Radiofrequency tonsillotomy versus bipolar scissors tonsillectomy for the treatment of OSAS in children: a prospective study.
BACKGROUND
Tonsillotomy is an effective treatment for the management of obstructive sleep apnoea syndrome (OSAS) in children with tonsillar hypertrophy and appears to be associated with less pain and postoperative morbidity.


OBJECTIVE
To compare postoperative morbidity and short-term and intermediate-term efficacy of radiofrequency tonsillotomy (TT) and bipolar scissors tonsillectomy (TE) in children.


METHODS
Children with OSAS due to tonsillar hypertrophy were included in a prospective, non-randomized study between February 4, 2008 and March 20, 2010. Exclusion criteria were recurrent tonsillitis (≥ 3 episodes per year), clotting disorders and age less than 2 years. Postoperative complications, efficacy on OSAS, and operating times were evaluated. Pain was evaluated by the Postoperative Pain Measure for Parents score on D0, D1, D7 and D30.


RESULTS
One hundred and ninety-three children were included: 105 in the TE group (age: 4.75 ± 2.37 years) and 88 in the TT group (age: 4.88 ± 2.6 years). The pain score was significantly lower in the TT group than in the TE group during the first postoperative week (P<0.05). A significant difference was observed for the secondary postoperative bleeding rate (1 after TT versus 8 after TE). No significant difference was observed between the two techniques in terms of the efficacy on OSAS. At 1 year, the tonsil regrowth rate in the TT group was 4.5%.


CONCLUSIONS
Radiofrequency tonsillotomy is a safe technique for the treatment of obstructive tonsillar hypertrophy in children with good results on OSAS and a reduction of postoperative pain.
Service d'oto-rhino-laryngologie et de chirurgie cervico-faciale, hôpital pédiatrique Clocheville, CHRU, 37044 Tours cedex 9, France. moriniere@med.univ-tours.fr
S
S
Morinière
A
A
Roux
D
D
Bakhos
J-P
JP
Trijolet
S
S
Pondaven
E
E
Pinlong
E
E
Lescanne
D000234:Adenoids / Q000503:physiopathology / Q000601:surgery*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006984:Hypertrophy; D053685:Laser Therapy; D008297:Male; D010149:Postoperative Pain / Q000517:prevention & control; D019106:Postoperative Hemorrhage / Q000517:prevention & control; D011446:Prospective Studies; D061208:Pulsed Radiofrequency Treatment; D020181:Sleep Apnea, Obstructive / Q000601:surgery*; D012913:Snoring / Q000601:surgery; D014068:Tonsillectomy / Q000295:instrumentation* / Q000379:methods*