Abstract
Objectives:
In Sweden, tonsillotomy has for a decade been the favored surgical method for reducing airway obstruction from enlarged tonsils. Less postoperative morbidity with comparative symptom relief are the advantages seen. The concern has been raised that tonsillotomy increases risk of secondary tonsil surgery compared with tonsillectomy. The study aimed to evaluate the risk of secondary tonsil surgery following tonsillotomy and tonsillectomy in the Swedish population.
Methods:
This is a retrospective register-study including all patients registered in the National Patient Register from 2000 until 2012 who underwent tonsil surgery. Personal identity numbers make it possible to follow patients over time in the register. All patients who underwent tonsillectomy and tonsillotomy, with or without simultaneous adenoidectomy, without previous history of tonsil surgery were included in the study. Individual information on demographic data, diagnoses, and surgery performed were recorded.
Results:
A total of 120,719 tonsil surgeries were identified, out of which 98,717 were tonsillectomies and 22,002 were tonsillotomies. A total of 1409 events of revision surgery were identified of which 40.3% were after primary tonsillectomy and 59.7% were after primary tonsillotomy. Tonsillotomy showed a 7-times higher risk of secondary tonsil surgery. The accumulated risks of secondary tonsil surgery after 5 and 10 years in the tonsillectomy group were 0.6% and 0.8%, respectively. In the tonsillotomy group, the accumulated risks were 6.1% and 7.2%, respectively.
Conclusions:
The risk of secondary tonsil surgery in the Swedish population is 7 times higher after tonsillotomy compared with tonsillectomy. When interpreting this result the differences in postoperative morbidity between tonsillotomy and tonsillectomy must be considered.
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