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Tonsillotomy versus tonsillectomy on young children: 2 year post surgery follow-up

Elisabeth Ericsson, Jonas Graf, Inger Lundeborg-Hammarstrom

    Journal of Otolaryngology - Head & Neck Surgery = Le Journal D'Oto-Rhino-Laryngologie Et De Chirurgie Cervico-Faciale
    |July 28, 2014
    PubMed

    Insights

    Tonsillotomy and tonsillectomy offer similar long-term benefits for children with sleep-disordered breathing, improving quality of life and behavior. A small risk of symptom recurrence exists after tonsillotomy, but positive effects generally persist.

    Area of Science:

    • Otolaryngology
    • Pediatric Surgery
    • Sleep Medicine

    Background:

    • Sleep-disordered breathing (SDB) in young children is often associated with tonsil hyperplasia.
    • Tonsillotomy (TT) and tonsillectomy (TE) are surgical options for managing SDB.
    • Long-term comparative outcomes of TT and TE in pediatric SDB are not fully established.

    Purpose of the Study:

    • To compare the long-term (24-month) effects of tonsillotomy versus tonsillectomy in young children with SDB.
    • To evaluate the durability of surgical benefits on snoring, infections, quality of life, and behavior.

    Main Methods:

    • A randomized controlled trial involving children aged 4-5 with SDB and tonsil hyperplasia.
    • Patients were randomized to undergo either tonsillectomy (TE) or tonsillotomy (TT) using radiofrequency.
    • Surgical outcomes were assessed at 6 and 24 months postoperatively using clinical evaluations, questionnaires, and standardized surveys (OSA-18, Child Behavior Checklist).

    Main Results:

    • No significant differences were observed between TT and TE groups regarding snoring or upper airway infection frequency/severity at 24 months.
    • Both procedures demonstrated significant short-term and long-term improvements in quality of life and behavior.
    • A small proportion of TT patients (3/35) and one TE patient (1/32) required re-operation for recurrent obstructive symptoms.

    Conclusions:

    • Tonsillotomy in young children carries a small risk of symptom recurrence requiring re-surgery within two years.
    • For most children, the positive effects of both tonsillotomy and tonsillectomy on snoring, infections, behavior, and quality of life are sustained and comparable at two years.

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