Tonsillotomies have gained popular acceptance in children with sleep-disordered breathing (SDB) in recent years. Short-term advantages that have been shown in the literature include lower haemorrhage rates, shorter operation times and less pain. Evidence for long-term effects are sparse due to the technique being relatively new. The Swedes were early proponents of the technique, and this retrospective paper examines data from the Swedish National Patient Register. The focus is the reoperation rates of tonsillotomies (presumably coblation) versus traditional tonsillectomies (techniques not described). Inclusion criteria regarding surgery included recurrent tonsillitis as well as SDB (a total of 27,535 children aged between one and twelve years).

Findings showed a statistically higher rate of reoperation in the tonsillotomy (with or without adenoidectomy) for SDB group compared with the tonsillectomy (with or without adenoidectomy) for SDB group, especially in younger children.

The mean time for reoperation in both groups was in the order of 1.6 years. Regrowth of tonsillar tissue is the presumed cause. This is certainly food for thought for clinicians thinking about making the big changeover to tonsillotomies for SDB.

Risk of reoperation after tonsillectomy versus tonsillotomy: a population-based cohort study.
Odhagen E, Sunnergren O, Hemlin C, et al.
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Sidhartha Nagala

Royal Hallamshire Hospital, Sheffield, UK.

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