Justin E R E Wong Chung1,2, Peter Paul G van Benthem1, Henk M Blom1,2. 1. a Department of Otolaryngology Head and Neck Surgery , University Medical Center Leiden , Leiden , The Netherlands. 2. b Department of Otolaryngology Head and Neck Surgery , HagaZiekenhuis , the Hague , The Netherlands.
Abstract
OBJECTIVE: Tonsillotomy has emerged as an alternative for tonsillectomy in treating patients with tonsil-related afflictions. Tonsillotomy provides favourable outcomes in children, but treatment of choice in adults remains unclear. This systematic review sought to evaluate the current literature on the efficacy and adverse events of tonsillotomy compared to tonsillectomy in adults. METHODS: A Medline and Cochrane search was conducted for randomized clinical trials (RCTs) and cohort studies comparing tonsillotomy to tonsillectomy in adults. Risk of bias was assessed. Outcome measures were efficacy of the procedure in resolving the initial tonsil-related symptoms (tonsillitis, obstructive sleep apnoea, tonsil stones, halitosis, dysphagia), procedure-related complications, recovery time, post-operative use of analgesics, patient satisfaction, and operating time. RESULTS: In total nine papers were included. These trials had a high risk of bias and the inter-comparability of results was poor. The reported studies found generally a similar efficacy for both interventions. With regard to pain, the use of analgesics, patient satisfaction and operation time, the results were generally in favour of tonsillotomy. Post-operative haemorrhages were more frequent after tonsillectomy. CONCLUSION: Current evidence suggests an equal efficacy of tonsillotomy and tonsillectomy in adults and a preference for tonsillotomy in terms of pain, analgesics use, patient-satisfaction, operation time and post-operative complications.
OBJECTIVE: Tonsillotomy has emerged as an alternative for tonsillectomy in treating patients with tonsil-related afflictions. Tonsillotomy provides favourable outcomes in children, but treatment of choice in adults remains unclear. This systematic review sought to evaluate the current literature on the efficacy and adverse events of tonsillotomy compared to tonsillectomy in adults. METHODS: A Medline and Cochrane search was conducted for randomized clinical trials (RCTs) and cohort studies comparing tonsillotomy to tonsillectomy in adults. Risk of bias was assessed. Outcome measures were efficacy of the procedure in resolving the initial tonsil-related symptoms (tonsillitis, obstructive sleep apnoea, tonsil stones, halitosis, dysphagia), procedure-related complications, recovery time, post-operative use of analgesics, patient satisfaction, and operating time. RESULTS: In total nine papers were included. These trials had a high risk of bias and the inter-comparability of results was poor. The reported studies found generally a similar efficacy for both interventions. With regard to pain, the use of analgesics, patient satisfaction and operation time, the results were generally in favour of tonsillotomy. Post-operative haemorrhages were more frequent after tonsillectomy. CONCLUSION: Current evidence suggests an equal efficacy of tonsillotomy and tonsillectomy in adults and a preference for tonsillotomy in terms of pain, analgesics use, patient-satisfaction, operation time and post-operative complications.
Authors: Justin E R E Wong Chung; Rozemarie van Geet; Noud van Helmond; Chloé Kastoer; Stefan Böhringer; Wilbert B van den Hout; Hendrik P Verschuur; Ferdinand A W Peek; Patrick F M Dammeijer; Gijs K A van Wermeskerken; Peter Paul G van Benthem; Henk M Blom Journal: JAMA Netw Open Date: 2022-02-01
Authors: Joanna Katarzyna Strzelczyk; Agata Świętek; Krzysztof Biernacki; Karolina Gołąbek; Jadwiga Gaździcka; Katarzyna Miśkiewicz-Orczyk; Wojciech Ścierski; Janusz Strzelczyk; Rafał Fiolka; Maciej Misiołek Journal: Biomed Res Int Date: 2022-08-08 Impact factor: 3.246
Authors: Jaakko Matias Piitulainen; Tapani Uusitalo; Henrik M Sjöblom; Lotta E Ivaska; Henri Jegoroff; Tommi Kauko; Hannu Kokki; Eero Kytö; Iisa Mansikka; Jenni Ylikoski; Jussi Jero Journal: BMJ Open Date: 2022-09-14 Impact factor: 3.006