Tonsillotomy or Tonsillectomy: What Do Parents Prefer?

Abstract

Objectives:

Tonsillotomy has been presented as a less-invasive alternative to the traditional tonsillectomy. The decreased pain and recovery time after tonsillotomy have been well established, but questions regarding tonsil regrowth remain. It has been assumed that parents would prefer tonsillotomy because of its recovery advantages. The objective of this study is to (1) directly sample the opinion of typical parents who would be considering tonsillotomy versus tonsillectomy. (2) Assess the role of age, educational level, and risk aversion in this parental choice.

Methods:

Parents in a busy pediatric otolaryngology waiting room were approached and asked to hypothetically choose either tonsillectomy or tonsillotomy for their child via a written survey. Each procedure was described in basic terms listing basic risks and benefits including pain, recovery, regrowth, and incidence of complications. Parents were also asked simple questions regarding age range, educational level, and risk tolerance. Data analysis included simple descriptive statistics and contingency table analysis.

Results:

Two hundred thirty parents completed the survey. Parents overwhelmingly (85.8%) preferred tonsillectomy over tonsillotomy. An increasing risk aversion score was associated with a preference for tonsillectomy (P = .001, Fisher’s exact test). Education and age range were not significantly related to procedural preference or risk tolerance. As might be expected, most parents (72%) were generally risk averse.

Conclusions:

Despite prevailing opinion that presumes parents generally prefer tonsillotomy over tonsillectomy because of its recovery advantages, an overwhelming majority of parents surveyed actually prefer tonsillectomy. The basis of this decision appears to be in part risk aversion of tonsil regrowth.