BACKGROUND: Tonsillotomy is accepted as a safe and effective method for treatment of obstructive sleep-related respiratory disturbances in children. However, the question of inflammatory complications in the remaining tonsillar tissue is still present for long-term progression. Investigations performed with multiple-year observations should contribute to a clarification of the indicative conditions. PATIENTS AND METHODS: A total of 181 patients were observed following a tonsillotomy performed with CO(2) laser (age: 4.6 years;+/-1.9 years). Using a standardized questionnaire, 145 patients were evaluated over an observation period of up to 6 years (average 3.0 years) with respect to post-operative complications, as well as subsequent inflammatory illnesses. Of these, 131 patients were evaluated with regard to long-term development of obstructive symptoms. RESULTS: Within the subsequent observation period no abscess formation occurred, a re-occurrence of tonsillitis was observed in fewer than 3% of the patients. Subsequent bleeding requiring treatment did not occur during the post-operative progress for any of the 145 patients. Obstructive symptoms in the form of snoring, respiratory interruptions, daytime symptoms, or dysphagy could also be significantly reduced (p<0.001) in the long-term. The overall success of the operation was evaluated by 95% of parents as "good" or "very good". CONCLUSIONS: A CO(2) laser tonsillotomy using for treatment of obstructive tonsil hyperplasy in small children (with consideration of an inflammation-free anamnesis) represents a safe, effective, and low-complication method, also for long-term continued development. Georg Thieme Verlag KG Stuttgart * New York.
BACKGROUND: Tonsillotomy is accepted as a safe and effective method for treatment of obstructive sleep-related respiratory disturbances in children. However, the question of inflammatory complications in the remaining tonsillar tissue is still present for long-term progression. Investigations performed with multiple-year observations should contribute to a clarification of the indicative conditions. PATIENTS AND METHODS: A total of 181 patients were observed following a tonsillotomy performed with CO(2) laser (age: 4.6 years;+/-1.9 years). Using a standardized questionnaire, 145 patients were evaluated over an observation period of up to 6 years (average 3.0 years) with respect to post-operative complications, as well as subsequent inflammatory illnesses. Of these, 131 patients were evaluated with regard to long-term development of obstructive symptoms. RESULTS: Within the subsequent observation period no abscess formation occurred, a re-occurrence of tonsillitis was observed in fewer than 3% of the patients. Subsequent bleeding requiring treatment did not occur during the post-operative progress for any of the 145 patients. Obstructive symptoms in the form of snoring, respiratory interruptions, daytime symptoms, or dysphagy could also be significantly reduced (p<0.001) in the long-term. The overall success of the operation was evaluated by 95% of parents as "good" or "very good". CONCLUSIONS: A CO(2) laser tonsillotomy using for treatment of obstructive tonsil hyperplasy in small children (with consideration of an inflammation-free anamnesis) represents a safe, effective, and low-complication method, also for long-term continued development. Georg Thieme Verlag KG Stuttgart * New York.