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Pediatric Tonsillotomy with Radiofrequency Technique: Long-Term Follow-Up

Authors

  • Elisabeth Ericsson CRNA, MscN,

    1. Division of Otorhinolaryngology, Department of Neuroscience and Locomotion, Faculty of Health Sciences, University of Linköping, Linköping, Sweden.
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  • Jonas Graf MD,

    1. Division of Otorhinolaryngology, Department of Neuroscience and Locomotion, Faculty of Health Sciences, University of Linköping, Linköping, Sweden.
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  • Elisabeth Hultcrantz MD, PhD

    Corresponding author
    1. Division of Otorhinolaryngology, Department of Neuroscience and Locomotion, Faculty of Health Sciences, University of Linköping, Linköping, Sweden.
    • Dr. Elisabeth Hultcrantz, Professor of Otorhinolaryngology, Division of Otorhinolaryngology, Department of Neuroscience and Locomotion, Faculty of Health Sciences, SE-581 85 Linköping, Sweden.
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  • The results from this paper have partly been presented at the ESPO Conference, Paris, France, June 2006.

    The sources of financial support for this project come from the Research Council of South East Sweden (FORSS), Capio Research Foundation, Sweden, the County Council of South East Sweden, and the Research Foundation of Ollie and Elof Ericsson, Sweden.

Abstract

Objectives: Compare the effects of partial tonsil resection using a radiofrequency technique, tonsillotomy (TT), with total tonsillectomy (TE, blunt dissection) after 1 and 3 years. Compare frequency of relapse in snoring or infections and possible long-term changes in behavior among TT children with those in TE children.

Method: Ninety-two children (5–15 yr) randomized to TT (n = 49) or TE (n = 43) groups because of obstructive problems with or without recurrent tonsillitis. One year after surgery, general health, degree of obstruction, history of infections, and behavior were investigated using two questionnaires, the Qu1 and Child Behavior Checklist, as well as an ENT visit. After 3 years, two questionnaires, Qu2 and the Glasgow Children's Benefit Inventory, were answered by mail.

Results: After 1 year, both groups were in good health. The effect on snoring and total behavior was the same for both groups, and the rate of recurrence of infections was not higher in the TT group. After 3 years, two children in the TT group were tonsillectomized (4%, 2/49), one because of peritonsillitis and another because of increased snoring. Otherwise, no differences existed between the groups in general health, snoring, or number of infections.

Conclusion: Removing only the protruding parts of the tonsils has the same beneficial long-term effect on obstructive symptoms and recurrent throat infections as complete TE in the majority of cases. The need for re-operation is low; therefore, it appears inadvisable to follow the current common practice of routinely removing the whole tonsil given its higher morbidity and risk for serious complications.

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