Tonsilloplasty in children with obstructive symptoms.

Objective: Obstructive symptoms, caused by tonsillar hypertrophy, have been attracting increasing interest, and tonsillectomy is often performed as a result of this indication. This study was undertaken to investigate the effect of the different surgical techniques, tonsilloplasty and tonsillectomy, on clinical symptoms in children with obstructive symptoms owing to tonsillar hypertrophy.

Methods: Thirty children, 3 to 12 years old, were included; 15 of them underwent tonsilloplasty and 15 tonsillectomy. Tonsilloplasty was performed with a knife or scissors, and the trauma was closed with two or three sutures. The tonsillar capsule and about 15 to 20% of tonsillar tissue remain as a barrier to prevent exposure of the pharyngeal muscles. All children were operated on under the same anesthesia and followed the same postoperative scheme for analgesia.

Results: All of the children were cured of their breathing obstruction. In the tonsilloplasty group, the tonsillar remnants healed completely within 1 week. The postoperative pain recorded was significantly less than in the tonsillectomy group. No major side effects occurred. The mean time used for the surgery was the same, and no postoperative bleeding was seen in both groups. The intraoperative bleeding observed was small in both groups, although significantly smaller for the tonsilloplasty group.

Conclusions: Tonsilloplasty is a less traumatic and much less painful surgical method, and children recover more quickly. The results with respect to breathing obstruction are almost the same for both methods at the 1-year follow-up. It seems to be the most suitable method for children with tonsillar hypertrophy and obstructive symptoms.