Tonsillectomy vs. partial tonsillectomy for OSAS in children--10 years post-surgery follow-up.
BACKGROUND
Today, obstructive hypertrophic tonsils are completely resected to remove the obstruction. Since tonsillar tissue has important protective characteristics, it is more logical to resect only the obstructive tonsillar tissue and leave remnants in the tonsillar beds, thereby presuming to preserve the immunological function of the tonsillar tissue. However, it is as yet unclear whether or not rehypertrophy of this remnant of the tonsils and/or tonsillitis reoccur in the long-term.


OBJECTIVE
To evaluate the remnants of the tonsils 10-14 years post-tonsillotomy in children who suffered from obstructive sleep apnea syndrome (OSAS) due to obstructive tonsils.


METHODS
We conducted a retrospective study, telephone survey and selective physical examination of 33 children who had obstructive hypertrophic tonsils (suffered from OSAS due to hypertrophic tonsils), and underwent tonsillotomy (TT) at Assaf Harofeh Medical Center between July 1990 and April 1993, and compared them with a group of 16 children treated by tonsillectomy (TE) for the same diagnosis.


RESULTS
No statistically significant difference was found between the TT and TE groups in all parameters compared: non-obstructing tonsils recurred (97% vs. 87%); snoring (3% vs. 12.5%); recurrent tonsillitis (6% vs. 6.25%); and recurrent obstruction and unilateral enlargement (3% vs. 12.5%).


CONCLUSIONS
TT is as effective as TE for the long-term treatment of children suffering from OSAS due to hypertrophic tonsils.
Eviatar
Ephraim
E
Department of Otorhinolaryngology Head and Neck Surgery, Assaf Harofeh Medical Center, Zerifin 70300, Israel.
Kessler
Alexander
A
Shlamkovitch
Nathan
N
Vaiman
Michael
M
Zilber
Drorit
D
Gavriel
Haim
H
D000233:Adenoidectomy; D000234:Adenoids / Q000473:pathology* / Q000601:surgery*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006984:Hypertrophy / Q000150:complications / Q000473:pathology / Q000601:surgery; D007223:Infant; D008221:Lymphoid Tissue / Q000473:pathology / Q000601:surgery; D008297:Male; D014066:Palatine Tonsil / Q000473:pathology* / Q000601:surgery*; D011184:Postoperative Period; D012008:Recurrence; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000209:etiology*; D011795:Surveys and Questionnaires; D013997:Time Factors; D014068:Tonsillectomy / Q000379:methods*