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Clinical practice guideline: tonsillitis II. Surgical management

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Abstract

In 2013, a total of 84,332 patients had undergone extracapsular tonsillectomies (TE) and 11,493 a tonsillotomy (TT) procedure in Germany. While the latter is increasingly performed, the number of the former is continually decreasing. However, a constant number of approximately 12,000 surgical procedures in terms of abscess-tonsillectomies or incision and drainage are annually performed in Germany to treat patients with a peritonsillar abscess. The purpose of this part of the clinical guideline is to provide clinicians in any setting with a clinically focused multi-disciplinary guidance through the surgical treatment options to reduce inappropriate variation in clinical care, improve clinical outcome and reduce harm. Surgical treatment options encompass intracapsular as well as extracapsular tonsil surgery and are related to three distinct entities: recurrent episodes of (1) acute tonsillitis, (2) peritonsillar abscess and (3) infectious mononucleosis. Conservative management of these entities is subject of part I of this guideline. (1) The quality of evidence for TE to resolve recurrent episodes of tonsillitis is moderate for children and low for adults. Conclusions concerning the efficacy of TE on the number of sore throat episodes per year are limited to 12 postoperative months in children and 5–6 months in adults. The impact of TE on the number of sore throat episodes per year in children is modest. Due to the heterogeneity of data, no firm conclusions on the effectiveness of TE in adults can be drawn. There is still an urgent need for further research to reliably estimate the value of TE compared to non-surgical therapy of tonsillitis/tonsillo-pharyngitis. The impact of TE on quality of life is considered as being positive, but further research is mandatory to establish appropriate inventories and standardized evaluation procedures, especially in children. In contrast to TE, TT or comparable procedures are characterized by a substantially lower postoperative morbidity in terms of pain and bleeding. Although tonsillar tissue remains along the capsule, the outcome appears not to differ from TE, at least in the pediatric population and young adults. Age and a history of tonsillitis are not a contraindication, abscess formation in the tonsillar remnants is an extremely rare finding. The volume of the tonsils should be graded according to Brodsky and a grade >1 is considered to be eligible for TT. The number of episodes during 12 months prior to presentation is crucial to indicate either TE or TT. While surgery is not indicated in patients with less than three episodes, a wait-and-see policy for 6 months is justified to include the potential of a spontaneous healing before surgery is considered. Six or more episodes appear to justify tonsil surgery. (2) Needle aspiration, incision and drainage, and abscess tonsillectomy are effective methods to treat patients with peritonsillar abscess. Compliance and ability of the patient to cooperate must be taken into account when choosing the surgical method. Simultaneous antibiotic therapy is recommended but still subject of scientific research. Abscess tonsillectomy should be preferred, if complications have occurred or if alternative therapeutic procedures had failed. Simultaneous TE of the contralateral side should only be performed when criteria for elective TE are matched or in cases of bilateral peritonsillar abscess. Needle aspiration or incision and drainage should be preferred if co-morbidities exist or an increased surgical risk or coagulation disorders are present. Recurrences of peritonsillar abscesses after needle aspiration or incision and drainage are rare. Interval TE should not be performed, the approach is not supported by contemporary clinical studies. (3) In patients with infectious mononucleosis TE should not be performed as a routine procedure for symptom control. TE is indicated in cases with clinically significant upper airway obstruction resulting from inflammatory tonsillar hyperplasia. If signs of a concomitant bacterial infection are not present, antibiotics should not be applied. Steroids may be administered for symptom relief.

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References

  1. www.thecochranelibrary.com

  2. Randall DA, Hoffer ME (1998) Complications of tonsillectomy and adenoidectomy. Otolaryngol Head Neck Surg 118:61–68

    Article  CAS  PubMed  Google Scholar 

  3. Carmody D, Vamadevan T, Cooper SM (1982) Post tonsillectomy haemorrhage. J Laryngol Otol 96:635–638

    Article  CAS  PubMed  Google Scholar 

  4. Windfuhr J, Seehafer M (2001) Classification of haemorrhage following tonsillectomy. J Laryngol Otol 115:457–461

    Article  CAS  PubMed  Google Scholar 

  5. Kang J, Brodsky L, Danziger I, Volk M, Stanievich J (1994) Coagulation profile as a predictor for post-tonsillectomy and adenoidectomy (T + A) hemorrhage. Int J Pediatr Otorhinolaryngol 28:157–165

    Article  CAS  PubMed  Google Scholar 

  6. Handler SD, Miller L, Richmond KH, Baranak CC (1986) Post-tonsillectomy hemorrhage: incidence, prevention and management. Laryngoscope 96:1243–1247

    CAS  PubMed  Google Scholar 

  7. Watson M, Dawes P, Samuel P et al (1993) A study of haemostasis following tonsillectomy comparing ligatures with diathermy. J Laryngol Otol 107:711–715

    Article  CAS  PubMed  Google Scholar 

  8. Sarny S, Ossimitz G, Habermann W, Stammberger H (2012) „Die Österreichische Tonsillenstudie 2010“—Teil 1: Statistischer Überblick. Laryngo- rhino- otologie 91:16–21

    Article  CAS  PubMed  Google Scholar 

  9. Georgalas CC, Tolley NS, Narula A (2009) Tonsillitis. Clin Evid 2009:1–12

    Google Scholar 

  10. Lowe D, van der Meulen J (2004) Tonsillectomy technique as a risk factor for postoperative haemorrhage. Lancet 364:697–702

    Article  CAS  PubMed  Google Scholar 

  11. Windfuhr JP, Wienke A, Chen YS (2009) Electrosurgery as a risk factor for secondary post-tonsillectomy hemorrhage. Eur Arch Otorhinolaryngol 266:111–116

    Article  CAS  PubMed  Google Scholar 

  12. Sarny S, Ossimitz G, Habermann W, Stammberger H (2011) Hemorrhage following tonsil surgery: a multicenter prospective study. Laryngoscope 121:2553–2560

    Article  PubMed  Google Scholar 

  13. Neumann C, Street I, Lowe D, Sudhoff H (2007) Harmonic scalpel tonsillectomy: a systematic review of evidence for postoperative hemorrhage. Otolaryngol Head Neck Surg 137:378–384

    Article  PubMed  Google Scholar 

  14. Pinder D, Hilton M (2001) Dissection versus diathermy for tonsillectomy. Cochrane Database Syst Rev 2001(4):CD002211

    Google Scholar 

  15. Pinder DK, Wilson H, Hilton MP (2011) Dissection versus diathermy for tonsillectomy. Cochrane Database Syst Rev 2011(3):CD002211

    Google Scholar 

  16. Dhiwakar M, Clement WA, Supriya M, McKerrow W (2012) Antibiotics to reduce post-tonsillectomy morbidity. Cochrane Database Syst Rev 12:CD005607

