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Role of subtotal tonsillectomy (‘tonsillotomy’) in children with sleep disordered breathing

Published online by Cambridge University Press:  26 November 2013

J M Wood ,
M Cho  and
A S Carney
J M Wood
Affiliation:
Flinders ENT, Department of Surgery, Flinders University and Flinders Medical Centre, Australia
M Cho
Affiliation:
Medical School, Flinders University, Adelaide, South Australia, Australia
A S Carney*
Affiliation:
Flinders ENT, Department of Surgery, Flinders University and Flinders Medical Centre, Australia
*
Address for correspondence: Prof A Simon Carney, Flinders ENT, Dept of Surgery, Flinders Medical Centre, Bedford Park, South Australia, Australia5042 Fax:+61 8204 7524 E-mail: [email protected]
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Abstract

Introduction:

Sleep disordered breathing in children causes disturbance in behaviour and also in cardiorespiratory and neurocognitive function. Subtotal tonsillectomy (‘tonsillotomy’) has been performed to treat sleep disordered breathing, with outcomes comparable to established therapies such as total tonsillectomy or adenoidectomy. This review critically assesses the role of subtotal tonsillectomy in a paediatric setting.

Method:

The Medline database (1966 to October 2012) was electronically searched using key terms including subtotal or intracapsular tonsillectomy, tonsillotomy, tonsillectomy, paediatrics, and sleep disordered breathing.

Results:

Eighteen papers were identified and reviewed. Subtotal tonsillectomy would appear to have an efficacy equal to that of total tonsillectomy for the treatment of sleep disordered breathing, and has significant benefits in reducing post-operative pain and analgesia use. Subtotal tonsillectomy patients appear to have less frequent post-operative haemorrhage compared with total tonsillectomy patients.

Conclusion:

In children, subtotal tonsillectomy is associated with fewer post-operative complications whilst having a comparable effect in improving sleep disordered breathing, compared with total tonsillectomy.

Keywords

TonsillectomySleep Disordered BreathingSleep ApneaPediatrics
Type
Review Articles
Information
The Journal of Laryngology & Otology , Volume 128 , Supplement S1 , January 2014 , pp. S3 - S7
Copyright
Copyright © JLO (1984) Limited 2013 

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