries and TT patients 1.8 visits/100 surgeries. The most common complication was postoperative hemorrhage: 200 cases (6.3%) in the TE group and 11 cases (0.6%) in the TT group. During the two-year follow-up after tonsil surgery the total costs of healthcare services were significantly lower in the TT group than in the TE group. Conclusion: Considerable changes have occurred in tonsil surgery in children during the 10-year study period; TT is today performed more often than TE. As a consequence, complications, readmissions to hospital, and number of patients treated in the operating room because of postoperative hemorrhage have decreased, lowering the costs of healthcare.

show abstract

The effect of tonsillotomy on chronic recurrent tonsillitis in children

Abstract: Tonsillotomy is beneficial for patients with recurrent tonsillitis and carries less risk of postoperative complications than tonsillectomy.

Cited by 16 publications

References 19 publications

Current Status and Future Trends: Pediatric Intracapsular Tonsillectomy in the United States

Current Status and Future Trends: Pediatric Intracapsular Tonsillectomy in the United States

Feasibility of Powered Intracapsular Tonsillectomy in Pediatric Patients with Tonsil Problem, Including Recurrent Tonsillitis: A Single Surgeon’s Experience

Changing trends in pediatric tonsil surgery

Contact Info

Product

Resources

About