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  • 1.
    Ahn, Sang Hyeon
    et al.
    Department of Otorhinolaryngology, Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea; Department of Medicine, The Graduate School of Yonsei University, Seoul, Korea.
    Lee, Eun Jung
    Linköping University, Department of Clinical and Experimental Medicine, Division of Children's and Women's health. Linköping University, Faculty of Medicine and Health Sciences. Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
    Hong, Min Pyo
    Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
    Shin, Geun Cheol
    Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
    Kim, Kyung-Su
    Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. ydrhinol@yuhs.ac.
    Comparison of the clinical characteristics of bilateral and unilateral fungal balls in Korea2019In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 276, no 7, p. 1975-1980Article in journal (Refereed)
    Abstract [en]

    Fungal rhinosinusitis occurs in different forms depending on race and region. While allergic fungal rhinosinusitis is common in Caucasians, fungal ball (FB) is more common in Asians. However, most cases are reported as unilateral, and clinical data on bilateral FB (BFB) are rare. Therefore, the purpose of this study was to analyze and to compare the clinical characteristics of BFB and unilateral FB (UFB) in Koreans.

  • 2.
    Ali, Fatema Mohammed
    et al.
    Univ Sydney, Australia.
    Westling, Martin
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Zhao, Luke Hong Lu
    Univ Sydney, Australia.
    Corneil, Brian D.
    Univ Western Ontario, Canada.
    Camp, Aaron J.
    Univ Sydney, Australia.
    Splenius capitis: sensitive target for the cVEMP in older and neurodegenerative patients2019In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 276, no 11, p. 2991-3003Article in journal (Refereed)
    Abstract [en]

    Background The vestibular evoked myogenic potential (VEMP) is a technique used to assess vestibular function. Cervical VEMPs (cVEMPs) are obtained conventionally from the sternocleidomastoid (SCM) muscle; however, the dorsal neck muscle splenius capitis (SPL) has also been shown to be a reliable target alongside the SCM in young subjects. Objective This study aimed to compare cVEMPs from the SCM and SPL in two positions across young, older, and Parkinsons disease (PD) patients. Method Experiments were carried out using surface EMG electrodes placed over the SCM and SPL. cVEMPs were measured using a 30 s, 126 dB sound stimulus with 222 individual tone bursts, while subjects were in a supine and head-turned posture (also known as the head elevation method), and in a seated head-turned posture. Results When comparing cVEMPs across positions, the incidence of supine and seated SCM-cVEMPs diminished significantly in older and PD patients in comparison with young subjects. However, no statistically significant differences in incidences were found in seated SPL-cVEMPs when comparing young, older and PD patients. SPL-cVEMPs were present significantly more often than seated SCM-cVEMPs in PD patients. Conclusions SPL-cVEMPs are not altered to the same extent that SCM-cVEMPs are by aging and disease and its addition to cVEMP testing may reduce false-positive tests for vestibulopathy.

  • 3.
    Boéthius, Helena
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology.
    Saarto, Tiina
    Helsinki Univ Hosp, Finland; Univ Helsinki, Finland.
    Laurell, Goran
    Uppsala Univ, Sweden.
    Farnebo, Lovisa
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology.
    Makitie, Antti A.
    Univ Helsinki, Finland; Helsinki Univ Hosp, Finland; Univ Helsinki, Finland; Karolinska Inst, Sweden; Karolinska Hosp, Sweden.
    A Nordic survey of the management of palliative care in patients with head and neck cancer2021In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 278, p. 2027-2032Article in journal (Refereed)
    Abstract [en]

    Background The five Nordic countries with a population of 27M people form a rather homogenous region in terms of health care. The management of Head and Neck Cancer (HNC) is centralized to the 21 university hospitals in these countries. Our aim was to survey the current status of organization of palliative care for patients with HNC in the Nordic countries as the field is rapidly developing. Materials and methods A structured web-based questionnaire was sent to all the Departments of Otorhinolaryngology-Head and Neck Surgery and Oncology managing HNC in the Nordic countries. Results All 21 (100%) Nordic university hospitals responded to the survey. A majority (over 90%) of the patients are discussed at diagnosis in a multidisciplinary tumor board (MDT), but the presence of a palliative care specialist is lacking in 95% of these MDTs. The patients have access to specialized palliative care units (n = 14, 67%), teams (n = 10, 48%), and consultants (n = 4, 19%) in the majority of the hospitals. Conclusion The present results show that specialized palliative care services are available at the Nordic university hospitals. A major finding was that the collaboration between head and neck surgeons, oncologists and palliative care specialists is not well structured and the palliative care pathway of patients with HNC is not systematically organized. We suggest that early integrated palliative care needs to be included as an addition to the already existing HNC care pathways in the Nordic countries.

