Indications and Safety of Up-to-Date Lingual Tonsillectomy

Abstract

Objectives:

To describe the main indications for lingual tonsillectomy (LT) and to analyze the safety and post-operative morbidity of LT with laryngoscopic approach.

Methods:

In this prospective observational study, 70 consecutive adult patients (31 males and 39 females) with hypertrophic lingual tonsils proven by fibronasolaryngoscopy during April 2009 to December 2012 operated at a university hospital were selected. LT was performed under general anesthesia and direct micropharyngoscopy with laryngeal microinstruments and electrocoagulator. Indications for operation, procedure time, intraoperative blood loss, post-operative pain measured using 100-mm visual analogue scale (0– no pain, 100– extreme pain), complications (post-operative bleeding, edema of epiglottis and infection), and length of stay in the hospital were assessed.

Results:

Dysphagia in relation to laryngopharyngeal reflux (55.7% of cases) and sleep-disordered breathing (38.6% of cases) were the main indications for LT. Mean procedure time was 41.1+/- 10.2 min. with an average intraoperative blood loss of 21.9+/- 11.1 ml. Post-operative pain score for the first two days was mild and ranged from 0 to 51 points (mean 27.8+/- 9.8 points). There was no post-operative bleeding. Three patients (4.3%) had slight edema of epiglottis. Mean discharge time was 2.4 days. Post-operative pain was positively moderately related to procedure time, amount of intraoperative blood loss, and degree of lingual tonsil hypertrophy (p<0.01).

Conclusions:

Lingual tonsillectomy using laryngoscopic approach is a safe method with minimal post-operative morbidity and could be routinely used in clinical practice.