[The Austrian tonsil study 2010--part 1: statistical overview].
BACKGROUND
Tonsillectomy (TE), tonsillotomy (TO) and adenoidectomy (AE) are surgeries performed routinely by otorhinolaryngologists. There were 5 cases of fatal postoperative bleeding in Austria during the years 2006 and 2007, all in children under 6 years of age. The intensive discussion following these sad events resulted in a Consensus Paper of the Austrian Society of ORL, H&NS with the Austrian Society of Pediatrics with modified recommendations towards indications and surgical techniques in different age groups; in addition, the prospective study presented here was initiated. In Austria for the first time a full census could be performed assessing all TE, TO and AE with standardized definitions.


METHODS
Within the study period of 9 months' from October 1, 2009, to June 30, 2010, data on patients' characteristics, indication for surgery, surgical technique and postoperative haemorrhage were prospectively collected. Postoperative haemorrhage was defined as any bleeding after extubation regardless of whether or not a surgical intervention was required. Postoperative bleeding events were categorised into 7 grades depending on severity.


RESULTS
More than one million data of 9,405 patients from 32 ENT-departments in Austria were collected and analysed. One third were children younger than 6 years (n=3,474; 37%) and one third were adults (n=3,507, 37%). A TE ±AE was performed in 48.8% (n=4,594), an AE in 37.1% (n=3,492) and a TO in 14.0% (n=1, 319). For the indication "recurrent tonsillitis and tonsilar hypertrophy" 70% of children had a TO but 95% of adults had a TE (p<0.001). Adults with OSAS had a TE whereas in children aged younger than 6 with the same indication a TO was preferably performed in 90% (p<0.001). For TO the Colorado-needle and the Coblation technique were most commonly used. The Adenotome by La Force and the Adenoid curette by Beckmann, with or without endoscopic control, were most frequently used for AE.


CONCLUSIONS
For the first time a prospective full survey could be performed in one country assessing all tonsil and adenoid surgeries along standardized criteria. The study gives an overview about the types of surgery, the indications, the operation techniques and the frequency of postoperative haemorrhage. The latter, because of its clinical importance, is dealt with and described in detail in the second part of this publication.
Klinische Abteilung für Allgemeine HNO, Medizinische Universität Graz, Österreich. stephanie@sarny.at
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D000233:Adenoidectomy / Q000009:adverse effects* / Q000401:mortality*; D000293:Adolescent; D000328:Adult; D001317:Austria; D002648:Child; D002675:Child, Preschool; D003625:Data Collection; D006801:Humans; D006965:Hyperplasia / Q000601:surgery; D014066:Palatine Tonsil / Q000473:pathology; D019106:Postoperative Hemorrhage / Q000401:mortality*; D011446:Prospective Studies; D014068:Tonsillectomy / Q000009:adverse effects* / Q000401:mortality*; D014069:Tonsillitis / Q000601:surgery