Results of a prospective clinical follow-up after tonsillotomy for obstructive sleep apnea in children

Introduction Tonsillotomy has increasingly replaced tonsillectomy in the treatment of obstructive sleep apnea in children with reduced risk of bleeding and need for analgesia, fast convalescence and outpatient feasibility. Since tonsil tissue is left in place and the risk of recurrent hypertrophy is generated, there are still reservations regarding the long-term success of the therapy. To date, there is no prospective follow-up study regarding recurrent hypertrophy after tonsillotomy. Therefore, the aim of the present study was to assess the recurrence rate, associated symptoms and impact on quality of life.

M&M: 122 children who underwent tonsillotomy at the ENT-University Hospital Ulm, Germany, between 01/2013-10/2018 at the age of 3-6 years were prospectively followed up. A systematic ENT medical examination was performed, esp. with regard to recurrence of tonsillar hypertrophy. In addition, symptom improvement as well as quality of life were recorded by validated questionnaires (OSA-18, Brouillette, KINDL).

Results The median follow-up was close to three years. No relevant recurrent hypertrophy could be detected in 89% of the children. Symptoms could be reduced in at least 89%, nocturnal apneas were no longer observed in 85%. Quality of life was improved in all questionnaires compared to postoperatively. Revision surgery was necessary in only 3%.

Conclusion The risk for recurrent hypertrophy after tonsillotomy is very low with good symptom control even in long-term follow-up. Furthermore, with a low revision rate, it can be assumed that recurrent hypertrophy does not always have to lead to symptoms requiring therapy.

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Artikel online veröffentlicht:
24. Mai 2022