Tonsillotomy in children with tonsillar hypertrophy

Tonsillectomy is one of the most frequent surgical procedures carried out o n children. Obstructive sleep apnea syndrome, caused by tonsillar hypertrop hy, has been attracting increasing interest and tonsillectomy is often perf ormed as a result of this indication. Regardless of the indication, the mai n aim of tonsillectomy has always been to remove the tonsils completely. Th e present study was undertaken in order to investigate the effect of two di fferent surgical techniques, tonsillectomy and tonsillotomy, on clinical sy mptoms in children with symptoms of obstructive sleep apnea syndrome due to tonsillar hypertophy. The study was conducted as a prospective, randomized trial comparing the clinical effects of standard tonsillectomy and tonsill otomy using a CO, laser. Forty-three children aged 2-9 years were included, Both groups of patients experienced comparable relief from symptoms of sno ring and apneas at follow-up after 3 months and 2 years. There was no signi ficant statistical difference between the two groups of patients in terms o f both short- and long-term effects on clinical symptoms. Tonsillotomy caus ed no measurable bleeding during surgery. Postoperative pain and distress w ere less pronounced in the tonsillotomy group according to visual analog sc ale evaluations made by patients, parents and nursing staff. In conclusion tonsillotomy appears to be the less traumatic surgical method in cases of u pper airway obstruction in children caused by tonsillar hypertrophy.