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Updated: Aug 19, 2026
CO2-Lasertonsillotomy Under Local Anesthesia in Adults
Published on: November 6, 2019
Long-term effects of intracapsular partial tonsillectomy (tonsillotomy) compared with full tonsillectomy
Elisabeth Hultcrantz1, Arne Linder, Agneta Markström
1Department of Neuroscience and Locomotion, Division of Otorhinolaryngology, Linköping University, SE-58185 Linköping, Sweden. elihu@inr.liu.se
Insights
Pediatric tonsil surgery using CO(2)-laser tonsillotomy (TT) and traditional tonsillectomy (TE) show similar long-term benefits for snoring and sleep apnea. Both methods offer high patient satisfaction and improved health outcomes six years post-surgery.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Sleep Medicine
Background:
- Sleep-related breathing distress (SRBD) is a common indication for pediatric tonsil surgery.
- Traditional tonsillectomy (TE) involves complete removal, while tonsillotomy (TT) is a partial removal technique.
- Long-term comparisons of these techniques, particularly with laser assistance, are crucial for clinical decision-making.
Purpose of the Study:
- To compare the six-year post-operative outcomes of CO(2)-laser tonsillotomy (TT) versus traditional tonsillectomy (TE) in children.
- To evaluate the long-term efficacy of both surgical methods regarding snoring, apneas, eating difficulties, infections, and general health.
Main Methods:
- A prospective randomized clinical trial involving 41 children (ages 9-15) who underwent either TT (n=21) or TE (n=20) for SRBD.
- A 10-question mail survey was administered to parents six years after the initial surgery.
- Follow-up data from six months and one year post-surgery were also considered.
Main Results:
- No significant differences were observed between TT and TE in the long-term effects on snoring and apneas.
- While snoring recurrence was noted, it was less severe than pre-operatively in both groups.
- Both surgical methods resulted in high patient satisfaction, improved general health, and no persistent eating difficulties. Upper respiratory tract infections occurred at similar rates.
Conclusions:
- CO(2)-laser tonsillotomy (TT) is a reliable pediatric tonsil surgery method.
- TT demonstrates comparable long-term efficacy to traditional tonsillectomy (TE) for sleep-related breathing issues.
- TT offers the advantage of substantially lower primary morbidity compared to TE.
Objective:
To compare the long-term effects (six years after surgery) of two techniques for pediatric tonsil surgery with respect to snoring, apneas, eating difficulties, infections and general health. The two methods were intracapsular partial tonsillectomy (tonsillotomy, "TT") using CO(2)-laser technique and traditional (total) blunt dissection tonsillectomy (TE).
Study Design:
A questionnaire distributed by mail to the parents of children, who, in 1998, were included in a prospective clinical randomized study in one tertiary care ENT clinic.
Method:
A 10 question survey follow-up of 41 children, between 9 and 15 years of age, who originally, six years earlier had been randomized to either TT with CO(2)-laser (n=21) or TE (n=20). The main indication for the surgery was a history of sleep related breathing distress (SRBD). Before the present study, all of the children had participated in earlier follow-ups at six months and one year after surgery.
Results:
All the children in both groups answered the questionnaire. There were no significant differences between the answers from the two groups in any respects: the effect on snoring and apneas was equally stable for both groups. The number of children who remained free from snoring decreased from 40 after the first year to 25 after six years (11 TT, 14 TE). Snoring in the recurrent cases was not rated to be as frequent or as loud as before the surgery. Infections of the upper respiratory tract (URI) that had been treated with antibiotics occurred to the same extent in both groups. None had eating difficulties. The patients' satisfaction with the results of the surgery was high or very high in 18/21 TT and 20 TE cases, and the vast majority of the parents rated their children's present health status as improved compared with the preoperative condition.
Conclusion:
Tonsillotomy with CO(2)-laser seems to be a reliable method for tonsil surgery with substantially less primary morbidity than conventional tonsillectomy and with the same positive long-term effects after six years.
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