title: Laser-tonsillotomy for treatment of obstructive tonsillar hyperplasia in early childhood: a retrospective review.
abstract: BACKGROUND
  Tonsillar hyperplasia leading to dyspnea, dysphagia and other symptoms of obstruction represents a common problem especially in young children where tonsillectomy should be avoided in order to preserve the immunological function of the tonsils. Aim of the study was to assess carbon-dioxide-laser-tonsillotomy as a considered alternative procedure to reduce the tonsillar volume in these children.
  
  
  METHODS
  Between 1993 and 2004, 109 children with tonsillar hyperplasia without former episodes of tonsillitis received laser-tonsillotomy mostly (n=98) combined with adenoidectomy. The protruding part of the tonsil was reduced by a CO2-laser. Seventy-five children were available for follow-up with a standard questionnaire. Five patients required a subsequent tonsillectomy due to a recurrence of tonsillar hyperplasia. Histological investigations were performed. Twenty-two children were reevaluated by clinical examination.
  
  
  RESULTS
  Most of the patients were relieved from obstructive symptoms. There was no occurrence of postoperative hemorrhage or peritonsillar abscesses. The histological investigations on the specimens from later performed tonsillectomy (n=5) showed no evidence of inflammation or scar formations, but open and deep crypts. The clinical examination did not reveal any signs of chronic infections.
  
  
  CONCLUSIONS
  In this retrospective study tonsillotomy with CO2-laser in early childhood leads to a long-term elimination of obstructive symptoms due to tonsillar hyperplasia with minimal discomfort for the patient while preserving normally functioning immunocompetent tonsillar tissue. Further prospective studies are planned.
authors.affiliation: Department of Otorhinolaryngology, University of Essen, Universitaets HNO Klinik, ENT/HNO, Hufelandstr. 55, 45122 Essen, NRW, Germany. claus.unkel@uni-essen.de
authors.forename: Claus
authors.initials: C
authors.lastname: Unkel
authors.forename: Goetz
authors.initials: G
authors.lastname: Lehnerdt
authors.forename: Klaus Juergen
authors.initials: KJ
authors.lastname: Schmitz
authors.forename: Klaus
authors.initials: K
authors.lastname: Jahnke
mesh_terms: D002648:Child; D002675:Child, Preschool; D006801:Humans; D006965:Hyperplasia; D007223:Infant; D053685:Laser Therapy / Q000379:methods*; D014066:Palatine Tonsil / Q000473:pathology* / Q000601:surgery*; D012008:Recurrence; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome