[Volume reduction of tonsil hyperplasia in childhood with a surgical ultrasound device]

We present the results of a prospective study concerning the use of a surgical-ultrasound device (use of ultrasound mechanical vibrations in the tonsil tissue with denaturizing effect on collagen and proteins for tonsil ablation, coablation) for the therapy of non-infectious tonsillar hyperplasia resulting in upper airway obstruction in childhood.

51 patients with a median age of 6.9 years (3.5-12 years) were treated with surgical ultrasound, under general anesthesia. The intervention did not include tissue excision, but the denaturation of hyperplastic tonsil tissue. Intra- and postoperative bleeding, pain (by visual analog scale), tonsil-to-tonsil diameter and swallowing difficulties were under consideration. Also an bacteriological examination of tonsils was performed.

The procedure was generally well tolerated. There was no intra- or postoperative bleeding. Swallowing difficulties were described as not very disturbing. Median follow up was 2.1 years. The postoperative "wound healing" lasted 7-9 days. A reduction of tonsil's size was visible since the first post treatment week with the final results occurring after 3-6 months. Intertonsillar distance was 9 mm preoperatively and 22.14 mm after coablation. A higher incidence of bacterial tonsillitis or development of quinsies were not reported.

The treatment of tonsilar hyperplasia by means of surgical ultrasound is highly effective and causes relatively mild post surgical complaints without intra- or postoperative bleeding.