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Erschienen in: European Archives of Oto-Rhino-Laryngology 8/2012

01.08.2012 | Laryngology

Health-related quality of life after tonsillotomy versus tonsillectomy in young adults: 6 years postsurgery follow-up

verfasst von: Sara Wireklint, Elisabeth Ericsson

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 8/2012

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Abstract

The indication for tonsil surgery is tonsillitis or obstructive symptoms due to tonsillar hypertrophy, associated with morbidity affecting health related quality of life (HRQL). Surgery performed is either tonsillectomy (TE) or partial intra capsular tonsillectomy/tonsillotomy (TT). TT is associated with fewer postoperative complications and rapid recovery, but with risk for regrowth of tonsillar tissue and return of sleep disordered breathing (SDB) or infections. The aim of this study was to investigate the long-term effects of TT and TE in young adults relating to HRQL and well-being as consequence of obstructive symptoms or ENT-infections after 6 years versus effect after 1 year. Young adults with symptoms of tonsillar hyperplasia were randomized to TE (44) or TT (32). Patients were assessed prior to surgery and 1 and 6 years postoperatively. Short Form 36 and the EuroQul Visual Analog Scale evaluated HRQL. Questionnaire was used to explore well-being, obstruction symptoms and infections. Patient BMI was calculated. Six years after surgery, 91 % of young adults (TE39/TT29) reported persisting benefits in well-being, reduced obstructive problems and fewer infections. Some patients in both groups reported a slight increase in snoring compared to 1 year after surgery, but still less than before surgery. Obesity was more frequent among those snoring. Both TT and TE in young adults yielded HRQL improvements and reduction in symptoms defining SDB persisting through 6 years postsurgery. Results indicated that both surgical methods were equally effective. Findings favor choice of TT due to lesser postoperative morbidity.
Literatur
1.
Zurück zum Zitat Koempel JA, Solares CA, Koltai PJ (2006) The evolution of tonsil surgery and rethinking the surgical approach to obstructive sleep-disordered breathing in children. J Laryngol Otol 120(12):993–1000PubMedCrossRef Koempel JA, Solares CA, Koltai PJ (2006) The evolution of tonsil surgery and rethinking the surgical approach to obstructive sleep-disordered breathing in children. J Laryngol Otol 120(12):993–1000PubMedCrossRef
2.
Zurück zum Zitat Stalfors J, Ericsson E, Hemlin C, et al (2012) Tonsil surgery efficiently relieves symptoms: analysis of 54 696 patients in the National Tonsil Surgery Register in Sweden. Acta otolaryngol Stalfors J, Ericsson E, Hemlin C, et al (2012) Tonsil surgery efficiently relieves symptoms: analysis of 54 696 patients in the National Tonsil Surgery Register in Sweden. Acta otolaryngol
3.
Zurück zum Zitat Ericsson E, Hultcrantz E (2007) Tonsil surgery in youths: good results with a less invasive method. Laryngoscope 117(4):654–661PubMedCrossRef Ericsson E, Hultcrantz E (2007) Tonsil surgery in youths: good results with a less invasive method. Laryngoscope 117(4):654–661PubMedCrossRef
4.
Zurück zum Zitat Hessen Soderman AC, Ericsson E, Hemlin C et al (2011) Reduced risk of primary postoperative hemorrhage after tonsil surgery in Sweden: results from the National Tonsil Surgery Register in Sweden covering more than 10 years and 54, 696 operations. Laryngoscope 121(11):2322–2326PubMedCrossRef Hessen Soderman AC, Ericsson E, Hemlin C et al (2011) Reduced risk of primary postoperative hemorrhage after tonsil surgery in Sweden: results from the National Tonsil Surgery Register in Sweden covering more than 10 years and 54, 696 operations. Laryngoscope 121(11):2322–2326PubMedCrossRef
5.
Zurück zum Zitat Reichel O, Mayr D, Winterhoff J, de la Chaux R, Hagedorn H, Berghaus A (2007) Tonsillotomy or tonsillectomy?—a prospective study comparing histological and immunological findings in recurrent tonsillitis and tonsillar hyperplasia. Eur Arch Otorhinolaryngol 264(3):277–284PubMedCrossRef Reichel O, Mayr D, Winterhoff J, de la Chaux R, Hagedorn H, Berghaus A (2007) Tonsillotomy or tonsillectomy?—a prospective study comparing histological and immunological findings in recurrent tonsillitis and tonsillar hyperplasia. Eur Arch Otorhinolaryngol 264(3):277–284PubMedCrossRef
6.
7.
8.
Zurück zum Zitat WHO (1946) Constitution of the World Health Organization, Geneva. Accessed September 2011 WHO (1946) Constitution of the World Health Organization, Geneva. Accessed September 2011
9.
Zurück zum Zitat Bhattacharyya N, Kepnes LJ, Shapiro J (2001) Efficacy and quality-of-life impact of adult tonsillectomy. Arch Otolaryngol Head Neck Surg 127(11):1347–1350PubMed Bhattacharyya N, Kepnes LJ, Shapiro J (2001) Efficacy and quality-of-life impact of adult tonsillectomy. Arch Otolaryngol Head Neck Surg 127(11):1347–1350PubMed
