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Updated: Aug 16, 2026
CO2-Lasertonsillotomy Under Local Anesthesia in Adults
Published on: November 6, 2019
[Laser-assisted tonsillotomy in children with obstructive sleep apnea and adenotonsillary hyperplasia--experiences as
1Gemeinschaftspraxis und Belegabteilung Dr. med. Frank Ilgen, Dr. med. Klaus Kirchner, Biberach. Frank.Ilgen@HNO-Biberach.de
Insights
Laser-assisted tonsillotomy with adenotomy effectively treats obstructive sleep apnea in children, significantly reducing symptoms like snoring and breathing difficulties. This minimally invasive procedure offers a faster recovery and less pain compared to traditional methods.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Sleep Medicine
Background:
- Adenotonsillar hyperplasia is a primary cause of obstructive sleep apnea (OSA) in children.
- Laser-assisted tonsillotomy is an emerging alternative treatment for pediatric OSA, particularly in children without a history of tonsillitis.
- The combined efficacy of laser-assisted tonsillotomy and adenotomy for pediatric OSA has not been extensively studied.
Purpose of the Study:
- To evaluate the therapeutic effect of combined laser-assisted tonsillotomy and adenotomy in children with adenotonsillar hyperplasia and suspected obstructive sleep apnea.
- To assess postoperative pain levels and recovery time in pediatric patients undergoing this procedure.
Main Methods:
- A prospective study involving 50 outpatients (mean age 5.3 years) with adenotonsillar hyperplasia and potential OSA.
- Procedures performed between May 2000 and May 2004.
- Postoperative assessment via anonymous questionnaires to parents, evaluating symptoms, Brouillette score, pain, and recovery duration.
Main Results:
- Of 36 evaluated questionnaires, 89% of children were symptom-free regarding snoring, breathing difficulty, and apnea post-procedure.
- Significant improvement in Brouillette scores (p=0.001), with reductions in snoring (91%), breathing difficulty (93%), and apnea (100%).
- Pain was reported as mild to moderate; 91.6% recovered within 6 days (mean 4.7 days), with no reported bleeding.
Conclusions:
- Outpatient laser-assisted tonsillotomy with adenotomy is a recommended treatment for pediatric adenotonsillar hyperplasia and OSA.
- The procedure demonstrates comparable efficacy to conventional tonsillectomy with adenotomy regarding symptom improvement.
- This approach offers reduced pain, faster recovery, and fewer postoperative complications.
Background:
The adenotonsillar hyperplasia is the most relevant cause for the obstructive sleep apnea in children. Since several years laser-assisted tonsillotomy becomes more common as an alternative treatment especially in children having no tonsillitis history. The therapeutical effect of laser-assisted tonsillotomy in combination with the traditional adenotomy treating the obstructive sleep apnea in children has not yet been researched. In addition literature indicates less pain and fast recovery of the children compared to conventional tonsillectomy.
Materials And Methodology:
Starting May 2000 until May 2004 laser-assisted tonsillotomy and adenotomy have been performed in 50 outpatient children, mean age of 5.3 +/- 1.7 years, with adenotonsillar hyperplasia and possible sleep apnea. Postoperatively the parents of the patients were questioned with an anonymous questionnaire. Pre- and postoperative symptoms and Brouillette score, the degree of pain and the post-surgical time of recovery have been investigated.
Results:
36 questionnaires have been evaluated. The follow-up time was between 4 weeks and 4 years (mean = 1.3 years). With regard to the symptoms snoring, difficulty breathing during sleep and apnea 32 of the children (89%) were symptom-free after laser-assisted tonsillotomy with adenotomy. The Brouillette-score improved significantly (p = 0.001), snoring was reduced in 91%, difficulty breathing in 93% and apnea in 100% of the children. The pain of the surgical intervention has been valued by the patient's parents as mild to moderate. Postoperatively 91.6% of the children recovered within 6 days (mean = 4.7 days), no bleeding occurred.
Conclusion:
Outpatient laser-assisted tonsillotomy with adenotomy can be recommended in children with adenotonsillar hyperplasia and possible obstructive sleep apnea. The surgical intervention is less painful, the children recover more quickly and the results on snoring, difficulty breathing and apnea are equal in comparison to conventional tonsillectomy with adenotomy. In addition the recommended procedure shows less post-operative complications.
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