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Risk of reoperation after tonsillotomy versus tonsillectomy: a population-based cohort study

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Abstract

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”.

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Acknowledgments

Thank you to Henrik Passmark at The National Board of Health and Welfare for help with retrieving data from the Swedish National Patient Register. Thanks also to Statistiska Konsultgruppen AB and especially Bengt Bengtsson for statistical analysis.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Sahlgrenska University Hospital, Gröna stråket 5, 413 45, Gothenburg, Sweden

    Erik Odhagen & Joacim Stalfors

  2. Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden

    Erik Odhagen & Joacim Stalfors

  3. Department of Otorhinolaryngology, Ryhov County Hospital, Jönköping, Sweden

    Ola Sunnergren

  4. Futurum-The Academy for Health and Care, County Council, Jönköping, Sweden

    Ola Sunnergren

  5. Sollentuna Specialist Clinic, Stockholm, Sweden

    Claes Hemlin

  6. Department of Otorhinolaryngology, Aleris Sabbatsberg, Stockholm, Sweden

    Anne-Charlotte Hessén Söderman

  7. Division of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden

    Anne-Charlotte Hessén Söderman

  8. Faculty of Medicine and Health, School of Health and Medical Sciences, Örebro University, Örebro, Sweden

    Elisabeth Ericsson

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  1. Erik Odhagen
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  2. Ola Sunnergren
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  3. Claes Hemlin
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  4. Anne-Charlotte Hessén Söderman
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  5. Elisabeth Ericsson
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  6. Joacim Stalfors
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Correspondence to Erik Odhagen.

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Odhagen, E., Sunnergren, O., Hemlin, C. et al. Risk of reoperation after tonsillotomy versus tonsillectomy: a population-based cohort study. Eur Arch Otorhinolaryngol 273, 3263–3268 (2016). https://doi.org/10.1007/s00405-015-3871-7

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  • DOI: https://doi.org/10.1007/s00405-015-3871-7

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