title: Paradigm shift in Sweden from tonsillectomy to tonsillotomy for children with upper airway obstructive symptoms due to tonsillar hypertrophy.
abstract: Tonsillotomy (TT) is now used more often than tonsillectomy (TE) for tonsil obstructive symptoms in Sweden. Both TE and TT give high patient satisfaction although TT results in fewer postoperative bleedings and shorter time when analgesics are needed. The objective of this study is to analyze the current prevalence of different tonsil surgery procedures, the rates of early and late bleeding and other complications. Data from the National Tonsil Surgery Register in Sweden were analyzed. Patients 1-15 years operated for symptoms due to tonsil hypertrophy were included. Surgical procedure, technique and bleedings during hospital stay were registered. Thirty days after surgery, unplanned contacts due to bleeding, infection or pain were reported as were symptom relief after 6 months. 24,083 patients were registered. Of the 10,826 children 1-15 years operated for obstructive symptoms, 64 % were TT or TT+A, and 34 % TE, TE+A. 69 % answered the 30-day questionnaire and 50 % the 6 months. Bleeding in hospital occurred in 1.38 %, late bleedings in 2.06 %: 3.7 % after TE+A, 0.8 % after TT+A. Differences in readmissions due to bleeding, number of days using analgesics, health care contacts due to pain and nosocomial infections were significant between TT and TE, but not differences with regard to symptom relief after 6 months.
authors: Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden. Elisabeth.Hultcrantz@liu.se
authors: Elisabeth
authors: E
authors: Hultcrantz
authors: Elisabeth
authors: E
authors: Ericsson
authors: Claes
authors: C
authors: Hemlin
authors: Anne-Charlotte
authors: AC
authors: Hessén-Söderman
authors: Kristian
authors: K
authors: Roos
authors: Ola
authors: O
authors: Sunnergren
authors: Joacim
authors: J
authors: Stalfors
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D007223:Infant; D008297:Male; D010149:Postoperative Pain / Q000453:epidemiology*; D014066:Palatine Tonsil / Q000473:pathology* / Q000601:surgery; D017060:Patient Satisfaction; D019106:Postoperative Hemorrhage / Q000453:epidemiology*; D012042:Registries; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D014068:Tonsillectomy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome
references: Laryngoscope. 2011 Nov;121(11):2322-6
references: 21994191
references: Clin Otolaryngol Allied Sci. 2004 Apr;29(2):161-4
references: 15113303
references: Int J Pediatr Otorhinolaryngol. 2008 Jul;72(7):1029-40
references: 18455808
references: Laryngoscope. 2007 Apr;117(4):717-24
references: 17415144
references: Int J Pediatr Otorhinolaryngol. 2009 May;73(5):637-40
references: 19167099
references: Int J Pediatr Otorhinolaryngol. 2009 May;73(5):667-70
references: 19181397
references: Am J Respir Crit Care Med. 2010 Sep 1;182(5):676-83
references: 20448096
references: Int J Pediatr Otorhinolaryngol. 2008 Sep;72(9):1411-7
references: 18635269
references: Laryngoscope. 2004 May;114(5):871-7
references: 15126747
references: Acta Otolaryngol. 2012 May;132(5):533-9
references: 22235871
references: Int J Pediatr Otorhinolaryngol. 2011 Nov;75(11):1395-8
references: 21889219
references: J Laryngol Otol. 2008 Jul;122(7):719-21
references: 17666144
references: Int J Pediatr Otorhinolaryngol. 2005 Jan;69(1):21-6
references: 15627442
references: Eur Arch Otorhinolaryngol. 2007 Mar;264(3):277-84
references: 17021780
references: Laryngoscope. 2006 Oct;116(10):1851-7
references: 17003713
references: Int J Pediatr Otorhinolaryngol. 1999 Dec 15;51(3):171-6
references: 10628543
references: Laryngoscope. 2002 Aug;112(8 Pt 2 Suppl 100):17-9
references: 12172232
references: Laryngoscope. 2007 Apr;117(4):654-61
references: 17415136
references: Ann Med. 1998 Aug;30(4):350-6
references: 9783833
references: J Laryngol Otol. 2006 Dec;120(12):993-1000
references: 16923328