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Role of subtotal tonsillectomy ('tonsillotomy') in children with sleep disordered breathing

J M Wood1, M Cho2, A S Carney1

  • 1Flinders ENT, Department of Surgery, Flinders University and Flinders Medical Centre, Australia.

The Journal of Laryngology and Otology
|November 28, 2013
PubMed

Insights

Subtotal tonsillectomy effectively treats pediatric sleep disordered breathing with fewer complications than total tonsillectomy. This procedure reduces post-operative pain and bleeding, offering a safer alternative.

Area of Science:

  • Otolaryngology
  • Pediatric Surgery
  • Sleep Medicine

Background:

  • Sleep disordered breathing (SDB) in children impacts behavior, cardiorespiratory function, and neurocognition.
  • Subtotal tonsillectomy (tonsillotomy) is an alternative treatment for SDB with outcomes comparable to total tonsillectomy or adenoidectomy.

Purpose of the Study:

  • To critically assess the role and efficacy of subtotal tonsillectomy in managing pediatric sleep disordered breathing.

Main Methods:

  • A systematic review of the Medline database from 1966 to October 2012.
  • Keywords included: subtotal tonsillectomy, tonsillotomy, tonsillectomy, pediatrics, and sleep disordered breathing.

Main Results:

  • Eighteen papers were reviewed, indicating subtotal tonsillectomy has equal efficacy to total tonsillectomy for SDB.
  • Subtotal tonsillectomy demonstrated significant reductions in post-operative pain and analgesia requirements.
  • Fewer instances of post-operative hemorrhage were observed in patients undergoing subtotal tonsillectomy compared to total tonsillectomy.

Conclusions:

  • Subtotal tonsillectomy in children offers comparable efficacy to total tonsillectomy for improving SDB.
  • This procedure is associated with a lower incidence of post-operative complications, including pain and bleeding.
Abstract

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