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  • 4.
    Hultcrantz, Elisabeth
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Ericsson, Elisabeth
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Hemlin, Claes
    Öron näsa hals, Aleris Specialistvård Sabbatsberg, Stockholm, Sweden.
    Hessén-Söderman, Anne-Charlotte
    Öron näsa hals, Aleris Specialistvård Sabbatsberg, Stockholm, Sweden.
    Roos, Kristian
    Öron-näsa-halsmottagningen, Capio Lundby Närsjukhus, Göteborg, Sweden.
    Sunnergren, Ola
    Öron-näs-halsmottagningen, Ryhovs Länssjukhus, Jönköping, Sweden.
    Stalfors, Joacim
    Öron-näs-halsmottagningen, Sahlgrenska Universitetssjukhuset, Göteborg, Sweden.
    Paradigm shift in Sweden from tonsillectomy to tonsillotomy for children with upper airway obstructive symptoms due to tonsillar hypertrophy2013In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 270, no 9, p. 2531-2536Article in journal (Refereed)
    Abstract [en]

    Tonsillotomy (TT) is now used more often than tonsillectomy (TE) for tonsil obstructive symptoms in Sweden. Both TE and TT give high patient satisfaction although TT results in fewer postoperative bleedings and shorter time when analgesics are needed. The objective of this study is to analyze the current prevalence of different tonsil surgery procedures, the rates of early and late bleeding and other complications. Data from the National Tonsil Surgery Register in Sweden were analyzed. Patients 1–15 years operated for symptoms due to tonsil hypertrophy were included. Surgical procedure, technique and bleedings during hospital stay were registered. Thirty days after surgery, unplanned contacts due to bleeding, infection or pain were reported as were symptom relief after 6 months. 24,083 patients were registered. Of the 10,826 children 1–15 years operated for obstructive symptoms, 64 % were TT or TT+A, and 34 % TE, TE+A. 69 % answered the 30-day questionnaire and 50 % the 6 months. Bleeding in hospital occurred in 1.38 %, late bleedings in 2.06 %: 3.7 % after TE+A, 0.8 % after TT+A. Differences in readmissions due to bleeding, number of days using analgesics, health care contacts due to pain and nosocomial infections were significant between TT and TE, but not differences with regard to symptom relief after 6 months.

  • 5.
    Hultcrantz, Elisabeth
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Ericsson, Elisabeth
    Linköping University, Department of Medical and Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Intensive Care. Linköping University, Faculty of Health Sciences.
    Hemlin, Claes
    Ear-, Nose- and Throat Clinic, Aleris Sabbatsberg Hospital, Stockholm, Sweden.
    Hessén-Söderman, Anne-Charlotte
    Ear-, Nose- and Throat Clinic, Aleris Sabbatsberg Hospital, Stockholm, Sweden.
    Roos, Kristian
    Ear-, Nose- and Throat Clinic, Capio Lundby Hospital, Gothenburg, Sweden.
    Sunnergren, Ola
    Ear-, Nose- and Throat Clinic, County Hospital Ryhov, Jönköping, Sweden.
    Stalfors, Joacim
    Ear-, Nose- and Throat Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Paradigm shift in Sweden from tonsillectomy to tonsillotomy for children with upper airway obstructive symptoms due to tonsillar hypertrophy2013In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 270, p. 2531-2536Article in journal (Refereed)
    Abstract [en]

    Tonsillotomy (TT) is now used more often than tonsillectomy (TE) for tonsil obstructive symptoms in Sweden. Both TE and TT give high patient satisfaction although TT results in fewer postoperative bleedings and shorter time when analgesics are needed. The objective of this study is to analyze the current prevalence of different tonsil surgery procedures, the rates of early and late bleeding and other complications. Data from the National Tonsil Surgery Register in Sweden were analyzed. Patients 1–15 years operated for symptoms due to tonsil hypertrophy were included. Surgical procedure, technique and bleedings during hospital stay were registered. Thirty days after surgery, unplanned contacts due to bleeding, infection or pain were reported as were symptom relief after 6 months. 24,083 patients were registered. Of the 10,826 children 1–15 years operated for obstructive symptoms, 64 % were TT or TT+A, and 34 % TE, TE+A. 69 % answered the 30-day questionnaire and 50 % the 6 months. Bleeding in hospital occurred in 1.38 %, late bleedings in 2.06 %: 3.7 % after TE+A, 0.8 % after TT+A. Differences in readmissions due to bleeding, number of days using analgesics, health care contacts due to pain and nosocomial infections were significant between TT and TE, but not differences with regard to symptom relief after 6 months.

