Laser CO₂ tonsillotomy versus argon plasma coagulation (APC) tonsillotomy: A retrospective study with 10-year...

Tonsillotomy is increasingly gaining acceptance as the treatment for tonsillar hyperplasia resulting in obstructive symptoms. The aim of this study was to compare the long-term results of CO₂ laser tonsillotomy with those of argon plasma coagulation (APC) tonsillotomy.

The data of 64 children, aged 2-10 years (mean 4.7 years), treated in the Department of Otolaryngology, Head and Neck Surgery, in Homburg, Germany with APC (36 patients) or CO₂ laser (28 patients) for tonsillar hyperplasia between June 2004 and December 2004 were available for analysis.

Forty-five (APC: 26 patients, CO₂: 19 patients) of the 64 patients (70.3%) could be contacted and were available for follow-up in a telephone survey conducted 10 years after surgery. The mean operation time was 17 min (range 10-25 min) in the APC group and 23 min (range 13-32 min) in the CO₂ group (p = 0.0003). No case of intra- or postoperative bleeding was documented. One minor intraoperative complication in the form of a superficial lip burn was documented in the APC group. During the minimum 10 years of follow-up, 1 patient treated with APC underwent a surgical revision because of tonsillar regrowth, whereas in the group of patients treated with CO₂, no surgical revision was needed. Regarding the parents' assessment of their children's symptoms, 89.4% of the parents of the CO₂ laser group and 84.6% of the parents of the APC group reported that the overall long-term operation results of their children to be "very satisfying." Regarding complications, the need for secondary tonsillectomy, and parents' satisfaction, no statistically significant differences were found.

Both CO₂ laser tonsillotomy and APC tonsillotomy are safe procedures leading to very satisfying results with respect to intra- and postoperative complications.