Global tonsillectomy practice patterns – A survey study of pediatric otolaryngologists

IF 1.2 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology Pub Date : 2025-02-19 DOI:10.1016/j.ijporl.2025.112276

Gina M. Spencer , Claire A. Wilson , Jacob Davidson , Julie E. Strychowsky , Claire M. Lawlor , Hannah Burns , Eishaan K. Bhargava , James Fowler , M. Elise Graham

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引用次数: 0

Abstract

Objective

There is variation in surgical techniques and postoperative management of tonsillectomy globally. Our objective was to consolidate international similarities and differences in tonsillectomy management by pediatric otolaryngologists.

Methods

This cross-sectional survey study was conducted from April 4 to May 16, 2024. It involved a 55-item questionnaire distributed online to an international sample of pediatric otolaryngologists via an international WhatsApp group comprising pediatric otolaryngologists from various countries. The study achieved responses from 132 out of 293 invited pediatric otolaryngologists (45.1 % response rate). Participants were from 22 countries. Eligibility included proficiency in English and currently practicing pediatric otolaryngology.

Results

Among respondents, the majority primarily performed extracapsular tonsillectomy (44.7 %), followed by those who used both intracapsular and extracapsular tonsillectomy equally (34.8 %), and those who predominantly performed intracapsular tonsillectomy (20.5 %). Ideal patient candidates for extracapsular tonsillectomy included those with recurrent tonsillitis (70.5 %), recurrent peritonsillar abscesses (67.4 %), and obstructive sleep apnea (46.2 %). Ideal candidates for intracapsular tonsillectomy were those with obstructive sleep apnea (50.0 %) and bleeding disorders (38.6 %). Intracapsular tonsillectomy adoption was notably high in this cohort, with 68.8 % of European respondents favoring intracapsular tonsillectomy. Postoperative pain management varied, with 76.5 % of respondents using acetaminophen, 77.3 % using ibuprofen, and 28.8 % prescribing opioids, primarily oxycodone (48.6 %). Access to polysomnography was reported by 84.0 % of respondents. Common indications for inpatient admission included age under three (75.8 %), medical comorbidity (71.2 %), and severe sleep apnea (59.1 %).

Conclusion

This study highlights the increasing adoption of intracapsular tonsillectomy and the need for comprehensive guidelines addressing the observed global variability in practices.

Level of evidence

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来源期刊

International journal of pediatric otorhinolaryngology 医学-耳鼻喉科学

CiteScore

3.20

自引率

6.70%

发文量

276

审稿时长

62 days

期刊介绍： The purpose of the International Journal of Pediatric Otorhinolaryngology is to concentrate and disseminate information concerning prevention, cure and care of otorhinolaryngological disorders in infants and children due to developmental, degenerative, infectious, neoplastic, traumatic, social, psychiatric and economic causes. The Journal provides a medium for clinical and basic contributions in all of the areas of pediatric otorhinolaryngology. This includes medical and surgical otology, bronchoesophagology, laryngology, rhinology, diseases of the head and neck, and disorders of communication, including voice, speech and language disorders.