Making sense out of the tonsillectomy literature

Mink, Jonah; Shaha, Steven H.; Brodsky, Linda

doi:10.1016/j.ijporl.2009.02.022

Cited by 18 publications

(11 citation statements)

References 87 publications

(143 reference statements)

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“…A blinded observer in the two-year follow up would have added strength to the observations and eliminated some observer’s bias. Mink et al [31] suggest that the family and assessors of outcome should be blinded, as should the surgeon until immediately before surgery.…”

Section: Discussionmentioning

confidence: 99%

Tonsillotomy versus tonsillectomy on young children: 2 year post surgery follow-up

Ericsson

Graf

LundeborgHammarström

et al. 2014

Journal of Otolaryngology - Head & Neck Surgery

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Objectives: To study the long-term effect of tonsillotomy and tonsillectomy in young children after two years in comparison to the results after six months.Method: Children, age 4-5 with Sleep Disordered Breathing (SDB) and tonsil hyperplasia, were randomized to TE (32) or TT (35). TT was performed ad modum Hultcrantz with radiofrequency technique (Ellman). An adenoidectomy with cold steel was performed in the same session for 80% of cases. The patients were assessed prior to surgery, at six and 24 months postoperatively. Effects of surgery were evaluated clinically, through questionnaire (general health/snoring/ENT-infections), Quality of Life (QoL), survey of pediatric obstructive sleep apnea with OSA-18, and children's behavior with the Child Behavior Checklist.Results: After two years there was still no difference between the groups with respect to snoring and frequency or severity of upper airway infections. Both TT and TE had resulted in large improvement in short and long term QoL and behavior. Three TT-children and one TE child had been re-operated due to recurrence of obstructive problems, the TE-child and one of the TT-children with adenoidectomy and two of the TT-children with tonsillectomy. Three of the TT-children had tonsil tissue protruding slightly out of the tonsil pouch and twelve TE-children had small tonsil remnants within the tonsil pouches, but with no need for surgery. Conclusion:Younger children have a small risk of symptom-recurrence requiring re-surgery within two years after TT. For the majority, the positive effect on snoring, infections, behavior and quality of life remain and is similar to TE.

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Section: Discussionmentioning

confidence: 99%

Tonsillotomy versus tonsillectomy on young children: 2 year post surgery follow-up

Ericsson

Graf

LundeborgHammarström

et al. 2014

Journal of Otolaryngology - Head & Neck Surgery

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“…The number of tonsil procedures increased. When this change of surgical methods and also aseptic techniques was introduced in the late 19th century, the indications could also be widened [1,2,3,4]. …”

Section: Introductionmentioning

confidence: 99%

“…The techniques used up to 1900 with a snare or a guillotine, always resulted in a tonsillotomy. The so-called tonsil capsule in the bottom of the tonsil pouch was seldom damaged with tonsillotomy, and therefore the surgery could be done without too much bleeding and the patient could go home as soon as the short anesthesia was over [1,2,3,4]. …”

Section: Introductionmentioning

confidence: 99%

Factors Influencing the Indication for Tonsillectomy: A Historical Overview and Current Concepts

Hultcrantz

Ericsson²

2013

ORL

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Tonsil surgery has been performed for more than 3,000 years. During the 19th century when anesthesia became available, techniques were refined and the number of procedures performed increased. Repeated throat infections often causing big tonsils was the reason why parents asked for the procedure. During the preantibiotic era, scarlet fever was feared since potential heart or kidney complications were life-threatening. The technique used before 1900 was tonsillotomy since neither a fingernail, snare nor the later ʼguillotineʼ were used extracapsularly. Bleeding was small and the surgery ambulatory. Extracapsular tonsillectomy developed around the turn of the 20th century with the purpose of avoiding remnants - the ‘focal infection theory' was prevailing. The whole tonsil was now extirpated with good visibility of the tonsillar area in a deeply anesthetized patient. During the first half of the 20th century, the two methods competed, but by 1950, total tonsillectomy had become the only ‘correct' tonsil surgery. The indication was still recurrent infections. The risk for serious bleeding increased; therefore large clinics arose where patients remained for at least a week after tonsillectomy. When oral penicillin for children became available during the 1960s, the threat of throat infection decreased and the number of tonsillectomies declined. The awareness of obstructive problems in children rose at the same time when obstructive sleep apnea syndrome became a disease for adults (1970s). Tonsillotomy was revived during the 1990s and is today used increasingly in many countries. The indication is mainly obstructive sleep apnea syndromeor sleep-disordered breathing, especially in small children. Total tonsillectomy is still preferred for recurrent infections, which include periodic fever/adenitis/pharyngitis/aphthous ulcer syndrome and recurrent peritonsillitis.

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“…tonsillectomy have different impacts on post-operative mortality [45], even though no technique has ever been described as the "gold standard" [46].…”

Section: Originalmentioning

confidence: 99%

Can a Surgical Technique Be a Risk for Post-tonsillectomy Haemorrhage? Our Point of View

Motta¹,

Testa²,

Ferrillo³

et al. 2018

AOHNS

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Making sense out of the tonsillectomy literature

Cited by 18 publications

References 87 publications

Tonsillotomy versus tonsillectomy on young children: 2 year post surgery follow-up

Tonsillotomy versus tonsillectomy on young children: 2 year post surgery follow-up

Factors Influencing the Indication for Tonsillectomy: A Historical Overview and Current Concepts

Can a Surgical Technique Be a Risk for Post-tonsillectomy Haemorrhage? Our Point of View

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