Çetin Yaser Said, Düzenli Ufuk
Department of Otorhinolaryngology, Van Yüzüncü Yıl University School of Medicine, Van, Turkey.
Turk Arch Otorhinolaryngol. 2020 Mar;58(1):30-34. doi: 10.5152/tao.2020.4837. Epub 2019 Oct 5.
This study was conducted to compare two different surgical methods; partial tonsil resection using the bipolar technique, tonsillotomy (TT), and total tonsillectomy (TE) (blunt dissection) for recurrent tonsillitis in children. The frequency of recurrent throat infections was determined during postoperative follow-up.
A total of 393 patients were included in this study. TT was performed on 174 patients (100 males, 74 females) and TE on 219 patients (112 males, 107 females). Following surgery, an analysis was made of treatment outcomes of patients with upper respiratory tract infections. The patients were followed up for 12-48 months. Their parents were also contacted by telephone to determine the frequency of reinfection and their satisfaction with the surgery. Also, parents of the patients completed a questionnaire pertaining to postoperative satisfaction (scale of 1-10).
In the TT group, 14 (8.1%) patients had recurrent tonsillitis postoperatively. In the TE group, 12 (5.4%) patients required antibiotherapy due to recurrent pharyngitis after the surgery. There was no significant difference between the two groups in terms of the one-year infection recurrence rate after surgery (p=0.281). Three patients (1.6%) in the TT group and 12 (5.4%) in the TE group complained of bleeding within the first 24 hours. The rate of bleeding was significantly lower in the TT group than the TE group (p=0.001). There were no fatalities in either group.
In both groups, the rate of reinfection accorded with the requirement for postoperative antibiotics. For recurrent tonsillitis, TT was as effective as TE. However, TT was superior in terms of the risk of bleeding.
本研究旨在比较两种不同的手术方法，即使用双极技术进行部分扁桃体切除术（扁桃体切开术，TT）和全扁桃体切除术（TE，钝性分离法）治疗儿童复发性扁桃体炎的效果。在术后随访期间确定复发性咽喉感染的频率。
本研究共纳入393例患者。174例患者（100例男性，74例女性）接受了扁桃体切开术，219例患者（112例男性，107例女性）接受了全扁桃体切除术。术后对患有上呼吸道感染的患者的治疗结果进行了分析。对患者进行了12至48个月的随访。还通过电话联系了他们的父母，以确定再次感染的频率以及他们对手术的满意度。此外，患者的父母完成了一份关于术后满意度的问卷（1-10分制）。
在扁桃体切开术组中，14例（8.1%）患者术后出现复发性扁桃体炎。在全扁桃体切除术组中，12例（5.4%）患者术后因复发性咽炎需要抗生素治疗。两组术后一年感染复发率无显著差异（p = 0.281）。扁桃体切开术组有三名患者（1.6%），全扁桃体切除术组有12例患者（5.4%）在术后24小时内出现出血。扁桃体切开术组的出血率显著低于全扁桃体切除术组（p = 0.001）。两组均无死亡病例。
两组的再次感染率与术后抗生素的使用需求相符。对于复发性扁桃体炎，扁桃体切开术与全扁桃体切除术效果相同。然而，扁桃体切开术在出血风险方面更具优势。
