Global tonsillectomy practice patterns - A survey study of pediatric otolaryngologists

Area of Science:

• Otolaryngology
• Pediatric Surgery
• Surgical Techniques

Background:

• Global tonsillectomy practices exhibit significant variation in surgical techniques and postoperative management.
• Understanding these international differences is crucial for optimizing patient care and developing consistent protocols.

Purpose of the Study:

• To consolidate and analyze international similarities and differences in tonsillectomy management among pediatric otolaryngologists worldwide.
• To identify trends in surgical approaches and postoperative care for tonsillectomy.

Main Methods:

• A cross-sectional online survey with 55 items was distributed to pediatric otolaryngologists across 22 countries.
• 132 responses were collected from an international WhatsApp group, achieving a 45.1% response rate.

Main Results:

• Extracapsular tonsillectomy was most common (44.7%), but intracapsular tonsillectomy adoption was high, especially in Europe (68.8%).
• Indications for both techniques varied, with obstructive sleep apnea being a key consideration for both.
• Postoperative pain management commonly involved acetaminophen and ibuprofen, with opioid use in 28.8% of cases. Polysomnography access was high (84.0%).

Conclusions:

• The study indicates a growing trend towards intracapsular tonsillectomy globally.
• Significant international variability in tonsillectomy practices necessitates the development of comprehensive, evidence-based guidelines.