Our Summary

This research paper examines whether partial tonsil removal (tonsillotomy) is as effective as total tonsil removal (tonsillectomy) in treating children with obstructive sleep-disordered breathing (oSDB), a condition that causes breathing problems during sleep due to a blocked airway.

The researchers looked at 22 studies involving 1984 children. The studies had varying quality, with most having unclear or high risk of bias, and used different measures and follow-up periods ranging from six days to six years.

It was very uncertain whether there was any difference in disease-specific quality of life between the two surgical procedures in the short, medium, and long term. The researchers were also uncertain whether tonsillotomy reduces blood loss during surgery by a meaningful amount.

The risk of complications in the first week after surgery was probably lower in children who had a tonsillotomy. This group also likely returned to normal activity four days earlier than the group who had a total tonsil removal.

However, the long-term effects of the two surgeries on breathing disorder symptoms, quality of life, recurrence of the breathing disorder, and need for reoperation were unclear due to limited data and very low quality evidence. The researchers concluded that more robust data from high-quality studies is needed to determine the best tonsil surgery technique for children with oSDB.

FAQs

  1. Is partial tonsil removal (tonsillotomy) as effective as total tonsil removal (tonsillectomy) in treating children with obstructive sleep-disordered breathing (oSDB)?
  2. Does tonsillotomy reduce the risk of complications and recovery time after surgery compared to total tonsil removal?
  3. What are the long-term effects of partial versus total tonsil removal on children with obstructive sleep-disordered breathing?

Doctor’s Tip

It is important to follow your doctor’s post-operative instructions carefully, including taking prescribed pain medication, maintaining a soft diet, staying hydrated, and getting plenty of rest. Avoid strenuous activities and contact sports for at least two weeks after surgery to prevent bleeding. If you experience persistent or worsening symptoms such as severe pain, difficulty swallowing, or bleeding, contact your doctor immediately. Follow up with your doctor as scheduled to monitor your recovery and address any concerns.

Suitable For

According to the research paper, patients who are typically recommended tonsillectomy are children with obstructive sleep-disordered breathing (oSDB) who experience breathing problems during sleep due to a blocked airway. These patients may benefit from either partial tonsil removal (tonsillotomy) or total tonsil removal (tonsillectomy) as a treatment option.

Timeline

Before tonsillectomy, a patient may experience symptoms of obstructive sleep-disordered breathing such as snoring, pauses in breathing during sleep, restless sleep, and daytime fatigue. They may undergo a sleep study to diagnose the condition and may try other treatments such as medications or continuous positive airway pressure (CPAP) therapy.

After tonsillectomy, the patient can expect a recovery period that includes pain and discomfort in the throat, difficulty swallowing, ear pain, and bad breath. They may also experience temporary changes in their diet and activity level. In the short term, the patient may have a lower risk of complications with tonsillotomy compared to tonsillectomy and may return to normal activities sooner. However, the long-term effects of the two surgeries on symptoms, quality of life, and recurrence of the breathing disorder are uncertain and require further research.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with tonsillectomy?
  2. How long is the recovery period after tonsillectomy?
  3. Will my child need to stay overnight in the hospital after the surgery?
  4. How will tonsillectomy affect my child’s ability to eat and drink after the procedure?
  5. Are there any long-term effects or complications that can arise from having a tonsillectomy?
  6. What is the success rate of tonsillotomy compared to tonsillectomy in treating obstructive sleep-disordered breathing?
  7. How will the decision between tonsillotomy and tonsillectomy be made for my child’s specific case?
  8. What can we expect in terms of improvement in my child’s symptoms after the surgery?
  9. Will my child need any additional treatments or therapies after undergoing tonsil surgery?
  10. Are there any lifestyle changes or precautions my child should take post-surgery to ensure a successful recovery?

Reference

Authors: Blackshaw H, Springford LR, Zhang LY, Wang B, Venekamp RP, Schilder AG. Journal: Cochrane Database Syst Rev. 2020 Apr 29;4(4):CD011365. doi: 10.1002/14651858.CD011365.pub2. PMID: 32347984