    PubMed  Google Scholar 

  17. Cardozo AA, Hallikeri C, Lawrence H, Sankar V, Hargreaves S (2007) Teenage and adult tonsillectomy: dose–response relationship between diathermy energy used and morbidity. Clin Otolaryngol 32:366–371

    Article  CAS  PubMed  Google Scholar 

  18. http://www.awmf.org/uploads/tx_szleitlinien/001-025l_S3_Behandlung_akuter_perioperativer_und_posttraumatischer_Schmerzen_abgelaufen.pdf

  19. Kaiser AD (1930) Results of tonsillectomy. A comparative study of twenty-two hundred tonsillectomized children with an equal number of controls three and ten years after operation. JAMA 95:837–842

    Article  Google Scholar 

  20. Roydhouse N (1970) A controlled study of adenotonsillectomy. Arch Otolaryngol 92:611–616

    Article  CAS  PubMed  Google Scholar 

  21. Mawson SR, Adlington P, Evans M (1967) A controlled study evaluation of adeno-tonsillectomy in children. J Laryngol Otol 81:777–790

    Article  CAS  PubMed  Google Scholar 

  22. Mawson SR, Adlington P, Evans M (1968) A controlled study evaluation of adeno-tonsillectomy in children. J Laryngol Otol 82:963–979

    Article  CAS  PubMed  Google Scholar 

  23. McKee WJ (1963) A controlled study of the effects of tonsillectomy and adenoidectomy in children. Br J Prev Soc Med 17:133–140

    CAS  PubMed  PubMed Central  Google Scholar 

  24. Marshall T (1998) A review of tonsillectomy for recurrent throat infection. Br J Gen Pract 48:1331–1335

    CAS  PubMed  PubMed Central  Google Scholar 

  25. van Staaij BK, van den Akker EH, van der Heijden GJ, Schilder AG, Hoes AW (2005) Adenotonsillectomy for upper respiratory infections: evidence based? Arch Dis Child 90:19–25

    Article  PubMed  PubMed Central  Google Scholar 

  26. Clayburgh D, Milczuk H, Gorsek S, Sinden N, Bowman K, Macarthur C (2011) Efficacy of tonsillectomy for pediatric patients with Dysphagia and tonsillar hypertrophy. Arch Otolaryngol Head Neck Surg 137:1197–1202

    Article  PubMed  Google Scholar 

  27. Naiboglu B, Kulekci S, Kalaycik C, Sheidaei S, Toros SZ, Egeli E (2010) Improvement in quality of life by adenotonsillectomy in children with adenotonsillar disease. Clin Otolaryngol 35:383–389

    Article  CAS  PubMed  Google Scholar 

  28. Stalfors J, Ericsson E, Hemlin C et al (2012) Tonsil surgery efficiently relieves symptoms: analysis of 54 696 patients in the National Tonsil Surgery Register in Sweden. Acta Otolaryngol 132:533–539

    Article  PubMed  Google Scholar 

  29. Burton MJ, Glasziou PP (2009) Tonsillectomy or adeno-tonsillectomy versus non-surgical treatment for chronic/recurrent acute tonsillitis. Cochrane Database Syst Rev 2009(1):CD001802

    Google Scholar 

  30. www.ncbi.nlm.nih.gov/pubmed

  31. Barraclough J, Anari S (2014) Tonsillectomy for recurrent sore throats in children: indications, outcomes, and efficacy. Otolaryngol Head Neck Surg 150:722–729

    Article  PubMed  Google Scholar 

  32. McKee WJ (1963) The part played by adenoidectomy in the combined operation of tonsillectomy with adenoidectomy. Second part of a controlled study in children. Br J Prev Soc Med 17:133–140

    CAS  PubMed  PubMed Central  Google Scholar 

  33. Roydhouse N (1969) A controlled study of adenotonsillectomy. Lancet 2:931–932

    Article  CAS  PubMed  Google Scholar 

  34. Paradise JL, Bluestone CD, Bachman RZ et al (1984) Efficacy of tonsillectomy for recurrent throat infection in severely affected children. Results of parallel randomized and nonrandomized clinical trials. N Engl J Med 310:674–683

    Article  CAS  PubMed  Google Scholar 

  35. Paradise J, Bluestone C, Colborn D, Bernard B, Rockette H, Kurs-Lasky M (2002) Tonsillectomy and adenotonsillectomy for recurrent throat infection in moderately affected children. Pediatrics 110:7–15

    Article  PubMed  Google Scholar 

  36. van Staaij BK, van den Akker EH, Rovers MM, Hordijk GJ, Hoes AW, Schilder AG (2004) Effectiveness of adenotonsillectomy in children with mild symptoms of throat infections or adenotonsillar hypertrophy: open, randomised controlled trial. BMJ 329:651

    Article  PubMed  PubMed Central  Google Scholar 

  37. Lock C, Wilson J, Steen N et al (2010) North of England and Scotland Study of Tonsillectomy and Adeno-tonsillectomy in Children (NESSTAC): a pragmatic randomised controlled trial with a parallel non-randomised preference study. Health Technol Assess 14:1–164, iii–iv

  38. Buskens E, van Staaij B, van den Akker J, Hoes AW, Schilder AG (2007) Adenotonsillectomy or watchful waiting in patients with mild to moderate symptoms of throat infections or adenotonsillar hypertrophy: a randomized comparison of costs and effects. Arch Otolaryngol Head Neck Surg 133:1083–1088

    Article  PubMed  Google Scholar 

  39. Wilson JA, Steen IN, Lock CA et al (2012) Tonsillectomy: a cost-effective option for childhood sore throat? Further analysis of a randomized controlled trial. Otolaryngol Head Neck Surg 146:122–128

    Article  PubMed  Google Scholar 

  40. Goldstein NA, Fatima M, Campbell TF, Rosenfeld RM (2002) Child behavior and quality of life before and after tonsillectomy and adenoidectomy. Arch Otolaryngol Head Neck Surg 128:770–775

    Article  PubMed  Google Scholar 

  41. Goldstein NA, Stewart MG, Witsell DL et al (2008) Quality of life after tonsillectomy in children with recurrent tonsillitis. Otolaryngol Head Neck Surg 138:S9–S16

    Article  PubMed  Google Scholar 

  42. Hopkins C, Fairley J, Yung M, Hore I, Balasubramaniam S, Haggard M (2010) The 14-item Paediatric Throat Disorders Outcome Test: a valid, sensitive, reliable, parent-reported outcome measure for paediatric throat disorders. J Laryngol Otol 124:306–314

    Article  CAS  PubMed  Google Scholar 

  43. Kubba H, Swan IR, Gatehouse S (2004) The Glasgow Children’s Benefit Inventory: a new instrument for assessing health-related benefit after an intervention. Ann Otol Rhinol Laryngol 113:980–986

