Longterm results after tonsillotomy: outcome, residual symptoms and need for revision surgery

Background: Tonsillotomy (TT) has gradually replaced tonsillectomy for children with upper airway obstruction during sleep in Denmark. The disadvantage is potential tonsil regrowth.Objectives: To present results on outcome of TT in a Danish hospital setting.Material and methods: Observational cohort study with follow up. All patients were invited for a postoperative examination/telephone interview and to fill in a questionnaire.Results: Medical records from 141 consecutive children up to 12 years of age who underwent TT with or without adenoidectomy in 2015 and 2016 were analyzed. Median follow up time was 33 months (18-41 months), 132 (94%) completed the questionnaire, of which 84 underwent clinical examination. 97% would recommend the procedure. At follow up, a significant reduction of all symptoms was found as well as a significant increase in BMI. Tonsil size ≤ 2 was observed in 81% of patients at follow up. One patient had been referred due to postoperative bleeding. Six patients needed revision tonsil surgery.Conclusion and significance: TT is a safe and effective procedure. However, due to the risk of regrowth of tonsils or recurrent tonsillitis, revision surgery may be necessary, and physicians should pay attention to the risk of recurrence of obstructive symptoms.