  • 6.
    Hultcrantz, Elisabeth
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Nosrati Zare Noe, Ramesh
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Corticosteroid treatment of idiopathic sudden sensorineural hearing loss: analysis of an RCT and material drawn from the Swedish national database2015In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 272, no 11, p. 3169-3175Article in journal (Refereed)
    Abstract [en]

    A randomized placebo-controlled study has demonstrated no effect of prednisolone in customary dosage on idiopathic sudden sensorineural hearing loss (ISSNHL). The aim of the present paper is to analyse a larger patient group by meta-analysis of data from the RCT together with a corresponding material drawn from the Swedish national database for ISSNHL. Data from 192 patients, 18-80 years with ISSNHL, were available. All had an acute hearing loss of at least 30 dB measured as PTA in the three most affected contiguous frequencies. All patients had been enrolled within one week after onset and evaluated by audiograms after 3 months. 45/99 (RCT) and 54/99 (the database) had been treated with prednisolone in tapering doses from 60 mg daily and 42/93 with placebo (RCT) or 51/93 with no treatment (the database). Primary outcome was the mean hearing improvement on day 90 for the different groups. A mean difference of greater than 10 dB improvement was required to demonstrate a treatment effect for prednisolone compared to placebo/no treatment. No significant difference was seen between the prednisolone group and placebo/no treatment (p = 0.06). Total recovery was 38 % in prednisolone group, 40 % in the placebo and 14 % in the no treatment group. Vertigo at the onset of hearing loss and age at onset had an equal negative prognostic value in all groups and signs of inflammation had a positive effect. Prednisolone in customary dosage does not influence recovery after ISSNHL.

  • 7.
    Kiug, Tejs Ehlers
    et al.
    Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, Aarhus N, Denmark.
    Hentze, Malene
    Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, Aarhus N, Denmark.
    Schytte, Sten
    Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, Aarhus N, Denmark.
    Farnebo, Lovisa
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology.
    Rikardsen, Oddveig
    Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of North Norway, and University of Tromsø-The Arctic University of Norway, Tromsø, Norway.
    Sihvo, Eero
    Department of Surgery, Central Finland Central Hospital, Jyvaskyla, Finland.
    Rasanen, Jari
    Department of General Thoracic and Esophageal Surgery, Helsinki University Hospital, Helsinki, Finland; Department of Surgery, Clinicum, University of Helsinki, Helsinki, Finland.
    Makitie, Antti
    Department of Otorhinolaryngology, Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Research Programme in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska Hospital, Stockholm, Sweden.
    Laryngo-tracheal resections in the Nordic countries: an option for further centralization?2019In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 276, no 5, p. 1545-1548Article in journal (Refereed)
    Abstract [en]

    Purpose

    We aimed to obtain information on the number of Nordic centers performing tracheal resections, crico-tracheal resections, and laryngo-tracheal reconstructions, as well as the patient volume and the standard regimens associated with these procedures.

    Methods

    Consultants at all Departments of Otorhinolaryngology—Head and Neck Surgery (ORL-HNS, n = 22) and Thoracic Surgery (n = 21) in the five Nordic countries were invited (April 2018—January 2019) to participate in an online survey.

    Results

    All 43 departments responded to the survey. Twenty departments declared to perform one or more of the three types of tracheal resections. At five hospitals, departments of ORL-HNS and Thoracic Surgery perform these operations in collaboration. Hence, one or more of the tracheal operations in question are carried out at 15 centers. The median annual number of tracheal operations per center is five (range 1–20). Great variations were found regarding contraindications (relative and absolute) for surgery, the use of guardian sterno-mental sutures (all patients, 33%; selected cases, 40% of centers), prophylactic antibiotic therapy (cefuroxime +/− metronidazole, penicillin +/− metronidazole, clindamycin, imipenem, or none), post-operative follow-up time (range: children: 3–120 months; adults: 0–60 months), and the performance of post-operative bronchoscopy.

    Conclusions

    Fifteen centers each perform a low number of annual operations with significant variations in the selection of patients and the clinical setup, which raises the question if a higher degree of collaboration and centralization would be warranted. We encourage Nordic transnational collaboration, pursuing alignment on central management issues, and establishment of a common prospective database for future tracheal resection surgery.

  • 8.
    Magnuson, K.
    et al.
    Department of Otorhinolaryngology, University of Ume, Ume, S-901 85, Sweden, Department of Anatomy, University of Ume, Ume, S-901 87, Sweden.
    Hellstrom, S.
    Hellström, S., Department of Otorhinolaryngology, University of Ume, Ume, S-901 85, Sweden.
    Magnuson, Bengt
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion.
    Structural changes in the rat tympanic membrane following repeated pressure loads2004In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 252, no 2, p. 76-82Article in journal (Refereed)
    Abstract [en]

    Healthy adult laboratory rats were exposed to alternating negative pressure and atmospheric pressure to replicate the clinical situation found in patients with chronic sniffing habits and chronic middle ear disease. The rats were placed in a box in which the pressure changed at intervals of 30 s between atmospheric pressure and a negative pressure of -3 kPa. This was repeated continuously or periods of 3 and 7 days. At completion of the experimental period, all rats had a normal otomicroscopic status. However, histological studies demonstrated that the pars flaccida was wrinkled and the loose connective tissue contained large fibroblasts with their long axes lying in a disorganized manner. The cells of the keratinizing epithelium were thicker than normal and mitoses were seen. Epithelial crypts filled with keratin were numerous along the epithelium. In the pars tensa, all layers were thicker than normal. These findings demonstrate that repeated pressure loading can create structural changes in the tympanic membrane. © 1995 Springer-Verlag.

