title: Post-operative morbidity and 1-year outcomes in CO2-laser tonsillotomy versus dissection tonsillectomy.
abstract: OBJECTIVE
  In this study a type of partial tonsil surgery, CO2-laser tonsillotomy, was compared to regular tonsillectomy. The effectiveness and post-operative recovery rate of both interventions in adult patients was assessed by using a questionnaire.
  
  
  METHODS
  Prospective follow-up non-randomized cohort study.
  
  
  METHODS
  One hundred and seven adults were included; 46 tonsillectomies and 61 tonsillotomies were performed. Patients in the tonsillectomy group underwent general anaesthesia, while tonsillotomy was performed in an ambulatory setting with local anaesthesia. Post-operative questionnaires were administered by mail after 2 weeks, 6 months, and 1 year to assess recovery rate and symptom recurrence.
  
  
  RESULTS
  In total, 72.5% of patients were cured from their initial symptoms after tonsillotomy. Three patients (7.5%) required re-surgery for their initial complaints. After tonsillectomy, 97.2% of patients were cured. Both groups showed equally high satisfaction scores after treatment. Post-operative evaluation after 2 weeks showed a mean pain-intensity score of 5.4 (Visual Analogue Scale 0-10) after tonsillotomy and a mean pain-intensity score of 7.7 after tonsillectomy. The post-operative use of analgesics was twice as long in the tonsillectomy group compared to the tonsillotomy group and the tonsillectomy group required twice as many days for full recovery. After tonsillectomy a higher rate of major post-operative haemorrhage was seen.
  
  
  CONCLUSIONS
  CO2-laser tonsillotomy is associated with a shorter and less painful recovery period. Both surgical methods are equal in terms of long-term satisfaction, although tonsillotomy comes with a higher recurrence rate of mild symptoms. A strict pre-operative patient selection for CO2-laser tonsillotomy is necessary.
authors.affiliation: a Department of Otorhinolaryngology , HagaZiekenhuis , the Hague , the Netherlands.
authors.forename: Evelijn S
authors.initials: ES
authors.lastname: Lourijsen
authors.affiliation: a Department of Otorhinolaryngology , HagaZiekenhuis , the Hague , the Netherlands.
authors.forename: Justin E R E
authors.initials: JE
authors.lastname: Wong Chung
authors.affiliation: a Department of Otorhinolaryngology , HagaZiekenhuis , the Hague , the Netherlands.
authors.forename: Jan Pieter
authors.initials: JP
authors.lastname: Koopman
authors.affiliation: a Department of Otorhinolaryngology , HagaZiekenhuis , the Hague , the Netherlands.
authors.forename: Henk M
authors.initials: HM
authors.lastname: Blom
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D054020:Lasers, Gas / Q000627:therapeutic use*; D008297:Male; D010149:Postoperative Pain / Q000209:etiology; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D014068:Tonsillectomy / Q000379:methods* / Q000706:statistics & numerical data; D055815:Young Adult
keywords: CO2-laser; Tonsillotomy; complications; laser in adults; recovery; recurrent tonsillitis; symptoms; tonsil surgery; tonsillectomy; tonsilloliths