The safety and efficacy of pediatric lingual tonsillectomy

DeMarcantonio, Michael; Senser, Ethan; Meinzen‐Derr, Jareen; Roetting, Nicholas J; Shott, Sally R.; Ishman, Stacey L.

doi:10.1016/j.ijporl.2016.09.037

Cited by 33 publications

(40 citation statements)

References 24 publications

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“…The primary outcome of interest, reported in all 5 studies, was AHI. 17,19-22 The retrospective case series by Abdel-Aziz et al 20 reports the mean pre- and postoperative AHI and minSaO 2 . However, no standard deviation is reported, and no individual data were available despite contacting the senior author.…”

Section: Resultsmentioning

confidence: 99%

“…Qualitatively, all studies demonstrate a reduction in AHI and an increase in minSaO 2 postoperatively. Three studies performed statistical analysis revealing a significant reduction in AHI after LT. 19,21,22 Successful surgery, as defined by AHI <5 postoperatively, was achieved in only 60 of 116 (52%) of patients.…”

Section: Resultsmentioning

confidence: 99%

“…Three studies reported adverse outcomes associated with LT. 19,20,22 Abdel-Aziz et al 20 described 3 of 16 (19%) patients who developed postoperative airway obstruction from tongue base edema. All cases were managed conservatively with nasal airway insertion, oxygen administration, and intravenous steroids.…”

Section: Resultsmentioning

confidence: 99%

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Lingual Tonsillectomy for Pediatric Persistent Obstructive Sleep Apnea: A Systematic Review and Meta‐analysis

Rivero

Durr

2017

Otolaryngol.--head neck surg.

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Objective To determine the role of lingual tonsillectomy (LT) in pediatric patients with persistent obstructive sleep apnea (OSA) after tonsillectomy and adenoidectomy (T&A). Data Sources PubMed, OVID-MEDLINE, and Cochrane Central from 2006 to 2017. Review Methods Inclusion criteria included English-language studies containing original data on LT in pediatric patients with persistent OSA. Exclusion criteria included case reports and studies without outcome measures. Two investigators independently reviewed all manuscripts and performed quality assessment using validated tools. Meta-analysis was performed. Results Of the 866 abstracts identified, 5 studies met inclusion criteria. All studies were case series (level of evidence 4). Outcome measures included apnea-hypopnea index (AHI), minimum oxygen saturation (minSaO), comorbidity status, and adverse events. Qualitatively, all studies demonstrated reduction in AHI and increase in minSaO after LT. Comorbidities may not affect the success of LT for lingual tonsil hypertrophy (LTH). LT had similar adverse event rates as T&A. Meta-analysis was performed on 4 studies. LT showed a mean change in reduction of AHI and increase of minSaO of -6.64 (95% CI, -8.63 to -4.65) and 4.17 (95% CI, 1.25-7.08), respectively. The overall success rate, defined as postoperative AHI <5, was 52%. Conclusion LT for LTH can be a safe and effective adjunct surgery for persistent OSA in patients after T&A. LT may reduce AHI and increase minSaO, though complete resolution of OSA is rare. Given the limited number of patients studied, no formal recommendations can be made for the routine use of LT for LTH in persistent pediatric OSA.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Lingual Tonsillectomy for Pediatric Persistent Obstructive Sleep Apnea: A Systematic Review and Meta‐analysis

Rivero

Durr

2017

Otolaryngol.--head neck surg.

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“…At present, surgical effectiveness rates of traditional tonsillectomy vary among reports (24 –26). This may be related to the severity of the study subjects and the differences in efficacy evaluation indicators.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of minimally invasive tonsil surgery for treatment of obstructive sleep apnea-hypopnea syndrome in children

Zhang

Wang

Zhou

et al. 2017

Braz J Med Biol Res

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This study aimed to investigate the efficacy of minimally invasive tonsil surgery for the treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS) in children. Tonsil ablation or turbinate reduction was performed on 49 pediatric patients with OSAHS by minimally invasive tonsil surgery. In order to evaluate the efficacy of surgery, a comparison was conducted between pre-operation and post-operation data in terms of the symptoms, signs and polysomnography test. Total effectiveness rate of the surgery was 83.7%. Subgroup analysis was also performed based on the severity of their conditions: mild, moderate, and severe groups had an effectiveness rate of 90.0, 88.9, and 66.7%, respectively (Hc=6.665, P<0.05). Postoperatively, the apnea-hypopnea index, the minimum oxygen saturation (SaO2), and corresponding symptoms improved compared to pre-operation conditions (P<0.05). Minimally invasive tonsil surgery was a safe and effective method for treating OSAHS in children.

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“…On the other hand, PFAPA has been considered as a self-resolving disease and the role of surgery is controversial. 10,11 Lingual tonsillectomy remains a challenging procedure, with poor exposure and visualization, together with difficult haemostasis and risk of airway oedema. 12 There is no established standard procedure, and numerous approaches have been used, such as open surgical tongue base resection, coblation, radio frequency ablation (RFA) of the tongue base, and most recently transoral robotic surgery.…”

Section: Introductionmentioning

confidence: 99%

Targeted Treatment With Radio Frequency Ablation for Lingual Tonsil

Renkonen

Mäkitie

Bäck

2018

Clin Med Insights Ear Nose Throat

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Objectives:Benign enlargement of the lingual tonsils due to various causes may cause symptoms that warrant treatment. Conventional lingual tonsillectomy remains a challenging procedure, and there is no established standard procedure. We aimed to review the patients receiving different methods of lingual tonsil surgery for various indications at our institute.Methods:Retrospective clinical data on all patients with an ablative operation of the tongue base during the 8-year period between 2007 and 2014 at the Helsinki University Hospital, Helsinki, Finland, were reviewed. The larger cohort comprised 35 patients, of whom 26 were men (74%). Ten patients had undergone solely lingual tonsil radio frequency ablation (LTRFA). The minimum follow-up time for all patients was 2 years.Results:Of the 10 patients, 5 patients with LTRFA had been operated on because of symptomatic lingual tonsil hypertrophy and 5 because of periodic fever associated with possible lingual tonsil involvement. In 2 of the 5 patients with periodic fever, the fever cycles ended after the operation. Of the 5 patients, 3 patients with symptomatic lingual tonsil hypertrophy have been non-symptomatic after 1 to 3 treatment sessions. The last 2 patients continue to have persistent symptoms. There were no major complications.Conclusions:Development of new approaches for the management of various lingual tonsil conditions is warranted. Lingual tonsil volume reduction by LTRFA seems to be a treatment alternative with low morbidity but with limited curative effect only.

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The safety and efficacy of pediatric lingual tonsillectomy

Cited by 33 publications

References 24 publications

Lingual Tonsillectomy for Pediatric Persistent Obstructive Sleep Apnea: A Systematic Review and Meta‐analysis

Lingual Tonsillectomy for Pediatric Persistent Obstructive Sleep Apnea: A Systematic Review and Meta‐analysis

Efficacy of minimally invasive tonsil surgery for treatment of obstructive sleep apnea-hypopnea syndrome in children

Targeted Treatment With Radio Frequency Ablation for Lingual Tonsil

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