Ericsson Elisabeth, Hultcrantz Elisabeth
Department of Neuroscience and Locomotion, Division of Otorhinolaryngology, Faculty of Health Sciences, University of Linköping, Linköping, Sweden.
Laryngoscope. 2007 Apr;117(4):654-61. doi: 10.1097/mlg.0b013e318030ca69.
Comparison of two types of tonsil surgery for 16- to 25-year-old patients, with respect to primary morbidity, snoring, and recurrent infections after 1 year. Teenagers and young adults are a significant proportion (26%) of the population that receive tonsil surgery each year and appear to suffer more pain than younger children. Recurrent tonsillitis, in combination with obstructive problems, is the main indication for surgery.
One hundred fourteen patients 16 to 25 years of age were randomized to tonsillotomy (TT) with radiosurgery (RF) (Ellman International) or to cold tonsillectomy (TE). Pain and analgesics were logged until patients were pain free.
Thirty-two patients were operated on with TT and 44 with TE. The TT group had less blood loss during surgery and no postoperative bleedings, compared with the TE group (2 primary and 4 late hemorrhages). The TT group recorded significantly less pain from the first day, had less need of analgesics (diclofenac and paracetamol), and were pain free and in school/at work 4 days earlier than the TE group. After 7 days, the TE patients had lost a mean of 1.8 kg compared with TT, with no significant weight loss. After 1 year, both groups were satisfied. The positive effect on snoring was the same for both groups. There were few throat infections in both groups.
TT with RF is an effective method for tonsil surgery for many teenagers and young adults, with much less postoperative morbidity than regular TE. Long-term follow-up is necessary.
比较两种扁桃体手术方式在16至25岁患者中的应用效果，观察术后1年的原发性发病率、打鼾情况及反复感染情况。青少年和青年成年人占每年接受扁桃体手术人群的很大比例（26%），且似乎比年幼儿童遭受更多疼痛。复发性扁桃体炎合并阻塞性问题是手术的主要指征。
114名年龄在16至25岁的患者被随机分为接受放射外科（RF）扁桃体切除术（TT）（Ellman International公司）或冷刀扁桃体切除术（TE）。记录疼痛情况及使用的镇痛药，直至患者无痛。
32例患者接受了TT手术，44例接受了TE手术。与TE组相比，TT组手术期间失血更少，且无术后出血（TE组有2例原发性出血和4例迟发性出血）。TT组从第一天起疼痛明显减轻，镇痛药（双氯芬酸和对乙酰氨基酚）需求更少，比TE组提前4天无痛并返校/复工。7天后，TE组患者平均体重减轻1.8kg，而TT组无明显体重减轻。1年后，两组患者均满意。两组对打鼾的积极效果相同。两组咽喉感染均较少。
对于许多青少年和青年成年人，RF扁桃体切除术是一种有效的扁桃体手术方法，术后发病率远低于常规冷刀扁桃体切除术。有必要进行长期随访。