  • 9.
    Mjönes, Anna-Britta
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Borch, Kurt
    Linköping University, Department of Clinical and Experimental Medicine, Surgery . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Tibbling, Lita
    Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery Östergötland. Östergötlands Läns Landsting.
    Ledin, Torbjörn
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Hultcrantz, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Hoarseness and misdirected swallowing in patients with hiatal hernia2007In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 264, no 12, p. 1437-1439Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to elucidate whether misdirected swallowing is an extra-laryngeal cause of hoarseness and investigate whether the prevalence of misdirected swallowing and hoarseness in patients with hiatal hernias differ from those with and without pathological gastroesophageal reflux (GER). One hundred and ninety eight patients with hiatal hernias diagnosed via esophageal manometry and pH-reflux test and 262 subjects in the general population who did not have a hiatal hernia at endoscopy, filled in a questionnaire about symptoms on hoarseness, misdirected swallowing, and heartburn. Hoarseness (35%), misdirected swallowing to the larynx (MSL; 35%), misdirected swallowing to the nose (MSN; 22%) and heartburn (85%) were significantly more common in patients with hiatal hernia than in controls (13, 5, 1, and 6%, respectively, P<0.001). MSL and MSN in the patient group were significantly interrelated (P<0.0001). Hoarseness and MSL were not significantly associated (P<0.076). Hoarseness and MSL were as common in the hernia group with normal GER, as in the group with pathological GER. There is a predisposition for hoarseness and MSL in patients with hiatal hernias, but the cause-and-effect relationship is unclear. Hoarseness does not seem to be caused by pathological GER.

  • 10.
    Mäki-Torkko, Elina
    et al.
    Lund University Hospital, Sweden.
    Magnusson, Måns
    Lund University Hospital, Sweden.
    An office procedure to detect vestibular loss in children with hearing impairment2005In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 262, no 4, p. 328-330Article in journal (Refereed)
    Abstract [en]

    As coexisting vestibular and cochlear lesions are of etiological importance, evaluation of children with congenital or early acquired hearing impairment (HI) should include vestibular assessment. A rotation test requires specific equipment and allows only detection of bilateral vestibular impairment. An impulse or head thrust test allows assessment of one ear at a time, detects more pronounced caloric side differences and can be performed without any equipment. We report a consecutive series of children with profound sensorineural HI investigated at a tertiary hospital unit. Age at taking first steps without help, the results of temporal bone images (CT/MRT) and vestibular tests were collected retrospectively from patient files. The children were 12 to 90 months old at the time they attended both a rotation and an impulse test. All 14 children cooperated in the impulse test, and 12 completed the vestibular rotation test successfully. Three out of 14 children tested so far have been confirmed to have a bilaterally pathological vestibulo-ocular reflex confirmed both in the rotation test and the impulse test. Our results show that both the rotation test and the vestibular impulse test can be successfully performed on small children at a regular outpatient appointment.

  • 11.
    Odhagen, Erik
    et al.
    Department of Otorhinolaryngology, Sahlgrenska University Hospital, Gröna stråket 5, 413 45, Gothenburg, Sweden; Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
    Sunnergren, Ola
    Department of Otorhinolaryngology, Ryhov County Hospital, Jönköping, Sweden; Futurum-The Academy for Health and Care, County Council, Jönköping, Sweden.
    Hemlin, Claes
    Sollentuna Specialist Clinic, Stockholm, Sweden.
    Hessén Söderman, Anne-Charlotte
    Department of Otorhinolaryngology, Aleris Sabbatsberg, Stockholm, Sweden; Division of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
    Ericsson, Elisabeth
    Faculty of Medicine and Health, School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Stalfors, Joacim
    Department of Otorhinolaryngology, Sahlgrenska University Hospital, Gröna stråket 5, 413 45, Gothenburg, Sweden; Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
    Risk of reoperation after tonsillotomy versus tonsillectomy: a population-based cohort study2016In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 273, no 10, p. 3263-3268Article in journal (Refereed)
    Abstract [en]

    Tonsil surgery to address upper airway obstruction in children can be performed either as a tonsillectomy (TE) or as a tonsillotomy/intracapsular/partial tonsillectomy (TT). The advantage of TT is a decreased risk of postoperative morbidity. The disadvantage is the risk of tonsil regrowth with recurrence of symptoms and/or problems with future tonsil infections, which may demand a reoperation of the tonsils. The aim of this study is to compare the risk of reoperation of the tonsils following TE and TT in children with tonsil-related upper airway obstruction. This is a retrospective register-based cohort study of the Swedish National Patient Register. All children aged 1–12 years who underwent TE or TT from 2007 to 2012 for the main indication of upper airway obstruction were included in the study. The unique Personal Identity numbers were used to follow patients over time in the register and identify additional tonsil surgery. A total of 27,535 patients were included in the study, contributing 76,054 person-years of follow-up. A total of 684 patients (2.5 %) underwent a second tonsil surgery during follow-up. The incidences of reoperation were 1.94 per 1000 person-years in the TE group and 16.34 per 1000 person-years in the TT group. The risk for reoperation was seven times higher (HR 7.16) after TT compared to TE. Younger age was significantly associated with reoperation for both TE and TT and the difference in risk between TE and TT gradually decreased with time. The most common indication for reoperation after both TE and TT was “Upper airway obstruction”.

