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  • 1.
    Odhagen, Erik
    et al.
    Sodra Alvsborgs Hosp, Sweden; Univ Gothenburg, Sweden.
    Stalfors, Joacim
    Univ Gothenburg, Sweden; Sheikh Khalifa Med City, U Arab Emirates.
    Sunnergren, Ola
    Linköping University, Department of Clinical and Experimental Medicine, Division of Speech language pathology, Audiology and Otorhinolaryngology. Linköping University, Faculty of Medicine and Health Sciences. Ryhov Cty Hosp, Sweden.
    Morbidity after pediatric tonsillotomy versus tonsillectomy: A population-based cohort study2019In: The Laryngoscope, ISSN 0023-852X, E-ISSN 1531-4995, Vol. 129, no 11, p. 2619-2626Article in journal (Refereed)
    Abstract [en]

    Objectives/Hypothesis To compare and evaluate morbidity following pediatric tonsillectomy (TE) and tonsillotomy (TT) performed due to tonsil-related upper airway obstruction. Study Design Retrospective population-based cohort study based on data from the Swedish National Patient Register (NPR). Methods All patients aged 1 to 12 years who were registered in the NPR between January 1, 2007 and December 31, 2015, and who underwent an isolated tonsil surgery (+/- adenoidectomy) for the sole indication of upper airway obstruction were included. Postoperative morbidity within 30 days of surgery, including readmission due to hemorrhage and return to theater (RTT), was evaluated and compared between the two groups. A forward stepwise multivariable logistic regression analysis was used to identify independent predictors of postoperative morbidity. Results In total, 35,060 patients were included in the study, 23,447 of whom underwent TT and 11,613 of whom underwent TE. Readmission due to postoperative hemorrhage, RTT, readmission due to any reason, and contact with healthcare were all less common after TT than after TE. Readmission due to postoperative hemorrhage was significantly more common after TE (2.5%) than after TT (0.6%) (odds ratio: 3.91, 95% confidence interval: 3.20-4.77). Conclusions This study showed that TT is associated with a statistically significantly lower risk of postoperative complications than TE when performed in children to correct tonsil-related upper airway obstruction. Statistically significant differences were found for all outcome variables, namely, readmission to hospital due to bleeding, RTT, readmission due to any reason, and postoperative contact with healthcare for any reason. Level of Evidence 2b Laryngoscope, 129:2619-2626, 2019

  • 2.
    Ostvoll, Eirik
    et al.
    Sahlgrens Univ Hosp, Sweden; Univ Gothenburg, Sweden.
    Sunnergren, Ola
    Linköping University, Department of Clinical and Experimental Medicine, Division of Speech language pathology, Audiology and Otorhinolaryngology. Linköping University, Faculty of Medicine and Health Sciences. Ryhov Cty Hosp, Sweden.
    Stalfors, Joacim
    Univ Gothenburg, Sweden; Sheikh Khalifa Med City, U Arab Emirates.
    Does tonsillectomy reduce medical care visits for pharyngitis/tonsillitis in children and adults?: Retrospective cohort study from Sweden2019In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 11, article id e033817Article in journal (Refereed)
    Abstract [en]

    Objective To assess the effectiveness of tonsillectomy/adenotonsillectomy in reducing medical care visits for pharyngitis or tonsillitis in children and adults with chronic/recurrent tonsillitis.

    Design Retrospective cohort study.

    Setting Data were retrieved from the VEGA register, a comprehensive regional cohort in Sweden.

    Participants 1044 children (<15 years) and 2244 adults.

    Intervention Tonsillectomy/adenotonsillectomy compared with no surgical treatment.

    Main outcome measures Changes in yearly mean rates of medical care visits due to pharyngitis/tonsillitis.

    Results In children, there was a significant decrease in the yearly mean medical care visits rate from 1.93 (1.82 to 2.04) before surgery to 0.129 (0.099 to 0.165) after surgery, with a mean change of −1.80 (−1.90 to −1.69), p<0.0001. In patients who did not undergo surgery, the corresponding mean change was −1.51 (−1.61 to −1.41), resulting in a mean difference in the change in visit rates between the intervention and control groups of −0.283 (−0.436 to −0.135), p=0.0002. In adults, a significant decrease in the yearly mean medical care visit rate was observed from 1.45 (1.39 to 1.51) before surgery to 0.152 (0.132 to 0.173) after surgery, with a mean change of −1.30 (−1.36 to −1.24), p<0.0001, compared with −1.18 (−1.24 to −1.13) in the control group. The difference in the change in yearly mean visit rate between the surgical and non-surgical groups was −0.111 (−0.195 to −0.028), p=0.0097. The subgroup analysis showed a greater effect of surgery in children, in patients with a higher number of medical care visits before surgery and in the first year of follow-up.

    Conclusion In this cohort of patients moderately or less affected with chronic/recurrent tonsillitis, the effectiveness of tonsillectomy/adenotonsillectomy in reducing medical care visits for pharyngitis and tonsillitis compared with no surgical treatment was low and of questionable clinical value.

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