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Tonsillectomy Versus Tonsillotomy in Pediatric Sleep-Disordered Breathing: A Systematic Review and Multi-subgroup

Jiahong Lao1, Feitong Jian1, Rongrong Ge1

  • 1E.N.T. Department, The 3rd Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.

The Laryngoscope
|September 19, 2024
PubMed

Insights

Tonsillotomy (TT) offers similar symptom relief for obstructive sleep-disordered breathing (oSDB) as tonsillectomy (TE) in children. However, TT has a higher risk of recurrence and reoperation despite faster recovery and less bleeding.

Area of Science:

  • Otolaryngology
  • Pediatric Surgery
  • Sleep Medicine

Background:

  • Obstructive sleep-disordered breathing (oSDB) significantly impacts children's health and quality of life.
  • Tonsillectomy (TE) is a common treatment, but tonsillotomy (TT) is explored as a less invasive alternative.

Purpose of the Study:

  • To compare the efficacy and safety of tonsillotomy (TT) versus tonsillectomy (TE) in pediatric patients with oSDB.
  • To evaluate short- and long-term postoperative outcomes for both procedures.

Main Methods:

  • A systematic review and meta-analysis of controlled studies comparing TT and TE in children with oSDB.
  • Searched major databases including PubMed, Cochrane Library, and Embase.
  • Analyzed 32 studies involving 9,430 children.

Main Results:

  • TT showed comparable therapeutic effects to TE on OSA-18 scores.
  • TT resulted in shorter recovery times, less analgesic use, and reduced bleeding.
  • However, TT was associated with significantly higher risks of reoperation, oSDB recurrence, and postoperative infection.

Conclusions:

  • Tonsillotomy offers benefits like reduced pain, bleeding, and faster recovery for pediatric oSDB.
  • The increased risk of residual tonsil tissue issues and reoperation necessitates careful consideration of TT's long-term risks versus short-term advantages.
Abstract

Keywords:
coblationmicrodebriderpediatric obstructive sleep‐disordered breathingtonsillectomytonsillotomy

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