  • 12.
    Odhagen, Erik
    et al.
    Department of Otorhinolaryngology, Södra Älvsborgs Hospital, Borås, Sweden; Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
    Sunnergren, Ola
    Department of Otorhinolaryngology, Ryhov County Hospital Jönköping, Jönköping, Sweden.
    Söderman, Anne-Charlotte Hessén
    Division of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
    Thor, Johan
    The Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden.
    Stalfors, Joacim
    Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; Sheikh Khalifa Medical City, Ajman, United Arab Emirates.
    Reducing post-tonsillectomy haemorrhage rates through a quality improvement project using a Swedish National quality register: a case study2018In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 275, no 6, p. 1631-1639Article in journal (Refereed)
    Abstract [en]

    Purpose

    Tonsillectomy (TE) is one of the most frequently performed ENT surgical procedures. Post-tonsillectomy haemorrhage (PTH) is a potentially life-threatening complication of TE. The National Tonsil Surgery Register in Sweden (NTSRS) has revealed wide variations in PTH rates among Swedish ENT centres. In 2013, the steering committee of the NTSRS, therefore, initiated a quality improvement project (QIP) to decrease the PTH incidence. The aim of the present study was to describe and evaluate the multicentre QIP initiated to decrease PTH rates.

    Methods

    Six ENT centres, all with PTH rates above the Swedish average, participated in the 7-month quality improvement project. Each centre developed improvement plans describing the intended changes in clinical practice. The project’s primary outcome variable was the PTH rate. Process indicators, such as surgical technique, were also documented. Data from the QIP centres were compared with a control group of 15 surgical centres in Sweden with similarly high PTH rates. Data from both groups for the 12 months prior to the start of the QIP were compared with data for the 12 months after the QIP.

    Results

    The QIP centres reduced the PTH rate from 12.7 to 7.1% from pre-QIP to follow-up; in the control group, the PTH rate remained unchanged. The QIP centres also exhibited positive changes in related key process indicators, i.e., increasing the use of cold techniques for dissection and haemostasis.

    Conclusions

    The rates of PTH can be reduced with a QIP. A national quality register can be used not only to identify areas for improvement but also to evaluate the impact of subsequent improvement efforts and thereby guide professional development and enhance patient outcomes.

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  • 13.
    Ostvoll, Eirik
    et al.
    Sahlgrens University Hospital, Sweden.
    Sunnergren, Ola
    Ryhov County Hospital, Sweden.
    Ericsson, Elisabeth
    University of Örebro, Sweden.
    Hemlin, Claes
    Aleris Specialists Care Centre, Sweden.
    Hultcrantz, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Odhagen, Erik
    University of Gothenburg, Sweden.
    Stalfors, Joacim
    Sahlgrens University Hospital, Sweden.
    Mortality after tonsil surgery, a population study, covering eight years and 82,527 operations in Sweden2015In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 272, no 3, p. 737-743Article in journal (Refereed)
    Abstract [en]

    The objective of this retrospective cohort study was to evaluate mortality rate and cause of death after tonsil surgery in Sweden. Two national registries were used, both run by The Swedish National Board of Health and Welfare, an agency of the Ministry of Health and Social Affairs. In the National Patient register all tonsil surgeries performed in Sweden from 2004 through 2011 were identified. The result from this search was matched with the National Cause of Death Register to identify all deaths that occurred within 30 days of tonsil surgery. Personal identity numbers were used to do the matching of registers. Details on the cause of death were obtained from the Swedish National Board of Health and Welfare. Two deaths were identified in 82,527 operations. Both patients were male, otherwise healthy, children under the age of five, operated due to tonsil-related upper airway obstruction/snoring with coblation technique. Cause of death was bleeding-related airway obstruction in both cases and hemodynamic failure caused by blood loss. Both deaths occurred after discharge from the hospital within the first postoperative week. No abnormal levels of analgesics were found in the postmortal investigations. Two deaths related to tonsil surgery (performed on benign indications) were identified in 82,527 operations (2004-2011) in a well-defined national population. Both deaths were due to postoperative bleeding. Based on our findings, the frequency of post-tonsil-surgery mortality in Sweden was 1/41,263, 2004-2011. Level of evidence 2b retrospective cohort study.

  • 14.
    Pedersen, Lars
    et al.
    Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gröna Stråket 9, 413 45, Göteborg, Sweden.
    Schiöler, L.
    Department of Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
    Finjan, S.
    School of Medical Sciences, Örebro University, Campus USÖ, Örebro, Sweden.
    Davidsson, Å.
    School of Medical Sciences, Örebro University, Campus USÖ, Örebro, Sweden.
    Sunnergren, Ola
    Department of Otorhinolaryngology, Ryhov County Hospital, Jönköping, Sweden.
    Holmberg, K.
    Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gröna Stråket 9, 413 45, Göteborg, Sweden.
    Ahlström Emanuelsson, C.
    Department of Otorhinolaryngology, Head and Neck Surgery, Skane University Hospital, Lund University, Lund, Sweden.
    Hellgren, J.
    Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gröna Stråket 9, 413 45, Göteborg, Sweden.
    Prognostic factors for outcome after septoplasty in 888 patients from the Swedish National Septoplasty Register2019In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 276, no 8, p. 2223-2228Article in journal (Refereed)
    Abstract [en]

    Background

    The aim of this study was to identify predictors of outcome after septoplasty in 888 patients from the Swedish National Septoplasty Register.

