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Updated: Jun 15, 2025
CO2-Lasertonsillotomy Under Local Anesthesia in Adults
Published on: November 6, 2019
[Long-term effect observation after 10 years of tonsillotomy （Histological analysis of one case of secondary
Binyu Mo1, Shanjun Dai1, Li Yang2
1Department of Otolaryngology，Liuzhou People's Hospital，Liuzhou，545006，China.
Insights
Partial tonsillectomy (tonsillotomy) and total tonsillectomy both effectively treat pediatric obstructive sleep apnea (OSA). Tonsillotomy offers greater patient satisfaction and faster recovery with less trauma, making it a preferred option for tonsil hypertrophy.
Area of Science:
- Otorhinolaryngology
- Pediatric Surgery
- Sleep Medicine
Context:
- Tonsil hypertrophy is a common cause of obstructive sleep apnea (OSA) in children.
- Surgical interventions like tonsillotomy (TT) and total tonsillectomy (TE) are used to manage this condition.
- Long-term outcomes and comparative effectiveness of these procedures require further investigation.
Purpose:
- To compare the long-term efficacy and safety of tonsillotomy (TT) versus total tonsillectomy (TE) in children with tonsil hypertrophy and obstructive sleep apnea (OSA).
- To evaluate patient satisfaction, quality of life, residual tonsil size, and polysomnographic (PSG) outcomes 10 years post-surgery.
Summary:
- A 10-year follow-up study of 146 children with OSA undergoing TT or TE showed significant improvement in respiratory obstruction symptoms for both groups.
- Parental satisfaction was higher with TT, which also demonstrated less trauma, faster recovery, and a lower rate of residual hyperplasia.
- While both procedures improved OSA symptoms, TT emerged as a potentially superior option due to its favorable long-term profile and patient-reported outcomes.
Impact:
- Provides evidence supporting tonsillotomy as a primary treatment for pediatric tonsil hypertrophy, offering a less invasive approach with comparable or better outcomes than total tonsillectomy.
- Highlights the importance of considering patient satisfaction and recovery speed in surgical decision-making for pediatric OSA.
- Suggests that residual symptoms post-surgery may be linked to other factors like obesity and allergic rhinitis, warranting a comprehensive management approach.
Abstract:
Objective:To investigate the long-term effect of partial tonsillectomy in children with tonsil hypertrophy. Methods:A total of 146 children with obstructive sleep apnea（OSA） who received surgical treatment for tonsil hyperplasia from January 2010 to January 2013 were selected and divided into the observation group（n=69） and the control group（n=77）. The observation group was received tonsillotomy（TT）, and the control group was received total tonsillectomy（TE）. Parental satisfaction and OSA quality of life questionnaire for children（OSA-18） were surveyed. Residual tonsil size was measured, and polysomnography（PSG） was monitored after 10 years. HE and immunohistochemical analysis were performed on tonsil tissues of one patient who performed a second operation after TT in 2017 year. Results:The results of questionnaire survey showed that the symptoms of respiratory obstruction were significantly improved in both groups, and the satisfaction of TT group was higher than that in the TE group. No increase in the number of respiratory tract infections was observed in all patients. In the TT group, nine cases（13.04%） had tonsil hyperplasia toⅡ°, and the remaining patients had tonsil hyperplasia to Ⅰ°. In addition, one case hadtonsil suppurative infection at the 14th month after surgery, and no recurrence or reoperation was found after treatment. There were seven cases in the TT group and eight cases in the TE group with occasional snoring and mouth breathing after surgery, but the PSG examination of the patients did not meet the diagnosis of OSA. The main causes were obesity and allergic rhinitis. Compared with the first operation, the cicatricial obstruction and infection of tonsil tissue in the second operation were not significantly changed, and the immunohistochemical results also demonstrated that the expression of CD20 was not changed, and the expression of CD3 was decreased. Conclusion:Both TT and TE can effectively improve the symptoms of OSA obstruction in children. TT has less trauma, less postoperative pain, faster recovery and lower rate of hyperplasia, which can be used as one of the main methods for the treatment of tonsil hypertrophy in children.
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