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- Ericsson, Elisabeth, 1959-, et al.
(författare)
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Child Behavior and Quality of Life Before and After Tonsillotomy versus Tonsillectomy
- 2008
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Ingår i: Swedish Sleep Medicine Congress.
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Konferensbidrag (refereegranskat)abstract
- Objective: to compare two techniques for tonsil surgery with respect to postoperative pain and morbidity and changes in sleep, behavior, health related quality of life (HRQL) and benefit due to surgery. Methods: 67 pre-school children with tonsillar hypertrophy were randomized to regular tonsillectomy (TE) or tonsillotomy (TT) with Radiofrequency surgical technique. The parents completed a validated quality of life survey, Obstructive Sleep Apnea-18 (OSA18) , assessed the children’s behavior with the Child Behavior Checklist (CBCL) before and six month after surgery and evaluated the post-operative health related benefits using the Glasgow Children’s Benefit Inventory (GCBI). Results: TT-children recorded less pain from the first day, and were pain-free 3 days earlier than TE-children. Six months post-surgery, there was no difference between TT and TE with regard to snoring and ENT-infections. The total scores in all the individual domains between the initial OSA-18 and post-surgery scores differed (p<0.0001). Improvement in CBCL score was also significant (p<0.01) . There were no differences between TT- and TE-children. GCBI indicated a significant health benefit of both methods. Conclusions: Tonsillar hypertrophy shows impact on HRQL and behavior. After tonsillar operation, improvements occur as much after TT as after TE. TT should be first choice for treatment.
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| 3. |
- Ericsson, Elisabeth, 1959-, et al.
(författare)
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Child behavior and quality of life before and after tonsillotomy versus tonsillectomy
- 2008
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Ingår i: International conference in pediatric otorhinolaryngology, 2008. ; , s. 40-40
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: The objective of the present investigation was to compare two techniques for pediatric tonsil surgery with respect to postoperative pain and morbidity and changes in sleep behavior, health related quality of life (HRQL) and benefit due to surgery. Methods: 67 children (4,5-5,5 years) with tonsillar hypertrophy and obstructive sleep related distress with or without recurrent tonsillitis were randomized to either regular tonsillectomy (TE)(n=32) or intracapsular tonsillectomy/tonsillotomy (TT) (n=35) with Radiofrequency surgical technique (Ellman Int) Before TT/TE, the parents completed a validated Quality of Life survey of pediatric obstructive sleep apnea, the OSA18 (Obstructive Sleep Apnea-18) and a standardized assessment of their children-s behavior with the Child Behavior Checklist (CBCL). Six months after surgery, the parents repeated these measurements, and assessed the health related benefits of the surgery using the Glasgow Children´s Benefit Inventory (GCBI). Results: In the TT group, the children recorded less pain from the first day after surgery onwards, used fewer doses of painkillers and were pain-free 3 days earlier than the children in the TE group. Six months after surgery, there was no significant difference between TT and TE with regard to snoring and ENT-infections. The differences were all significant in the total scores and in all the individual domains between the initial OSA-18 and post-surgery scores (p<0.0001). The improvement in the total problem score measured with CBCL was also significant (p<0.01) and there were no differences between the TT and TE children. The improvements in all sub scores of the GCBI indicated a significant health benefit of both TT and TE. Conclusions: TT with RF-surgery is a safe method, which causes less pain and postoperative morbidity than regular TE and has a similar effect on snoring and recurrent infections. Young children with tonsillar hypertrophy and different degrees of obstructive sleep related distress all show an impact on HRQL and behavior. All improve dramatically after a tonsillar operation-improving just as much after TT as after TE. Based on these results, TT should be the first choice for treatment of these small children. Support: Financial support from the Research Council of South East Sweden (FORSS).
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| 4. |
- Ericsson, Elisabeth, 1959-, et al.
(författare)
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Intracapsular tonsillectomy with RF-surgery : Effects on snoring one-year results
- 2004
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Ingår i: 17th congress of the European Sleep research Sociaty, Prag, Tjeckien 5-9 okt, 2004.
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Konferensbidrag (refereegranskat)abstract
- Objektive: To compare two techniques for pediatric tonsil surgery with respect to postoperative pain and the long-term effects (one year) on snoring. Methods: 92 children with a history of snoring and few to several tonsillitis, were randomized to either regular tonsillectomy (T)(n=43) or intracapsular tonsillectomy (TT) with RF surgical technique, where only the obstructive parts of the tonsils were removed. Results: In the TT group, the children recorded less pain from the second hour after surgery onwards, and were back in school and pain-free 3 days earlier than the children in the T group. The TT children used fewer doses of painkillers and did not lose weight postoperatively compared to the T-children, who lost a mean of 660g in 10 days. Effect on snoring was the same in both groups. One year after surgery, some children in both groups still had slight snoring, but no apneás. Both groups were satisfied and in good health. The T-children remembered their pain more than TT-children. A surgical technique, which results in less suffering and a shorter time the child and a parent have to stay at home postoperatively, is a health- and socioeconomic gain. Is it defendable to continue performing traditional tonsillectomy? Intracapsular tonsillectomy with RF-surgery is a safe method, which causes less pain and morbidity than regular tonsillectomy and has the same effect on snoring.
