title: Tonsillotomy versus tonsillectomy--a randomized trial regarding dentofacial morphology and post-operative growth in children with tonsillar hypertrophy.
abstract: OBJECTIVE
  The primary aim of this study was to analyse two different methods of tonsil surgery, tonsillectomy (TE) and tonsillotomy (TT), regarding post-operative dentofacial growth in children with tonsillar hypertrophy. A secondary aim was to analyse these results in relation to cephalometric standards.
  
  
  METHODS
  The study group consisted of 64 subjects (39 boys and 25 girls), mean age 4.8 years ± 4 months. They were randomized to a complete removal of the pharyngeal tonsil, TE, (n = 31) or a partial removal, TT, (n = 33). Pre-operative and 2 years post-operative study material were obtained and analysed. The results were compared with cephalometric standards.
  
  
  RESULTS
  Pre-operative, children with hypertrophic tonsils displayed an increased vertical relation (P < 0.05) compared with cephalometric standards. Post-operative, no significant difference could be detected between the two surgical procedures regarding dentofacial growth. Mandibular growth with an anterior inclination was significant (P < 0.001/TE, P < 0.01/TT) for both groups. An increased upper and lower incisor inclination was noted (P < 0.01/TE,TT). The vertical relation decreased (P < 0.001/TE, P < 0.05/TT) as well as the mandibular angle (P < 0.01/TE, P < 0.001/TT). Reduction was also significant for the sagittal intermaxillar (P < 0.001/TE,TT) relation. These post-operative results, together with a more prognatic mandible (P < 0.05/TE,TT) and chin (P < 0.001/TE, P < 0.01/TT), might indicate a more horizontal direction of mandibular growth.
  
  
  CONCLUSIONS
  TE and TT yielded equal post-operative dentofacial growth in children treated for hypertrophic tonsils. This result should be considered when deciding upon surgical technique.
authors.affiliation: *The Center for Orthodontics and Pedodontics, jenny.kallunki@lio.se.
authors.forename: Jenny
authors.initials: J
authors.lastname: Kallunki
authors.affiliation: **Departments of Dentofacial Orthopaedics, University Hospital and.
authors.forename: Agneta
authors.initials: A
authors.lastname: Marcusson
authors.affiliation: ***Medical and Health Sciences, Linköping University and Anesthesia and Intensive Care , County Council of Östergötland, Linköping, Sweden.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Ericsson
mesh_terms: D002508:Cephalometry / Q000379:methods; D002675:Child, Preschool; D002680:Chin / Q000254:growth & development; D005145:Face / Q000033:anatomy & histology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006984:Hypertrophy; D007180:Incisor / Q000473:pathology; D008297:Male; D008334:Mandible / Q000254:growth & development; D008437:Maxilla / Q000254:growth & development; D008445:Maxillofacial Development / Q000502:physiology*; D009295:Nasal Bone / Q000254:growth & development; D014066:Palatine Tonsil / Q000473:pathology* / Q000601:surgery; D012737:Sex Factors; D014068:Tonsillectomy / Q000379:methods*; D016896:Treatment Outcome; D014716:Vertical Dimension