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

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...

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Bibliographic Details
Published in:Journal of laryngology and otology 2014-01, Vol.128 (S1), p.S3-S7
Main Authors: Wood, J M, Cho, M, Carney, A S
Format: Article
Language:English
Subjects:
Airway management
Child
Humans
Hypertrophy - surgery
Pain, Postoperative
Palatine Tonsil - surgery
Pediatrics
Pharyngeal Diseases - complications
Pharyngeal Diseases - surgery
Postoperative Hemorrhage
Quality of Life
Review Articles
Sleep apnea
Sleep Apnea, Obstructive - etiology
Sleep Apnea, Obstructive - surgery
Surgical outcomes
Tonsillectomy - methods
Treatment Outcome
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Summary: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. 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. 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. 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.
ISSN:0022-2151
1748-5460
DOI:10.1017/S0022215113003058