    Article  PubMed  Google Scholar 

  44. Schwentner I, Schmutzhard J, Schwentner C, Abraham I, Hofer S, Sprinzl GM (2008) The impact of adenotonsillectomy on children’s quality of life. Clin Otolaryngol 33:56–59

    Article  CAS  PubMed  Google Scholar 

  45. Camilleri A, MacKenzie K, Gatehouse S (1995) The effect of recurrent tonsillitis and tonsillectomy on growth in childhood. Clin Otolaryngol 20:153–157

    Article  CAS  PubMed  Google Scholar 

  46. Papakostas K, Moraitis D, Lancaster J, McCormick MS (2003) Depressive symptoms in children after tonsillectomy. Int J Pediatr Otorhinolaryngol 67:127–132

    Article  CAS  PubMed  Google Scholar 

  47. Afolabi OA, Alabi BS, Ologe FE, Dunmade AD, Segun-Busari S (2009) Parental satisfaction with post-adenotonsillectomy in the developing world. Int J Pediatr Otorhinolaryngol 73:1516–1519

    Article  CAS  PubMed  Google Scholar 

  48. Akgun K, Aktas I, Uluc K (2008) Conservative treatment for late-diagnosed spinal accessory nerve injury. Am J Phys Med Rehabil 87:1015–1021

    Article  PubMed  Google Scholar 

  49. Conlon B, Donnelly M, McShane D (1997) Improvements in health and behaviour following childhood tonsillectomy: a parental perspective at 1 year. Int J Pediatr Otorhinolaryngol 41:155–161

    Article  CAS  PubMed  Google Scholar 

  50. Faulconbridge R, Fowler S, Horrocks J, Topham J (2000) Comparative audit of tonsillectomy. Clin Otolaryngol 25:110–117

    Article  CAS  PubMed  Google Scholar 

  51. Fox R, Temple M, Owens D, Short A, Tomkinson A (2008) Does tonsillectomy lead to improved outcomes over and above the effect of time? A longitudinal study. J Laryngol Otol 122:1197–1200

    Article  CAS  PubMed  Google Scholar 

  52. Fujihara K, Koltai PJ, Hayashi M, Tamura S, Yamanaka N (2006) Cost-effectiveness of tonsillectomy for recurrent acute tonsillitis. Ann Otol Rhinol Laryngol 115:365–369

    Article  PubMed  Google Scholar 

  53. Nikakhlagh S, Rahim F, Boostani H, Shirazi ST, Saki N (2012) The effect of adenotonsillectomy on quality of life in adults and pediatric patients. Indian J Otolaryngol Head Neck Surg 64:181–183

    Article  PubMed  PubMed Central  Google Scholar 

  54. Robb PJ, Gowrinath K, Agyeman K, Joseph J (2009) Paediatric tonsillectomy: parental experience and outcomes. J Laryngol Otol 123:103–107

    Article  CAS  PubMed  Google Scholar 

  55. Wolfensberger M, Haury JA, Linder T (2000) Parent satisfaction 1 year after adenotonsillectomy of their children. Int J Pediatr Otorhinolaryngol 56:199–205

    Article  CAS  PubMed  Google Scholar 

  56. Akgun D, Seymour FK, Qayyum A, Crystal R, Frosh A (2009) Assessment of clinical improvement and quality of life before and after tonsillectomy. J Laryngol Otol 123(2):199–202

    Article  CAS  PubMed  Google Scholar 

  57. Robb PJ, Gowrinath K, Agyeman K, Joseph J (2009) Paediatric tonsillectomy: parental experience and outcomes. J Laryngol Otol 123(1):103–107

    Article  CAS  PubMed  Google Scholar 

  58. Schwentner I, Schmutzhard J, Schwentner C, Abraham I, Hofer S, Sprinzl GM (2008) The impact of adenotonsillectomy on children’s quality of life. Clin Otolaryngol 33(1):56–59

    Article  CAS  PubMed  Google Scholar 

  59. Goldstein NA, Stewart MG, Witsell DL et al (2008) Quality of life after tonsillectomy in children with recurrent tonsillitis. Otolaryngol Head Neck Surg 138(Suppl 1):S9–S16

    Article  PubMed  Google Scholar 

  60. Blakley BW, Magit AE (2009) The role of tonsillectomy in reducing recurrent pharyngitis: a systematic review. Otolaryngol Head Neck Surg 140:291–297

    Article  PubMed  Google Scholar 

  61. Alho OP, Koivunen P, Penna T, Teppo H, Koskela M, Luotonen J (2007) Tonsillectomy versus watchful waiting in recurrent streptococcal pharyngitis in adults: randomised controlled trial. Clin Otolaryngol 32:285

    Article  Google Scholar 

  62. Andreou N, Hadjisymeou S, Panesar J (2013) Does tonsillectomy improve quality of life in adults? A systematic literature review. J Laryngol Otol 127:332–338

    Article  CAS  PubMed  Google Scholar 

  63. Bhattacharyya N, Kepnes L (2002) Economic benefit of tonsillectomy in adults with chronic tonsillitis. Ann Otol Rhinol Laryngol 111:983–988

    Article  PubMed  Google Scholar 

  64. Baumann I, Kucheida H, Blumenstock G, Zalaman IM, Maassen MM, Plinkert PK (2006) Benefit from tonsillectomy in adult patients with chronic tonsillitis. Eur Arch Otorhinolaryngol 263:556–559

    Article  PubMed  Google Scholar 

  65. Schwentner I, Hofer S, Schmutzhard J, Deibl M, Sprinzl GM (2007) Impact of tonsillectomy on quality of life in adults with chronic tonsillitis. Swiss Med Wkly 137:454–461

    PubMed  Google Scholar 

  66. Richards AL, Bailey M, Hooper R, Thomson P (2007) Quality-of-life effect of tonsillectomy in a young adult group. ANZ J Surg 77:988–990

    Article  PubMed  Google Scholar 

  67. Koskenkorva T, Koivunen P, Penna T, Teppo H, Alho OP (2009) Factors affecting quality-of-life impact of adult tonsillectomy. J Laryngol Otol 123(9):1010–1014

    Article  CAS  PubMed  Google Scholar 

  68. Senska G, Ellermann S, Ernst S, Lax H, Dost P (2010) Rezidivierende Tonsillitis bei Erwachsenen: Lebensqualität nach Tonsillektomie. Dtsch Arztebl Int 107:622–628

    PubMed  PubMed Central  Google Scholar 

  69. Ericsson E, Ledin T, Hultcrantz E (2007) Long-term improvement of quality of life as a result of tonsillotomy (with radiofrequency technique) and tonsillectomy in youths. Laryngoscope 117:1272–1279