    Methodology

    This is an observational register study analysing data from patients undergoing septoplasty in Sweden between 2015 and 2016. The patients reported severity of nasal obstruction (mild, moderate, severe) pre- and again 12 months postoperatively (none, mild, moderate, severe), unplanned visits within 30 days after surgery. The examining doctor reported co-morbidities such as allergic rhinitis and snoring. The primary end-point was one level improvement of the nasal obstruction 12 months after surgery.

    Results

    Nasal obstruction had improved in 63% 12 months after surgery. Twelve months after surgery, 81% with severe nasal obstruction and 31% with mild nasal obstruction before surgery had improved. Only 56% reported that the results of the surgery were as they had expected. Higher patient age at surgery, no unplanned visits within 1 month of surgery and activity limitation before surgery were associated with improvements in nasal breathing in the logistic regression model.

    Conclusion

    Septoplasty should be offered to patients with severe nasal obstruction and surgery should be avoided in mild nasal obstruction confirmed by both an improvement in nasal obstruction and patient expectations in this study.

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  • 15.
    Sundh, Carolina
    et al.
    ENT Clinic, County Hospital Ryhov, Jönköping, Sweden.
    Sunnergren, Ola
    ENT Clinic, County Hospital Ryhov, Jönköping, Sweden; Futurum-Academy for Health and Care, Jönköping County Council, Jönköping, Sweden.
    Long-term symptom relief after septoplasty2015In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 272, no 10, p. 2871-2875Article in journal (Refereed)
    Abstract [en]

    The results for long-term symptom relief after septoplasty are contradictory in reviewed publications but the findings suggest that results are unsatisfactory. In this study, we analyzed and compared short- and long-term symptom relief after septoplasty and factors possibly associated with symptom relief. 111 patients that underwent septoplasty between 2008 and 2010 were included in the study. Medical charts were reviewed for preoperative characteristics and assessments. Data on short-term symptom relief (6 months) were retrieved from the Swedish National Quality Registry for Septoplasty; data on long-term symptom relief (34–70 months) were collected through a questionnaire. Upon the 34–70 month follow-up, 53 % of the patients reported that symptoms either remained or had worsened and 83 % reported nasal obstruction. Degree of symptom relief was significantly higher among patients not reporting nasal obstruction than among patients reporting nasal obstruction at long-term follow-up. The proportion of patients that reported “my symptoms are gone” declined from 53 % after 6 months to 18 % after 34–70 months. None of the factors taken into consideration, age at surgery, gender, follow-up time, primary operation/reoperation, history of nasal trauma, self-reported allergy, rhinometric obstruction, or same sided rhinometric, clinical and subjective nasal obstruction were associated with symptom relief. The long-term results after septoplasty are unsatisfactory. A majority of patients report that their symptoms remain after septoplasty.

  • 16.
    Sunnergren, Ola
    et al.
    Öron-näs- och halskliniken, Ryhovs länssjukhus, Jönköping.
    Hemlin, Claes
    Öron- näsa- halskliniken, Aleris specialistvård Sabbatsberg, Stockholm.
    Ericsson, Elisabeth
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Linköping.
    Hessén-Söderman, Anne-Charlotte
    Öron- näsa- halskliniken, Aleris specialistvård Sabbatsberg, Karolinska Institutet, Stockholm.
    Hultcrantz, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology in Linköping.
    Odhagen, Erik
    Öron-näs-halsmottgningen, Södra Älvsborgs sjukhus, Borås.
    Stalfors, Joacim
    Öron-näs och halsmottagningen, Sahlgrenska Universitetssjukhuset, Göteborg.
    Radiofrequency tonsillotomy in Sweden 2009-20122014In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 271, no 6, p. 1823-1827Article in journal (Refereed)
    Abstract [en]

