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扁桃体切除术与扁桃体剥离术的长期疗效:一项12年的随访研究。

Long-term effectiveness of tonsillotomy versus tonsillectomy: A 12-year follow-up study.

作者信息

Virkkunen Julia, Nokso-Koivisto Johanna, Sakki Anniina J

机构信息

Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

出版信息

Eur Arch Otorhinolaryngol. 2025 Jan;282(1):509-518. doi: 10.1007/s00405-024-09000-5. Epub 2024 Oct 1.

Abstract

PURPOSE

To evaluate the long-term effectiveness of tonsillotomy (TT) compared to tonsillectomy (TE) with respect to disease-specific quality of life (QOL), sleep-disordered breathing symptoms, throat infections, and rate of reoperations over a median follow-up period of 12 years.

METHODS

All patients < 16 years of age who underwent tonsil surgery between 2010 and 2011 at Helsinki University Hospital, Finland, were included in the study. In 2023, the patients answered a questionnaire concerning tonsil-related issues and a modified Tonsil and Adenoid Health Status Instrument (disease-specific QOL). Information about possible revisits and reoperations was gathered.

RESULTS

The study population consisted of 189 respondents, of which 87 had undergone TT and 102 TE. The median follow-up was 11.8 years in the TT group and 12.4 years in the TE group. The disease-specific QOL was equally good in both groups. Throat infections had not been an issue for the vast majority of patients and occurred to the same extent after TT and TE. The majority of participants (79.0% TT, 86.9% TE) were satisfied with the surgery, with no significant differences between the groups. After TT and TE, there were only a few revisits due to tonsil-related problems, and the reoperation rate was 6.9% and 1.0%, respectively.

CONCLUSION

Long-term clinical effectiveness of TT seems excellent. Compared to TE, with TT, equal disease-specific QOL can be achieved with a less invasive surgical method. Over a median follow-up period of 12-years, TT was not shown to be associated with an increased risk of tonsil infection problems.

摘要

目的

在12年的中位随访期内,比较扁桃体切除术(TT)与扁桃体剥离术(TE)在疾病特异性生活质量(QOL)、睡眠呼吸障碍症状、咽喉感染及再次手术率方面的长期疗效。

方法

纳入2010年至2011年在芬兰赫尔辛基大学医院接受扁桃体手术的所有16岁以下患者。2023年,患者回答了一份关于扁桃体相关问题的问卷以及一份改良的扁桃体和腺样体健康状况量表(疾病特异性QOL)。收集了有关可能的复诊和再次手术的信息。

结果

研究人群包括189名受访者,其中87人接受了TT,102人接受了TE。TT组的中位随访时间为11.8年,TE组为12.4年。两组的疾病特异性QOL同样良好。绝大多数患者未出现咽喉感染问题,TT和TE后咽喉感染的发生率相同。大多数参与者(TT组为79.0%,TE组为86.9%)对手术满意,两组之间无显著差异。TT和TE后,因扁桃体相关问题进行的复诊很少,再次手术率分别为6.9%和1.0%。

结论

TT的长期临床疗效似乎极佳。与TE相比,TT采用侵入性较小的手术方法可实现相同的疾病特异性QOL。在12年的中位随访期内,未显示TT与扁桃体感染问题风险增加相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eff4/11735506/4cb4b0280398/405_2024_9000_Fig1_HTML.jpg

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