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| 7. |
- Ericsson, Elisabeth, 1959-, et al.
(författare)
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Pediatric Tonsillotomy with the Radiofrequency Technique : Long-term Follow-up
- 2006
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Ingår i: The Laryngoscope. - : Wiley. - 0023-852X .- 1531-4995. ; 116:10, s. 1851-1857
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Compare the effects of partial tonsil resection using a radiofrequency technique, tonsillotomy (TT), with total tonsillectomy (TE, blunt dissection) after 1 and 3 years. Compare frequency of relapse in snoring or infections and possible long-term changes in behavior among TT children with those in TE children.Method: Ninety-two children (5-15 yr) randomized to TT (n = 49) or TE (n = 43) groups because of obstructive problems with or without recurrent tonsillitis. One year after surgery, general health, degree of obstruction, history of infections, and behavior were investigated using two questionnaires, the Qu1 and Child Behavior Checklist, as well as an ENT visit. After 3 years, two questionnaires, Qu2 and the Glasgow Children's Benefit Inventory, were answered by mail.Results: After 1 year, both groups were in good health. The effect on snoring and total behavior was the same for both groups, and the rate of recurrence of infections was not higher in the TT group. After 3 years, two children in the TT group were tonsillectomized (4%, 2/49), one because of peritonsillitis and another because of increased snoring. Otherwise, no differences existed between the groups in general health, snoring, or number of infections.Conclusion: Removing only the protruding parts of the tonsils has the same beneficial long-term effect on obstructive symptoms and recurrent throat infections as complete TE in the majority of cases. The need for re-operation is low; therefore, it appears inadvisable to follow the current common practice of routinely removing the whole tonsil given its higher morbidity and risk for serious complications.
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| 8. |
- Ericsson, Elisabeth, et al.
(författare)
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Tonsillotomy versus tonsillectomy on young children : 2 year post surgery follow-up
- 2014
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Ingår i: Journal of Otolaryngology - Head & Neck Surgery. - : BioMed Central (BMC). - 1916-0216. ; 43
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To study the long-term effect of tonsillotomy and tonsillectomy in young children after two years in comparison to the results after six months. Method: Children, age 4-5 with Sleep Disordered Breathing (SDB) and tonsil hyperplasia, were randomized to TE (32) or TT (35). TT was performed ad modum Hultcrantz with radiofrequency technique (Ellman). An adenoidectomy with cold steel was performed in the same session for 80% of cases. The patients were assessed prior to surgery, at six and 24 months postoperatively. Effects of surgery were evaluated clinically, through questionnaire (general health/snoring/ENT-infections), Quality of Life (QoL), survey of pediatric obstructive sleep apnea with OSA-18, and childrens behavior with the Child Behavior Checklist. Results: After two years there was still no difference between the groups with respect to snoring and frequency or severity of upper airway infections. Both TT and TE had resulted in large improvement in short and long term QoL and behavior. Three TT-children and one TE child had been re-operated due to recurrence of obstructive problems, the TE-child and one of the TT-children with adenoidectomy and two of the TT-children with tonsillectomy. Three of the TT-children had tonsil tissue protruding slightly out of the tonsil pouch and twelve TE-children had small tonsil remnants within the tonsil pouches, but with no need for surgery. Conclusion: Younger children have a small risk of symptom-recurrence requiring re-surgery within two years after TT. For the majority, the positive effect on snoring, infections, behavior and quality of life remain and is similar to TE.
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| 9. |
- Ericsson, Elisabeth, 1959-, et al.
(författare)
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Tonsillotomy versus tonsillectomy on young children : 2 year post surgery follow-up
- 2014
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Ingår i: Journal of Otolaryngology - Head & Neck Surgery. - London, United Kingdom : BioMed Central (BMC). - 1916-0216. ; 43:26
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To study the long-term effect of tonsillotomy and tonsillectomy in young children after two years in comparison to the results after six months.Method: Children, age 4-5 with Sleep Disordered Breathing (SDB) and tonsil hyperplasia, were randomized to TE (32) or TT (35). TT was performed ad modum Hultcrantz with radiofrequency technique (Ellman). An adenoidectomy with cold steel was performed in the same session for 80% of cases. The patients were assessed prior to surgery, at six and 24 months postoperatively. Effects of surgery were evaluated clinically, through questionnaire (general health/snoring/ENT-infections), Quality of Life (QoL), survey of pediatric obstructive sleep apnea with OSA-18, and children’s behavior with the Child Behavior Checklist.Results: After two years there was still no difference between the groups with respect to snoring and frequency or severity of upper airway infections. Both TT and TE had resulted in large improvement in short and long term QoL and behavior. Three TT-children and one TE child had been re-operated due to recurrence of obstructive problems, the TE-child and one of the TT-children with adenoidectomy and two of the TT-children with tonsillectomy. Three of the TT-children had tonsil tissue protruding slightly out of the tonsil pouch and twelve TE-children had small tonsil remnants within the tonsil pouches, but with no need for surgery.Conclusion: Younger children have a small risk of symptom-recurrence requiring re-surgery within two years after TT. For the majority, the positive effect on snoring, infections, behavior and quality of life remain and is similar to TE.
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