    Article  PubMed  Google Scholar 

  70. Witsell DL, Orvidas LJ, Stewart MG et al (2008) Quality of life after tonsillectomy in adults with recurrent or chronic tonsillitis. Otolaryngol Head Neck Surg 138:S1–S8

    Article  PubMed  Google Scholar 

  71. Motta G, Motta S, Cassano P et al (2013) Effects of guidelines on adeno-tonsillar surgery on the clinical behaviour of otorhinolaryngologists in Italy. BMC Ear Nose Throat Disord 13:1

    Article  PubMed  PubMed Central  Google Scholar 

  72. http://onlinelibrary.wiley.com/cochranelibrary/search. Accessed 01 June 2015

  73. Burton MJ, Glasziou PP, Chong LY, Venekamp RP (2014) Tonsillectomy or adenotonsillectomy versus non-surgical treatment for chronic/recurrent acute tonsillitis. Cochrane Database Syst Rev 11:CD001802

    PubMed  Google Scholar 

  74. Koskenkorva T, Koivunen P, Koskela M, Niemela O, Kristo A, Alho OP (2013) Short-term outcomes of tonsillectomy in adult patients with recurrent pharyngitis: a randomized controlled trial. CMAJ 185:E331–E336

    Article  PubMed  PubMed Central  Google Scholar 

  75. Windfuhr JP, Savva K, Dahm J, Werner JA (2015) Tonsillotomy: facts and fiction. Eur Arch Otorhinolaryngol 272(4):949–969

    Article  CAS  PubMed  Google Scholar 

  76. Ng SK, Lee DL, Li AM, Wing YK, Tong MC (2010) Reproducibility of clinical grading of tonsillar size. Arch Otolaryngol Head Neck Surg 136:159–162

    Article  PubMed  Google Scholar 

  77. Windfuhr J, Werner J (2013) Tonsillotomy: it’s time to clarify the facts. Eur Arch Otorhinolaryngol 270:2985–2996

    Article  PubMed  Google Scholar 

  78. Chatziavramidis A, Constantinidis J, Gennadiou D, Derwisis D, Sidiras T (2007) Volume reduction of tonsil hyperplasia in childhood with a surgical ultrasound device. Laryngo- rhino- otologie 86:177–183

    Article  CAS  PubMed  Google Scholar 

  79. Nelson LM (2000) Radiofrequency treatment for obstructive tonsillar hypertrophy. Arch Otolaryngol Head Neck Surg 126:736–740

    Article  CAS  PubMed  Google Scholar 

  80. Nelson LM (2003) Temperature-controlled radiofrequency tonsil reduction in children. Arch Otolaryngol Head Neck Surg 129:533–537

    Article  PubMed  Google Scholar 

  81. Palmieri B, Iannitti T, Fistetto G, Rottigni V (2013) The, “Swiss-cheese Doppler-guided laser tonsillectomy”: a new safe cribriform approach to intracapsular tonsillectomy. Lasers Med Sci 28:865–869

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  82. Pfaar O, Spielhaupter M, Schirkowski A et al (2007) Treatment of hypertrophic palatine tonsils using bipolar radiofrequency-induced thermotherapy (RFITT). Acta Otol 127(11):1176–1181

    Article  CAS  Google Scholar 

  83. Windfuhr JP (2013) Faults and failure of tonsil surgery and other standard procedures in otorhinolaryngology. Laryngo- rhino- otologie 92(Suppl 1):S33–S72

    PubMed  Google Scholar 

  84. Stelter K, de la Chaux R, Patscheider M, Olzowy B (2010) Double-blind, randomised, controlled study of post-operative pain in children undergoing radiofrequency tonsillotomy versus laser tonsillotomy. J Laryngol Otol 127(1):1176–1181

    Google Scholar 

  85. Hultcrantz E, Ericsson E (2004) Pediatric tonsillotomy with the radiofrequency technique: less morbidity and pain. Laryngoscope 114:871–877

    Article  PubMed  Google Scholar 

  86. Linder A, Markstrom A, Hultcrantz E (1999) Using the carbon dioxide laser for tonsillotomy in children. Int J Pediatr Otorhinolaryngol 50:31–36

    Article  CAS  PubMed  Google Scholar 

  87. Ericsson E, Wadsby M, Hultcrantz E (2006) Pre-surgical child behavior ratings and pain management after two different techniques of tonsil surgery. Int J Pediatr Otorhinolaryngol 70:1749–1758

    Article  PubMed  Google Scholar 

  88. Huber K, Sadick H, Maurer JT, Hörmann K, Hammerschmitt N (2005) Tonsillotomy with the argon-supported monopolar needle—first clinical results. Laryngo- rhino- otologie 84:671–675

    Article  CAS  PubMed  Google Scholar 

  89. Havel M, Sroka R, Englert E, Stelter K, Leunig A, Betz CS (2012) Intraindividual comparison of 1,470 nm diode laser versus carbon dioxide laser for tonsillotomy: a prospective, randomized, double blind, controlled feasibility trial. Lasers Surg Med 44:558–563

    Article  PubMed  Google Scholar 

  90. Moriniere S, Roux A, Bakhos D et al (2013) Radiofrequency tonsillotomy versus bipolar scissors tonsillectomy for the treatment of OSAS in children: a prospective study. Eur Ann Otorhinolaryngol Head Neck Dis 130:67–72

    Article  CAS  PubMed  Google Scholar 

  91. Ericsson E, Lundeborg I, Hultcrantz E (2009) Child behavior and quality of life before and after tonsillotomy versus tonsillectomy. Int J Pediatr Otorhinolaryngol 73:1254–1262

    Article  PubMed  Google Scholar 

  92. Hultcrantz E, Linder A, Markstrom A (1999) Tonsillectomy or tonsillotomy? A randomized study comparing postoperative pain and long-term effects. Int J Pediatr Otorhinolaryngol 51:171–176

    Article  CAS  PubMed  Google Scholar 

  93. de la Chaux R, Klemens C, Patscheider M, Reichel O, Dreher A (2008) Tonsillotomy in the treatment of obstructive sleep apnea syndrome in children: polysomnographic results. Int J Pediatr Otorhinolaryngol 72:1411–1417

    Article  PubMed  Google Scholar 

  94. Baharudin A, Shahid H, Rhendra MZ (2006) Laser tonsillotomy in children with tonsillar hyperplasia. Med J Malays 61:377–379

    CAS  Google Scholar 

  95. Ericsson E, Hultcrantz E (2007) Tonsil surgery in youths: good results with a less invasive method. Laryngoscope 117:654–661

