title: Tonsillectomy versus tonsillotomy: a study of parental preference.
abstract: OBJECTIVE
  To directly sample the preference of representative parents who would be hypothetically considering tonsillotomy versus tonsillectomy for their child and assess the role of parental age, educational level, and risk aversion in making this choice.
  
  
  METHODS
  Parents in a pediatric otolaryngology waiting room were asked to complete an anonymous survey which presented hypothetical scenarios for their child and described the specifics of tonsillectomy and tonsillotomy in terms of post-operative recovery, tonsil regrowth rates, and future strep throat risk. Other questions gathered parental demographic data and assessed risk tolerance.
  
  
  RESULTS
  Two hundred and thirty-four parents completed the survey. A large majority of parents (201 of 234, 85.9%) preferred tonsillectomy over tonsillotomy for their child. Parental education and age were not associated with procedural preference. An increasing self-reported risk aversion score (p=0.003, Fisher's exact test) and a classification as risk averse using validated questions (p=0.034) were both associated with a preference for tonsillectomy over tonsillotomy.
  
  
  CONCLUSIONS
  Parents of pediatric Otolaryngology patients strongly prefer tonsillectomy over tonsillotomy when described in general terms. This parental choice appears to correlate with risk aversion of the possible long-term complications of tonsillotomy including the need for future treatment of streptococcal pharyngitis and/or regrowth of the tonsils and subsequent revision tonsil surgery.
authors.affiliation: Walter Reed National Military Medical Center, Bethesda, MD, United States.
authors.forename: Sally D
authors.initials: SD
authors.lastname: Stasio
authors.affiliation: Uniformed Services of the University Health Sciences, Bethesda, MD, United States.
authors.forename: Charles
authors.initials: C
authors.lastname: Yang
authors.affiliation: Walter Reed National Military Medical Center, Bethesda, MD, United States; Uniformed Services of the University Health Sciences, Bethesda, MD, United States. Electronic address: SEBrietzke@msn.com.
authors.forename: Scott E
authors.initials: SE
authors.lastname: Brietzke
authors.affiliation: Children's National Medical Center, Washington, DC, United States.
authors.forename: Rahul K
authors.initials: RK
authors.lastname: Shah
mesh_terms: D000293:Adolescent; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014066:Palatine Tonsil / Q000601:surgery*; D010290:Parents; D057240:Patient Preference; D011795:Surveys and Questionnaires; D014068:Tonsillectomy; D055815:Young Adult
keywords: Pediatric surgery; Tonsillectomy; Tonsillotomy