Hanna Gerhardsson, Joacim Stalfors, Ola Sunnergren
{"title":"上气道梗阻儿童冷钢扁桃体切开术的术后出血、翻修手术和预后。","authors":"Hanna Gerhardsson, Joacim Stalfors, Ola Sunnergren","doi":"10.1002/lary.32174","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the safety and clinical outcomes (bleeding rate, requirement for revision surgery, and patient-reported symptom relief) of pediatric cold steel tonsillotomy with or without adenoidectomy (TT/TTA).</p><p><strong>Methods: </strong>Patients aged ≤ 18 years who underwent cold steel TT/TTA for the management of upper airway obstruction in Region Jönköping County, Sweden, between October 1, 2013, and September 31, 2023, were included in this single center, retrospective, cohort study. Data regarding postoperative bleeding and revision surgery were extracted from electronic medical records. Patient-reported outcomes were obtained from the Swedish Quality Register of Tonsil Surgery.</p><p><strong>Results: </strong>Among the 1810 cold steel TT/TTA procedures included in the analysis, 36 (2.0%) bleeding events were identified, comprising 12 (0.7%) and 24 (1.3%) cases involving tonsils and adenoid beds, respectively. Four (0.2%) and seven (0.4%) patients with tonsil and adenoid bleeding, respectively, required surgical intervention. No significant risk factors for postoperative bleeding were identified. The rate of revision surgery owing to regrowth of tonsil tissue or recurrent infections was 5.1%. Younger age at the time of the first surgery was a significant risk factor for revision surgery (p < 0.001). Complete (64.9%) or almost complete (29.5%) resolution of symptoms was reported in 94.4% (n = 868) of the patients 6 months postoperatively.</p><p><strong>Conclusion: </strong>Cold steel TT/TTA is a safe and efficient surgical procedure for pediatric patients with upper airway obstruction owing to tonsil and adenoid hypertrophy.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Postoperative Bleeding, Revision Surgery, and Outcome of Cold Steel Tonsillotomy in Children With Upper Airway Obstruction.\",\"authors\":\"Hanna Gerhardsson, Joacim Stalfors, Ola Sunnergren\",\"doi\":\"10.1002/lary.32174\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To evaluate the safety and clinical outcomes (bleeding rate, requirement for revision surgery, and patient-reported symptom relief) of pediatric cold steel tonsillotomy with or without adenoidectomy (TT/TTA).</p><p><strong>Methods: </strong>Patients aged ≤ 18 years who underwent cold steel TT/TTA for the management of upper airway obstruction in Region Jönköping County, Sweden, between October 1, 2013, and September 31, 2023, were included in this single center, retrospective, cohort study. Data regarding postoperative bleeding and revision surgery were extracted from electronic medical records. Patient-reported outcomes were obtained from the Swedish Quality Register of Tonsil Surgery.</p><p><strong>Results: </strong>Among the 1810 cold steel TT/TTA procedures included in the analysis, 36 (2.0%) bleeding events were identified, comprising 12 (0.7%) and 24 (1.3%) cases involving tonsils and adenoid beds, respectively. Four (0.2%) and seven (0.4%) patients with tonsil and adenoid bleeding, respectively, required surgical intervention. No significant risk factors for postoperative bleeding were identified. The rate of revision surgery owing to regrowth of tonsil tissue or recurrent infections was 5.1%. Younger age at the time of the first surgery was a significant risk factor for revision surgery (p < 0.001). Complete (64.9%) or almost complete (29.5%) resolution of symptoms was reported in 94.4% (n = 868) of the patients 6 months postoperatively.</p><p><strong>Conclusion: </strong>Cold steel TT/TTA is a safe and efficient surgical procedure for pediatric patients with upper airway obstruction owing to tonsil and adenoid hypertrophy.</p><p><strong>Level of evidence: 4: </strong></p>\",\"PeriodicalId\":49921,\"journal\":{\"name\":\"Laryngoscope\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-04-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Laryngoscope\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/lary.32174\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"MEDICINE, RESEARCH & EXPERIMENTAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Laryngoscope","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/lary.32174","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
Postoperative Bleeding, Revision Surgery, and Outcome of Cold Steel Tonsillotomy in Children With Upper Airway Obstruction.
Objective: To evaluate the safety and clinical outcomes (bleeding rate, requirement for revision surgery, and patient-reported symptom relief) of pediatric cold steel tonsillotomy with or without adenoidectomy (TT/TTA).
Methods: Patients aged ≤ 18 years who underwent cold steel TT/TTA for the management of upper airway obstruction in Region Jönköping County, Sweden, between October 1, 2013, and September 31, 2023, were included in this single center, retrospective, cohort study. Data regarding postoperative bleeding and revision surgery were extracted from electronic medical records. Patient-reported outcomes were obtained from the Swedish Quality Register of Tonsil Surgery.
Results: Among the 1810 cold steel TT/TTA procedures included in the analysis, 36 (2.0%) bleeding events were identified, comprising 12 (0.7%) and 24 (1.3%) cases involving tonsils and adenoid beds, respectively. Four (0.2%) and seven (0.4%) patients with tonsil and adenoid bleeding, respectively, required surgical intervention. No significant risk factors for postoperative bleeding were identified. The rate of revision surgery owing to regrowth of tonsil tissue or recurrent infections was 5.1%. Younger age at the time of the first surgery was a significant risk factor for revision surgery (p < 0.001). Complete (64.9%) or almost complete (29.5%) resolution of symptoms was reported in 94.4% (n = 868) of the patients 6 months postoperatively.
Conclusion: Cold steel TT/TTA is a safe and efficient surgical procedure for pediatric patients with upper airway obstruction owing to tonsil and adenoid hypertrophy.
期刊介绍：
The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope.
• Broncho-esophagology
• Communicative disorders
• Head and neck surgery
• Plastic and reconstructive facial surgery
• Oncology
• Speech and hearing defects
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