    Article  PubMed  Google Scholar 

  96. Stelter K, Ihrler S, Siedek V, Patscheider M, Braun T, Ledderose G (2012) 1-Year follow-up after radiofrequency tonsillotomy and laser tonsillotomy in children: a prospective, double-blind, clinical study. Eur Arch Otorhinolaryngol 269:679–684

    Article  PubMed  Google Scholar 

  97. Vlastos IM, Parpounas K, Economides J, Helmis G, Koudoumnakis E, Houlakis M (2008) Tonsillectomy versus tonsillotomy performed with scissors in children with tonsillar hypertrophy. Int J Pediatr Otorhinolaryngol 72:857–863

    Article  PubMed  Google Scholar 

  98. Densert O, Desai H, Eliasson A et al (2001) Tonsillotomy in children with tonsillar hypertrophy. Acta Otolaryngol 121:854–858

    Article  CAS  PubMed  Google Scholar 

  99. Reichel O, Mayr D, Winterhoff J, de la Chaux R, Hagedorn H, Berghaus A (2007) Tonsillotomy or tonsillectomy? A prospective study comparing histological and immunological findings in recurrent tonsillitis and tonsillar hyperplasia. Eur Arch Otorhinolaryngol 264:277–284

    Article  PubMed  Google Scholar 

  100. Korkmaz O, Bektas D, Cobanoglu B, Caylan R (2008) Partial tonsillectomy with scalpel in children with obstructive tonsillar hypertrophy. Int J Pediatr Otorhinolaryngol 72(7):1007–1012

    Article  PubMed  Google Scholar 

  101. Celenk F, Bayazit YA, Yilmaz M et al (2008) Tonsillar regrowth following partial tonsillectomy with radiofrequency. Int J Pediatr Otorhinolaryngol 72:19–22

    Article  PubMed  Google Scholar 

  102. Ericsson E, Graf J, Hultcrantz E (2006) Pediatric tonsillotomy with radiofrequency technique: long-term follow-up. Laryngoscope 72(7):1851–1857

    Article  Google Scholar 

  103. Sedlmaier B, Bohlmann P, Jakob O, Reinhardt A (2010) Outpatient diode laser tonsillotomy in children with tonsillar hyperplasia. Clinical results. HNO 58:244–254

    Article  CAS  PubMed  Google Scholar 

  104. Zagolski O (2010) Why do palatine tonsils grow back after partial tonsillectomy in children? Eur Arch Otorhinolaryngol 267:1613–1617

    Article  PubMed  Google Scholar 

  105. Hanenkamp U, Helling K, Mann WJ (2008) Die Tonsillotomie mit der bipolaren Koagulationsschere. Laryngo- rhino- otologie 87:870–873

    Article  CAS  PubMed  Google Scholar 

  106. Ilgen F (2005) Laser-assisted tonsillotomy in children with obstructive sleep apnea and adenotonsillary hyperplasia—experiences as an outpatient procedure. Laryngo- rhino- otologie 84:665–670

    Article  CAS  PubMed  Google Scholar 

  107. Hultcrantz E, Linder A, Markstrom A (2005) Long-term effects of intracapsular partial tonsillectomy (tonsillotomy) compared with full tonsillectomy. Int J Pediatr Otorhinolaryngol 69:463–469

    Article  PubMed  Google Scholar 

  108. Scherer H (2003) Tonsillotomie versus Tonsillektomie. Laryngo- rhino- otologie 82:754–755

    Article  CAS  PubMed  Google Scholar 

  109. Wireklint S, Ericsson E (2012) Health-related quality of life after tonsillotomy versus tonsillectomy in young adults: 6 years postsurgery follow-up. Eur Arch Otorhinolaryngol 269:1951–1958

    Article  PubMed  Google Scholar 

  110. Eisfeld W, Amler S, Deitmer T (2010) Long-term results following tonsillotomy in children. Laryngo- rhino- otologie 89:466–472

    Article  PubMed  Google Scholar 

  111. Helling K, Abrams J, Bertram WK, Hohner S, Scherer H (2002) Die Lasertonsillotomie bei der Tonsillenhyperplasie des Kleinkindes. HNO 50:470–478

    Article  CAS  PubMed  Google Scholar 

  112. Unkel C, Lehnerdt G, Metz K, Jahnke K, Dost P (2004) Langzeitverlauf nach Laser-Tonsillotomie bei symptomatischer Tonsillenhyperplasie. Laryngo- rhino- otologie 83:466–469

    Article  CAS  PubMed  Google Scholar 

  113. Unkel C, Lehnerdt G, Schmitz KJ, Jahnke K (2005) Laser-tonsillotomy for treatment of obstructive tonsillar hyperplasia in early childhood: a retrospective review. Int J Pediatr Otorhinolaryngol 69:1615–1620

    Article  PubMed  Google Scholar 

  114. Eviatar E, Kessler A, Shlamkovitch N, Vaiman M, Zilber D, Gavriel H (2009) Tonsillectomy vs. partial tonsillectomy for OSAS in children—10 years post-surgery follow-up. Int J Pediatr Otorhinolaryngol 73:637–640

    Article  PubMed  Google Scholar 

  115. Chang KW (2005) Randomized controlled trial of coblation versus electrocautery tonsillectomy. Otolaryngol Head Neck Surg 132:273–280

    Article  PubMed  Google Scholar 

  116. Nguyen CV, Parikh SR, Bent JP (2009) Comparison of intraoperative bleeding between microdebrider intracapsular tonsillectomy and electrocautery tonsillectomy. Ann Otol Rhinol Laryngol 118:698–702

    Article  PubMed  Google Scholar 

  117. Park A, Proctor MD, Alder S, Muntz H (2007) Subtotal bipolar tonsillectomy does not decrease postoperative pain compared to total monopolar tonsillectomy. Int J Pediatr Otorhinolaryngol 71:1205–1210

    Article  PubMed  Google Scholar 

  118. Pruegsanusak K, Wongsuwan K, Wongkittithawon J (2010) A randomized controlled trial for perioperative morbidity in microdebrider versus cold instrument dissection tonsillectomy. J Med Assoc Thail 93:558–565

    Google Scholar 

  119. Chang KW (2008) Intracapsular versus subcapsular coblation tonsillectomy. Otolaryngol Head Neck Surg 138:153–157

    Article  PubMed  Google Scholar 

  120. Arya AK, Donne A, Nigam A (2005) Double-blind randomized controlled study of coblation tonsillotomy versus coblation tonsillectomy on postoperative pain in children. Clin Otolaryngol 30:226–229

    Article  CAS  PubMed  Google Scholar 

  121. Sobol SE, Wetmore RF, Marsh RR, Stow J, Jacobs IN (2006) Postoperative recovery after microdebrider intracapsular or monopolar electrocautery tonsillectomy: a prospective, randomized, single-blinded study. Arch Otolaryngol Head Neck Surg 132:270–274

