title: Tonsillectomy versus tonsillotomy for sleep-disordered breathing in children: a meta analysis.
abstract: OBJECTIVE
  Tonsillotomy has gained popular acceptance as an alternative to the traditional tonsillectomy in the management of sleep-disordered breathing in children. Many studies have evaluated the outcomes of the two techniques, but uncertainty remains with regard to the efficacy and complications of tonsillotomy versus a traditional tonsillectomy. This study was designed to investigate the efficacy and complications of tonsillotomy versus tonsillectomy, in terms of the short- and long-term results.
  
  
  METHODS
  We collected data from electronic databases including MEDLINE, EMBASE, and the Cochrane Library. The following inclusion criteria were applied: English language, children, and prospective studies that directly compared tonsillotomy and tonsillectomy in the management of sleep disordered breathing. Subgroup analysis was then performed.
  
  
  RESULTS
  In total, 10 eligible studies with 1029 participants were included. Tonsillotomy was shown to be advantageous over tonsillectomy in short-term measures, such as a lower hemorrhage rate, shorter operation time, and faster pain relief. In long-term follow-up, there was no significant difference in resolution of upper-airway obstructive symptoms, the quality of life, or postoperative immune function between the tonsillotomy and tonsillectomy groups. The risk ratio of SDB recurrence was 3.33 (95% confidence interval = 1.62 6.82, P = 0.001), favoring tonsillectomy at an average follow-up of 31 months.
  
  
  CONCLUSIONS
  Tonsillotomy may be advantageous over tonsillectomy in the short term measures and there are no significant difference of resolving obstructive symptoms, quality of life and postoperative immune function. For the long run, the dominance of tonsillotomy may be less than tonsillectomy with regard to the rate of sleep-disordered breathing recurrence.
authors: Department of Otolaryngology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China, 200233.
authors: Hui
authors: H
authors: Wang
authors: Department of Otolaryngology, Dalian Municipal Central Hospital, 826 Xinan Road, Dalian, 116033 China.
authors: Yangyang
authors: Y
authors: Fu
authors: Department of Otolaryngology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China, 200233.
authors: Yanmei
authors: Y
authors: Feng
authors: Department of Otolaryngology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China, 200233.
authors: Jian
authors: J
authors: Guan
authors: Department of Otolaryngology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China, 200233.
authors: Shankai
authors: S
authors: Yin
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D010149:Postoperative Pain / Q000209:etiology; D014066:Palatine Tonsil / Q000601:surgery*; D019106:Postoperative Hemorrhage / Q000209:etiology; D011788:Quality of Life; D012891:Sleep Apnea Syndromes / Q000601:surgery*; D014068:Tonsillectomy / Q000009:adverse effects / Q000379:methods*