Tonsil surgery in youths: good results with a less invasive method.
OBJECTIVE
Comparison of two types of tonsil surgery for 16- to 25-year-old patients, with respect to primary morbidity, snoring, and recurrent infections after 1 year. Teenagers and young adults are a significant proportion (26%) of the population that receive tonsil surgery each year and appear to suffer more pain than younger children. Recurrent tonsillitis, in combination with obstructive problems, is the main indication for surgery.


METHODS
One hundred fourteen patients 16 to 25 years of age were randomized to tonsillotomy (TT) with radiosurgery (RF) (Ellman International) or to cold tonsillectomy (TE). Pain and analgesics were logged until patients were pain free.


RESULTS
Thirty-two patients were operated on with TT and 44 with TE. The TT group had less blood loss during surgery and no postoperative bleedings, compared with the TE group (2 primary and 4 late hemorrhages). The TT group recorded significantly less pain from the first day, had less need of analgesics (diclofenac and paracetamol), and were pain free and in school/at work 4 days earlier than the TE group. After 7 days, the TE patients had lost a mean of 1.8 kg compared with TT, with no significant weight loss. After 1 year, both groups were satisfied. The positive effect on snoring was the same for both groups. There were few throat infections in both groups.


CONCLUSIONS
TT with RF is an effective method for tonsil surgery for many teenagers and young adults, with much less postoperative morbidity than regular TE. Long-term follow-up is necessary.
Ericsson
Elisabeth
E
Department of Neuroscience and Locomotion, Division of Otorhinolaryngology, Faculty of Health Sciences, University of Linköping, Linköping, Sweden.
Hultcrantz
Elisabeth
E
D000233:Adenoidectomy; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D017288:Pain Threshold; D014066:Palatine Tonsil / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications; D019106:Postoperative Hemorrhage / Q000453:epidemiology; D016634:Radiosurgery / Q000295:instrumentation; D012720:Severity of Illness Index; D012913:Snoring / Q000175:diagnosis / Q000453:epidemiology; D014068:Tonsillectomy / Q000295:instrumentation* / Q000379:methods*; D015431:Weight Loss