    The Swedish National Registry for TonsilSurgery has been operational since 1997. All ENT clinicsin Sweden are encouraged to submit data for all patientsscheduled for tonsil surgery. Preoperatively, age, genderand indication are recorded. Postoperatively, method(tonsillectomy or tonsillotomy), technique, and perioperativecomplications are recorded. Postoperative bleedings,pain, infections, and symptom relief are assessed throughquestionnaires. An earlier report from this registry showedthat tonsillotomy had become more common than tonsillectomyin children with tonsil-related upper airwayobstruction. The aim of this study was to categorize whichinstruments were used for tonsillotomy in Sweden and tocompare their outcome and complication rate. All children2–18 years, reported to the registry from March 2009 untilSeptember 2012, who underwent tonsillotomy on theindication upper airway obstruction, were included in thestudy. 1,676 patients were identified. In 1,602 cases(96 %), a radiofrequency instrument was used. The postoperativebleeding rate was low (1.2 %) and the degree ofsymptom relief was high (95.1 %). Three different radiofrequencyinstruments (ArthroCare Coblation, EllmanSurgitron, and Sutter CURIS) were used in 96 % of thepatients. There were no significant differences in thenumber of postoperative bleedings, postoperative infectionsor symptom relief between the instruments. The onlydifference found was in the number of days on analgesics,where more days were registered after use of Coblation.In Sweden, radiofrequency tonsillotomy is the dominantsurgical technique used for tonsil hypertrophy causingupper airway obstruction in children. There are no significantdifferences in outcome between the different radiofrequencyinstruments except for number of days onanalgesics after surgery.

  • 17.
    Sunnergren, Ola
    et al.
    Ear-, Nose- and Throat Clinic, Ryhov County Hospital, Jönköping, Sweden.
    Hemlin, Claes
    Ear-, Nose- and Throat Clinic, Aleris Sabbatsberg Hospital, Stockholm, Sweden.
    Ericsson, Elisabeth
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Linköping.
    Hessén-Söderman, Anne-Charlotte
    Ear-, Nose- and Throat Clinic, Aleris Sabbatsberg Hospital, Karolinska Institutet, Stockholm, Sweden; Division of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
    Hultcrantz, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Odhagen, Erik
    Ear-, Nose- and Throat Clinic, Södra Älvsborgs Hospital, Borås, Sweden.
    Stalfors, Joacim
    Ear-, Nose- and Throat Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Radiofrequency tonsillotomy in Sweden 2009–20122014In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 271, no 6, p. 1823-1827Article in journal (Refereed)
    Abstract [en]

    The Swedish National Registry for Tonsil Surgery has been operational since 1997. All ENT clinics in Sweden are encouraged to submit data for all patients scheduled for tonsil surgery. Preoperatively, age, gender and indication are recorded. Postoperatively, method (tonsillectomy or tonsillotomy), technique, and perioperative complications are recorded. Postoperative bleedings, pain, infections, and symptom relief are assessed through questionnaires. An earlier report from this registry showed that tonsillotomy had become more common than tonsillectomy in children with tonsil-related upper airway obstruction. The aim of this study was to categorize which instruments were used for tonsillotomy in Sweden and to compare their outcome and complication rate. All children 2–18 years, reported to the registry from March 2009 until September 2012, who underwent tonsillotomy on the indication upper airway obstruction, were included in the study. 1,676 patients were identified. In 1,602 cases (96 %), a radiofrequency instrument was used. The postoperative bleeding rate was low (1.2 %) and the degree of symptom relief was high (95.1 %). Three different radiofrequency instruments (ArthroCare Coblation®, Ellman Surgitron®, and Sutter CURIS®) were used in 96 % of the patients. There were no significant differences in the number of postoperative bleedings, postoperative infections or symptom relief between the instruments. The only difference found was in the number of days on analgesics, where more days were registered after use of Coblation®. In Sweden, radiofrequency tonsillotomy is the dominant surgical technique used for tonsil hypertrophy causing upper airway obstruction in children. There are no significant differences in outcome between the different radiofrequency instruments except for number of days on analgesics after surgery.

  • 18.
    Sunnergren, Ola
    et al.
    Department of Otorhinolaryngology, Ryhov County Hospital, County Council Jönköping, Jönköping, Sweden.
    Odhagen, Erik
    Department of Otorhinolaryngology, Södra Älvsborgs Hospital, Borås, Sweden; Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
    Stalfors, Joacim
    Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; Sheikh Khalifa Medical City, Ajman, United Arab Emirates.
    Incidence of second surgery following pediatric adenotonsillar surgery: a population-based cohort study2017In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 274, p. 2945-2951Article in journal (Refereed)
    Abstract [en]

    The aim of the study is to evaluate the incidence and risk factors of a second surgery of the adenoids or tonsils for hypertrophy in children who have already undergone surgery for the same condition. This is a retrospective study (2004–2013) based on data from the National patient registry in Sweden. A total of 41,401 children underwent a first surgery of the adenoids or tonsils during the studied period. The most commonly performed (first) surgical procedure was adenoidectomy followed by adenotonsillotomy, adenotonsillectomy, tonsillotomy, and tonsillectomy. A total of 4459 patients underwent a second surgery for the same condition. The incidence of a second surgery was the highest in the primary adenoidectomy group (72.2, 95% CI 69.7–74.7) and lowest in the primary adenotonsillectomy group (14.2, 95% CI 12.6–15.9). A lower age at first surgery significantly increased the risk for a second surgery. A second surgery of the adenoids and tonsils due to lymphoid hypertrophy was common in the pediatric population. Adenoidectomy stands out in a negative way in most aspects of this study compared to the other types of first surgery. However, due to the design of this study, the results of this study cannot be taken as proof of a full adenotonsillectomy as the most appropriate first surgery in children with lymphoid upper airway obstruction. Nevertheless, the results clearly show that the topic needs to be addressed in future studies.