    Article  PubMed  Google Scholar 

  122. Wilson YL, Merer DM, Moscatello AL (2009) Comparison of three common tonsillectomy techniques: a prospective randomized, double-blinded clinical study. Laryngoscope 119:162–170

    Article  PubMed  Google Scholar 

  123. Gan K, Tomlinson C, El-Hakim H (2009) Post-operative bleeding is less after partial intracapsular tonsillectomy than bipolar total procedure. Int J Pediatr Otorhinolaryngol 73:667–670

    Article  PubMed  Google Scholar 

  124. Lister MT, Cunningham MJ, Benjamin B et al (2006) Microdebrider tonsillotomy vs electrosurgical tonsillectomy: a randomized, double-blind, paired control study of postoperative pain. Arch Otolaryngol Head Neck Surg 132:599–604

    Article  PubMed  Google Scholar 

  125. Cohen MS, Getz AE, Isaacson G, Gaughan J, Szeremeta W (2007) Intracapsular vs. extracapsular tonsillectomy: a comparison of pain. Laryngoscope 117:1855–1858

    Article  PubMed  Google Scholar 

  126. Hall DJ, Littlefield PD, Birkmire-Peters DP, Holtel MR (2004) Radiofrequency ablation versus electrocautery in tonsillectomy. Otolaryngol Head Neck Surg 130:300–305

    Article  PubMed  Google Scholar 

  127. Koltai PJ, Solares CA, Mascha EJ, Xu M (2002) Intracapsular partial tonsillectomy for tonsillar hypertrophy in children. Laryngoscope 112:17–19

    Article  PubMed  Google Scholar 

  128. Littlefield PD, Hall DJ, Holtel MR (2005) Radiofrequency excision versus monopolar electrosurgical excision for tonsillectomy. Otolaryngol Head Neck Surg 133:51–54

    Article  PubMed  Google Scholar 

  129. Derkay CS, Darrow DH, Welch C, Sinacori JT (2006) Post-tonsillectomy morbidity and quality of life in pediatric patients with obstructive tonsils and adenoid: microdebrider vs electrocautery. Otolaryngol Head Neck Surg 134:114–120

    Article  PubMed  Google Scholar 

  130. Lee KC, Altenau MM, Barnes DR et al (2002) Incidence of complications for subtotal ionized field ablation of the tonsils. Otolaryngol Head Neck Surg 127:531–538

    Article  PubMed  Google Scholar 

  131. Rakesh S, Anand TS, Payal G, Pranjal K (2012) A prospective, randomized, double-blind study of coblation versus dissection tonsillectomy in adult patients. Indian J Otolaryngol Head Neck Surg 64:290–294

    Article  PubMed  PubMed Central  Google Scholar 

  132. Tunkel DE, Hotchkiss KS, Carson KA, Sterni LM (2008) Efficacy of powered intracapsular tonsillectomy and adenoidectomy. Laryngoscope 118:1295–1302

    Article  PubMed  Google Scholar 

  133. Friedman M, LoSavio P, Ibrahim H, Ramakrishnan V (2003) Radiofrequency tonsil reduction: safety, morbidity, and efficacy. Laryngoscope 113:882–887

    Article  PubMed  Google Scholar 

  134. Cantarella G, Viglione S, Forti S, Minetti A, Pignataro L (2012) Comparing postoperative quality of life in children after microdebrider intracapsular tonsillotomy and tonsillectomy. Auris Nasus Larynx 39:407–410

    Article  PubMed  Google Scholar 

  135. Friedman M, Wilson MN, Friedman J, Joseph NJ, Lin HC, Chang HW (2009) Intracapsular coblation tonsillectomy and adenoidectomy for the treatment of pediatric obstructive sleep apnea/hypopnea syndrome. Otolaryngol Head Neck Surg 140:358–362

    Article  PubMed  Google Scholar 

  136. Koltai P, Solares C, Koempel J et al (2003) Intracapsular tonsillar reduction (partial tonsillectomy): reviving a historical procedure for obstructive sleep disordered breathing in children. Otolaryngol Head Neck Surg 129:532–538

    Article  PubMed  Google Scholar 

  137. Chan KH, Friedman NR, Allen GC et al (2004) Randomized, controlled, multisite study of intracapsular tonsillectomy using low-temperature plasma excision. Arch Otolaryngol Head Neck Surg 130:1303–1307

    Article  PubMed  Google Scholar 

  138. Bent JP, April MM, Ward RF, Sorin A, Reilly B, Weiss G (2004) Ambulatory powered intracapsular tonsillectomy and adenoidectomy in children younger than 3 years. Arch Otolaryngol Head Neck Surg 130:1197–1200

    Article  PubMed  Google Scholar 

  139. Colen TY, Seidman C, Weedon J, Goldstein NA (2008) Effect of intracapsular tonsillectomy on quality of life for children with obstructive sleep-disordered breathing. Arch Otolaryngol Head Neck Surg 134:124–127

    Article  PubMed  Google Scholar 

  140. Sorin A, Bent JP, April MM, Ward RF (2004) Complications of microdebrider-assisted powered intracapsular tonsillectomy and adenoidectomy. Laryngoscope 114:297–300

    Article  PubMed  Google Scholar 

  141. Babademez M, Yurekli M, Acar B, Günbey E (2011) Comparison of radiofrequency ablation, laser and coblator techniques in reduction of tonsil size. Acta Otolaryngol 131:750–756

    Article  PubMed  Google Scholar 

  142. Schmidt R, Herzog A, Cook S, O’Reilly R, Deutsch E, Reilly J (2007) Complications of tonsillectomy: a comparison of techniques. Arch Otolaryngol Head Neck Surg 133:925–928

    Article  PubMed  Google Scholar 

  143. Schmidt R, Herzog A, Cook S, O’Reilly R, Deutsch E, Reilly J (2007) Powered intracapsular tonsillectomy in the management of recurrent tonsillitis. Otolaryngol Head Neck Surg 137:338–340

    Article  PubMed  Google Scholar 

  144. Wood JM, Harris PK, Woods CM, McLean SC, Esterman A, Carney AS (2011) Quality of life following surgery for sleep disordered breathing: subtotal reduction adenotonsillectomy versus adenotonsillectomy in Australian children. ANZ J Surg 81:340–344

    Article  PubMed  Google Scholar 

  145. Divi V, Benninger M (2005) Postoperative tonsillectomy bleed: coblation versus noncoblation. Laryngoscope 115:31–33

    Article  PubMed  Google Scholar 

  146. Johnston DR, Gaslin M, Boon M, Pribitkin E, Rosen D (2010) Postoperative complications of powered intracapsular tonsillectomy and monopolar electrocautery tonsillectomy in teens versus adults. Ann Otol Rhinol Laryngol 119:485–489

