title: Role of subtotal tonsillectomy ('tonsillotomy') in children with sleep disordered breathing.
abstract: BACKGROUND
  Sleep disordered breathing in children causes disturbance in behaviour and also in cardiorespiratory and neurocognitive function. Subtotal tonsillectomy ('tonsillotomy') has been performed to treat sleep disordered breathing, with outcomes comparable to established therapies such as total tonsillectomy or adenoidectomy. This review critically assesses the role of subtotal tonsillectomy in a paediatric setting.
  
  
  METHODS
  The Medline database (1966 to October 2012) was electronically searched using key terms including subtotal or intracapsular tonsillectomy, tonsillotomy, tonsillectomy, paediatrics, and sleep disordered breathing.
  
  
  RESULTS
  Eighteen papers were identified and reviewed. Subtotal tonsillectomy would appear to have an efficacy equal to that of total tonsillectomy for the treatment of sleep disordered breathing, and has significant benefits in reducing post-operative pain and analgesia use. Subtotal tonsillectomy patients appear to have less frequent post-operative haemorrhage compared with total tonsillectomy patients.
  
  
  CONCLUSIONS
  In children, subtotal tonsillectomy is associated with fewer post-operative complications whilst having a comparable effect in improving sleep disordered breathing, compared with total tonsillectomy.
authors.affiliation: Flinders ENT, Department of Surgery, Flinders University and Flinders Medical Centre, Australia.
authors.forename: J M
authors.initials: JM
authors.lastname: Wood
authors.affiliation: Medical School, Flinders University, Adelaide, South Australia, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Cho
authors.affiliation: Flinders ENT, Department of Surgery, Flinders University and Flinders Medical Centre, Australia.
authors.forename: A S
authors.initials: AS
authors.lastname: Carney
mesh_terms: D002648:Child; D006801:Humans; D006984:Hypertrophy / Q000601:surgery; D010149:Postoperative Pain; D014066:Palatine Tonsil / Q000601:surgery*; D010608:Pharyngeal Diseases / Q000150:complications / Q000601:surgery*; D019106:Postoperative Hemorrhage; D011788:Quality of Life; D020181:Sleep Apnea, Obstructive / Q000209:etiology / Q000601:surgery*; D014068:Tonsillectomy / Q000379:methods*; D016896:Treatment Outcome