  • 19.
    Tibbling, Lita
    et al.
    Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery Östergötland.
    Johansson, Magnus
    Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery Östergötland. Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Mjönes, Anna-Britta
    Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Franzén, Thomas
    Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery Östergötland.
    Globus jugularis and dysphagia in patients with hiatus hernia2010In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 267, no 2, p. 251-254Article in journal (Refereed)
    Abstract [en]

    The aim of the article was to study if there is any relationship between globus sensation in the jugular fossa (GJ), intermittent esophageal dysphagia (IED), and the presence of a hiatus hernia, and if GJ can be relieved after hiatus hernia repair. 167 patients with a hiatus hernia (Group A) and 61 other patients with hiatus hernia and gastroesophageal reflux disease who were surgically treated with Nissen fundoplication (Group B), filled in a symptom questionnaire on GJ and IED. GJ was found in 66% and IED in 68% of patients in group A. In group B, 49% had GJ and 64% IED before surgery. At surgical follow-up 16% (P < 0.005) and 43% (P < 0.05) had GJ and IED, respectively. The combination of GJ and IED was found in 28% of IED patients before operation and in 31% at surgical follow-up. The high frequency of GJ in patients with hiatus hernia and the significant relief of GJ after hiatus hernia repair imply that GJ most likely is a referred sensation from the esophagus. IED and GJ are two parallel phenomena in patients with hiatus hernia, but do not seem to have any causal relationship.

  • 20.
    Westerberg, Johanna
    et al.
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Speech Therapy, Otorhinolaryngology and Audiology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology.
    Mäki-Torkko, Elina
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Orebro Univ, Sweden.
    Harder, Henrik
    Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Linköping University, Department of Biomedical and Clinical Sciences, Division of Sensory Organs and Communication.
    The evaluation of canal wall up cholesteatoma surgery with the Glasgow Benefit Inventory2020In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 277, no 1, p. 61-68Article in journal (Refereed)
    Abstract [en]

    Purpose The aim of the study was to investigate the change in health-related quality of life ( HRQoL) after canal wall up cholesteatoma surgery, using the Glasgow Benefit Inventory (GBI). Methods Data from a consecutive group of 47 adults scheduled for primary cholesteatoma surgery using canal wall up (CWU) with obliteration, from January 2005 to December 2009, were analysed. Information was extracted from a medical database, and complementary data from patient files and audiograms were collected and recorded retrospectively. The GBI questionnaire was used for the assessment of HRQoL after surgery. Results There was no finding of residual or recurrent cholesteatomas in the study group. Hearing was improved at 1 and 3 years postoperatively. No patient suffered a total hearing loss. The overall GBI scores showed an improved HRQoL after surgery. Twenty-nine (85%) patients benefitted from surgery, 1 (3%) had no change, and 4 (12%) expressed deterioration. Conclusions Cholesteatoma surgery using CWU with obliteration gives an improved HRQoL for the majority of patients. The GBI questionnaire provides complementary information to hearing and healing results after cholesteatoma surgery.

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  • 21.
    Wireklint, Sara
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ericsson, Elisabeth
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Health-related quality of life after tonsillotomy versus tonsillectomy in young adults: 6 years postsurgery follow-up2012In: European Archives of Oto-Rhino-Laryngology, ISSN 0937-4477, E-ISSN 1434-4726, Vol. 269, no 8, p. 1951-1958Article in journal (Refereed)
    Abstract [en]

    The indication for tonsil surgery is tonsillitis or obstructive symptoms due to tonsillar hypertrophy, associated with morbidity affecting health related quality of life (HRQL). Surgery performed is either tonsillectomy (TE) or partial intra capsular tonsillectomy/tonsillotomy (TT). TT is associated with fewer postoperative complications and rapid recovery, but with risk for regrowth of tonsillar tissue and return of sleep disordered breathing (SDB) or infections. The aim of this study was to investigate the long-term effects of TT and TE in young adults relating to HRQL and well-being as consequence of obstructive symptoms or ENT-infections after 6 years versus effect after 1 year. Young adults with symptoms of tonsillar hyperplasia were randomized to TE (44) or TT (32). Patients were assessed prior to surgery and 1 and 6 years postoperatively. Short Form 36 and the EuroQul Visual Analog Scale evaluated HRQL. Questionnaire was used to explore well-being, obstruction symptoms and infections. Patient BMI was calculated. Six years after surgery, 91 % of young adults (TE39/TT29) reported persisting benefits in well-being, reduced obstructive problems and fewer infections. Some patients in both groups reported a slight increase in snoring compared to 1 year after surgery, but still less than before surgery. Obesity was more frequent among those snoring. Both TT and TE in young adults yielded HRQL improvements and reduction in symptoms defining SDB persisting through 6 years postsurgery. Results indicated that both surgical methods were equally effective. Findings favor choice of TT due to lesser postoperative morbidity.

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