    Article  PubMed  Google Scholar 

  147. Bitar MA, Rameh C (2008) Microdebrider-assisted partial tonsillectomy: short- and long-term outcomes. Eur Arch Otorhinolaryngol 265:459–463

    Article  PubMed  Google Scholar 

  148. Mangiardi J, Graw-Panzer KD, Weedon J, Regis T, Lee H, Goldstein NA (2010) Polysomnography outcomes for partial intracapsular versus total tonsillectomy. Int J Pediatr Otorhinolaryngol 74:1361–1366

    Article  PubMed  Google Scholar 

  149. Solares CA, Koempel JA, Hirose K et al (2005) Safety and efficacy of powered intracapsular tonsillectomy in children: a multi-center retrospective case series. Int J Pediatr Otorhinolaryngol 69:21–26

    Article  PubMed  Google Scholar 

  150. Doshi HK, Rosow DE, Ward RF, April MM (2011) Age-related tonsillar regrowth in children undergoing powered intracapsular tonsillectomy. Int J Pediatr Otorhinolaryngol 75:1395–1398

    Article  PubMed  Google Scholar 

  151. Larrosa F, Dura MJ, Jeremias J, Guirao M, Alberti A, Romero E (2013) The cost associated with interstitial thermotherapy for tonsil reduction vs. standard tonsillectomy. Eur Arch Otorhinolaryngol 271(5):1271–1276

    Article  PubMed  Google Scholar 

  152. Coticchia JM, Yun RD, Nelson L, Koempel J (2006) Temperature-controlled radiofrequency treatment of tonsillar hypertrophy for reduction of upper airway obstruction in pediatric patients. Arch Otolaryngol Head Neck Surg 132:425–430

    Article  PubMed  Google Scholar 

  153. Andrews PJ, Latif A (2004) Outpatient laser tonsillar ablation under local anaesthetic. Eur Arch Otorhinolaryngol 261:551–554

    Article  PubMed  Google Scholar 

  154. Nemati S, Banan R, Kousha A (2010) Bipolar radiofrequency tonsillotomy compared with traditional cold dissection tonsillectomy in adults with recurrent tonsillitis. Otolaryngol Head Neck Surg 143:42–47

    Article  PubMed  Google Scholar 

  155. Tanyeri HM, Polat S (2011) Temperature-controlled radiofrequency tonsil ablation for the treatment of halitosis. Eur Arch Otorhinolaryngol 268:267–272

    Article  PubMed  Google Scholar 

  156. Remacle M, Keghian J, Lawson G, Jamart J (2003) Carbon-dioxide laser-assisted tonsil ablation for adults with chronic tonsillitis: a 6-month follow-up study. Eur Arch Otorhinolaryngol 260:456–459

    Article  PubMed  Google Scholar 

  157. Gallagher TQ, Wilcox L, McGuire E, Derkay CS (2010) Analyzing factors associated with major complications after adenotonsillectomy in 4776 patients: comparing three tonsillectomy techniques. Otolaryngol Head Neck Surg 142:886–892

    Article  PubMed  Google Scholar 

  158. Günzel T, Zenev E, Heinze N, Schwager K (2004) Tonsillektomienachblutungen im Zeitraum von 1985 bis 2001 und Erfahrungen bei der Anwendung der Lasertonsillotomie bei Kleinkindern. Laryngo- rhino- otologie 83:579–584

    Article  PubMed  Google Scholar 

  159. Stucken EZ, Grunstein E, Haddad J Jr et al (2013) Factors contributing to cost in partial versus total tonsillectomy. Laryngoscope 123:2868–2872

    Article  PubMed  Google Scholar 

  160. Mixson CM, Weinberger PM, Austin MB (2007) Comparison of microdebrider subcapsular tonsillectomy to harmonic scalpel and electrocautery total tonsillectomy. Am J Otolaryngol 28:13–17

    Article  PubMed  Google Scholar 

  161. Ahlstav Martensson U, Erling Hasselqvist N, Bostrom B (2012) Differences in pain and nausea in children operated on by Tonsillectomy or Tonsillotomy—a prospective follow-up study. J Adv Nurs 69(4):782–792

    Article  PubMed  Google Scholar 

  162. Sarny S, Habermann W, Ossimitz G, Schmid C, Stammberger H (2011) Tonsilar haemorrhage and re-admission: a questionnaire based study. Eur Arch Otorhinolaryngol 268:1803–1807

    Article  PubMed  Google Scholar 

  163. Smith E, Wenzel S, Rettinger G, Fischer Y (2008) Lebensqualität bei kindlichem obstruktiven Schlafapnoesyndrom nach Tonsillektomie. Tonsillotomie und/oder Adenotomie. Laryngo- rhino- otologie 87:490–497

    Article  CAS  PubMed  Google Scholar 

  164. Arya A, Donne A, Nigam A (2003) Double-blind randomized controlled study of coblation tonsillotomy versus coblation tonsillectomy on postoperative pain. Clin Otolaryngol 28:503–506

    Article  CAS  PubMed  Google Scholar 

  165. Cohen MS, Getz AE, Isaacson G, Gaughan J, Szeremeta W (2007) Intracapsular vs. extracapsular tonsillectomy: a comparison of pain. Laryngoscope 117(10):1855–1858

    Google Scholar 

  166. Duarte V, Liu Y, Shapiro N (2014) Coblation total tonsillectomy and adenoidectomy versus coblation partial intracapsular tonsillectomy and adenoidectomy in children. Laryngoscope 124(8):1959–1964

    Google Scholar 

  167. Gan K, Tomlinson C, El-Hakim H (2009) Post-operative bleeding is less after partial intracapsular tonsillectomy than bipolar total procedure. Int J Pediatr Otorhinolaryngol 117(10):667–670

    Article  Google Scholar 

  168. Powell E, Powell J, Samuel J, Wilson J (2013) A review of the pathogenesis of adult peritonsillar abscess: time for a re-evaluation. J Antimicrob Chemother 68:1941–1950

    Article  CAS  PubMed  Google Scholar 

  169. Lehnerdt G, Senska K, Fischer M, Jahnke K (2005) Smoking promotes the formation of peritonsillar abscess. Laryngo- rhino- otologie 73(5):676–679

    Article  Google Scholar 

  170. Johnson RF, Stewart MG (2005) The contemporary approach to diagnosis and management of peritonsillar abscess. Curr Opin Otolaryngol Head Neck Surg 13:157–160

    Article  PubMed  Google Scholar 

  171. Darrow D, Siemens C (2002) Indications for tonsillectomy and adenoidectomy. Laryngoscope 112:6–10

    Article  PubMed  Google Scholar 

  172. Powell J, Wilson JA (2012) An evidence-based review of peritonsillar abscess. Clin Otolaryngol 37:136–145

    Article  CAS  PubMed  Google Scholar 

  173. Federspil P (2009) Therapy options for peritonsillar abscess. HNO 57:223–229

    Article  CAS  PubMed  Google Scholar 

  174. Page C, Chassery G, Boute P, Obongo R, Strunski V (2010) Immediate tonsillectomy: indications for use as first-line surgical management of peritonsillar abscess (quinsy) and parapharyngeal abscess. J Laryngol Otol 124:1085–1090

    Article  CAS  PubMed  Google Scholar 

  175. Gysin C (2013) Indications of pediatric tonsillectomy. ORL 75:193–202

    Article  PubMed  Google Scholar 

  176. Herzon FS, Harris P (1995) Mosher Award thesis. Peritonsillar abscess: incidence, current management practices, and a proposal for treatment guidelines. Laryngoscope 105:1–17

    Article  CAS  PubMed  Google Scholar 

  177. Johnson RF, Stewart MG, Wright CC (2003) An evidence-based review of the treatment of peritonsillar abscess. Otolaryngol Head Neck Surg 128:332–343

    Article  PubMed  Google Scholar 

  178. Khan MI, Khan A (2011) Peritonsillar abscess: clinical presentation and efficacy of incision and drainage under local anaesthesia. J Ayub Med Coll: JAMC 23:34–36

    Google Scholar 

  179. Baldassari C, Shah RK (2012) Pediatric peritonsillar abscess: an overview. Infect Disord Drug Targets 12:277–280

    Article  CAS  PubMed  Google Scholar 

  180. Windfuhr JP, Remmert S (2005) Trends and complications in the management of peritonsillar abscess with emphasis on children. HNO 53:46–57

    Article  CAS  PubMed  Google Scholar 

  181. Lehnerdt G, Senska K, Fischer M, Jahnke K (2005) Bilateral peritonsillar abscesses. Eur Arch Otorhinolaryngol 262:573–575

    Article  CAS  PubMed  Google Scholar 

  182. Matschke RG, Plath P (1987) Clinical, histologic and bacteriologic findings in peritonsillar abscess. Laryngol Rhinol Otol 66:492–493

    Article  CAS  Google Scholar 

  183. Simon LM, Matijasec JW, Perry AP, Kakade A, Walvekar RR, Kluka EA (2013) Pediatric peritonsillar abscess: Quinsy ie versus interval tonsillectomy. Int J Pediatr Otorhinolaryngol 77:1355–1358

    Article  PubMed  Google Scholar 

  184. Giger R, Landis BN, Dulguerov P (2005) Hemorrhage risk after quinsy tonsillectomy. Otolaryngol Head Neck Surg 133:729–734

    Article  PubMed  Google Scholar 

  185. Segal N, El-Saied S, Puterman M (2009) Peritonsillar abscess in children in the southern district of Israel. Int J Pediatr Otorhinolaryngol 73(8):1148–1150

    Article  PubMed  Google Scholar 

  186. Baker KA, Stuart J, Sykes KJ, Sinclair KA, Wei JL (2012) Use of computed tomography in the emergency department for the diagnosis of pediatric peritonsillar abscess. Pediatr Emerg Care 28:962–965

    Article  PubMed  Google Scholar 

  187. Albertz N, Nazar G (2012) Peritonsillar abscess: treatment with immediate tonsillectomy—10 years of experience. Acta Otol 132(10):1102–1107

    Article  Google Scholar 

  188. Watanabe T, Suzuki M (2010) Bilateral peritonsillar abscesses: our experience and clinical features. Ann Otol Rhinol Laryngol 119:662–666

    PubMed  Google Scholar 

  189. Segal N, El-Saied S, Puterman M (2009) Peritonsillar abscess in children in the southern district of Israel. Int J Pediatr Otorhinolaryngol 73(8):1148–1150

    Article  PubMed  Google Scholar 

  190. Baugh RF, Archer SM, Mitchell RB et al (2011) Clinical practice guideline: tonsillectomy in children. Otolaryngol Head Neck Surg 144:S1–S30

    Article  PubMed  Google Scholar 

  191. Lescanne E, Chiron B, Constant I et al (2012) Pediatric tonsillectomy: clinical practice guidelines. Eur Ann Otorhinolaryngol Head Neck Dis 129:264–271

    Article  CAS  PubMed  Google Scholar 

  192. www.sign.ac.uk/guidelines/fulltext/117. Accessed 1 Feb 2015

  193. Wilke J, Swoboda R (1981) Der Einfluß der Tonsillektomie auf den Verlauf der infektiösen Mononukleose. HNO-Praxis 6:44–47

    Google Scholar 

  194. Mann W, Lange G (1974) Tonsillectomy for the acute anginous type of infectious mononucleosis. Laryngol Rhinol Otol 53:826–830

    CAS  Google Scholar 

  195. Walther LE, Ilgner J, Oehme A et al (2005) Infectious mononucleosis. HNO 53:383–392

    Article  CAS  PubMed  Google Scholar 

  196. Windfuhr J, Chen Y, Remmert S (2005) Hemorrhage Following Tonsillectomy and Adenoidectomy in 15.214 Patients. Otolaryngol Head Neck Surg 132:281–286

    Article  CAS  PubMed  Google Scholar 

  197. Wolfensberger M, Mund MT (2004) Evidence-based indications for tonsillectomy. Ther Umsch 61:325–328

    Article  CAS  PubMed  Google Scholar 

  198. Nagler J, Ruebner RL (2007) Suppurative complications and upper airway obstruction in infectious mononucleosis. J Hosp Med 2:280–282

    Article  PubMed  Google Scholar 

  199. Oddera I (2000) Infectious mononucleosis: when is tonsillectomy indicated? Schweiz Med Wochenschr Suppl 116:80S–82S

    CAS  PubMed  Google Scholar 

  200. Stevenson D, Webster G, Stewart I (1992) Acute tonsillectomy in the management of infectious mononucleosis. J Laryngol Otol 106:989–991

    Article  CAS  PubMed  Google Scholar 

  201. Candy B, Hotopf M (2006) Steroids for symptom control in infectious mononucleosis. Cochrane Database Syst Rev 19(3):CD004402

    Google Scholar 

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Acknowledgments

The authors would like to thank Susanne Zapf, Marburg University Hospital, Marburg, Germany, for her invaluable help in translating this clinical guideline.

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Windfuhr, J.P., Toepfner, N., Steffen, G. et al. Clinical practice guideline: tonsillitis II. Surgical management. Eur Arch Otorhinolaryngol 273, 989–1009 (2016). https://doi.org/10.1007/s00405-016-3904-x

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