10.
Zurück zum Zitat Witsell DL, Orvidas LJ, Stewart MG et al (2008) Quality of life after tonsillectomy in adults with recurrent or chronic tonsillitis. Otolaryngol Head Neck Surg 138(1 Suppl):S1–S8PubMedCrossRef Witsell DL, Orvidas LJ, Stewart MG et al (2008) Quality of life after tonsillectomy in adults with recurrent or chronic tonsillitis. Otolaryngol Head Neck Surg 138(1 Suppl):S1–S8PubMedCrossRef
11.
Zurück zum Zitat Ericsson E, Graf J, Hultcrantz E (2006) Pediatric tonsillotomy with radiofrequency technique: long-term follow-up. Laryngoscope 116(10):1851–1857PubMedCrossRef Ericsson E, Graf J, Hultcrantz E (2006) Pediatric tonsillotomy with radiofrequency technique: long-term follow-up. Laryngoscope 116(10):1851–1857PubMedCrossRef
12.
Zurück zum Zitat Ericsson E, Ledin T, Hultcrantz E (2007) Long-term improvement of quality of life as a result of tonsillotomy (with radiofrequency technique) and tonsillectomy in youths. Laryngoscope 117(7):1272–1279PubMedCrossRef Ericsson E, Ledin T, Hultcrantz E (2007) Long-term improvement of quality of life as a result of tonsillotomy (with radiofrequency technique) and tonsillectomy in youths. Laryngoscope 117(7):1272–1279PubMedCrossRef
13.
Zurück zum Zitat Sullivan M, Karlsson J, Ware JE Jr (1995) The Swedish SF-36 Health Survey; Evaluation of data quality, scaling assumptions, reliability and construct validity across general populations in Sweden. Soc Sci Med 41(10):1349–1358PubMedCrossRef Sullivan M, Karlsson J, Ware JE Jr (1995) The Swedish SF-36 Health Survey; Evaluation of data quality, scaling assumptions, reliability and construct validity across general populations in Sweden. Soc Sci Med 41(10):1349–1358PubMedCrossRef
15.
Zurück zum Zitat Svensson M, Franklin KA, Theorell-Haglow J, Lindberg E (2008) Daytime sleepiness relates to snoring independent of the apnea-hypopnea index in women from the general population. Chest 134(5):919–924PubMedCrossRef Svensson M, Franklin KA, Theorell-Haglow J, Lindberg E (2008) Daytime sleepiness relates to snoring independent of the apnea-hypopnea index in women from the general population. Chest 134(5):919–924PubMedCrossRef
17.
Zurück zum Zitat Hultcrantz E, Linder A, Markstrom A (2005) Long-term effects of intracapsular partial tonsillectomy (tonsillotomy) compared with full tonsillectomy. Int J Pediatr Otorhinolaryngol 69(4):463–469PubMedCrossRef Hultcrantz E, Linder A, Markstrom A (2005) Long-term effects of intracapsular partial tonsillectomy (tonsillotomy) compared with full tonsillectomy. Int J Pediatr Otorhinolaryngol 69(4):463–469PubMedCrossRef
18.
Zurück zum Zitat Eviatar E, Kessler A, Shlamkovitch N, Vaiman M, Zilber D, Gavriel H (2009) Tonsillectomy vs. partial tonsillectomy for OSAS in children-10 years post-surgery follow-up. Int J Pediatr Otorhinolaryngol Eviatar E, Kessler A, Shlamkovitch N, Vaiman M, Zilber D, Gavriel H (2009) Tonsillectomy vs. partial tonsillectomy for OSAS in children-10 years post-surgery follow-up. Int J Pediatr Otorhinolaryngol
19.
Zurück zum Zitat Carter R 3rd, Watenpaugh DE (2008) Obesity and obstructive sleep apnea: or is it OSA and obesity? Pathophysiology 15(2):71–77PubMedCrossRef Carter R 3rd, Watenpaugh DE (2008) Obesity and obstructive sleep apnea: or is it OSA and obesity? Pathophysiology 15(2):71–77PubMedCrossRef
20.
Zurück zum Zitat Dayyat E, Kheirandish-Gozal L, Gozal D (2007) Childhood obstructive sleep apnea: one or two distinct disease entities? Sleep Med Clin 2(3):433–444PubMedCrossRef Dayyat E, Kheirandish-Gozal L, Gozal D (2007) Childhood obstructive sleep apnea: one or two distinct disease entities? Sleep Med Clin 2(3):433–444PubMedCrossRef
21.
Zurück zum Zitat Lopes C, Esteves AM, Bittencourt LR, Tufik S, Mello MT (2008) Relationship between the quality of life and the severity of obstructive sleep apnea syndrome. Braz J Med Biol Res 41(10):908–913PubMedCrossRef Lopes C, Esteves AM, Bittencourt LR, Tufik S, Mello MT (2008) Relationship between the quality of life and the severity of obstructive sleep apnea syndrome. Braz J Med Biol Res 41(10):908–913PubMedCrossRef
22.
Zurück zum Zitat Tuomilehto HP, Seppa JM, Partinen MM et al (2009) Lifestyle intervention with weight reduction: first-line treatment in mild obstructive sleep apnea. Am J Respir Crit Care Med 179(4):320–327PubMedCrossRef Tuomilehto HP, Seppa JM, Partinen MM et al (2009) Lifestyle intervention with weight reduction: first-line treatment in mild obstructive sleep apnea. Am J Respir Crit Care Med 179(4):320–327PubMedCrossRef
23.
Zurück zum Zitat Brandtzaeg P (2003) Immunology of tonsils and adenoids: everything the ENT surgeon needs to know. Int J Pediatr Otorhinolaryngol 67(Suppl 1):S69–S76PubMedCrossRef Brandtzaeg P (2003) Immunology of tonsils and adenoids: everything the ENT surgeon needs to know. Int J Pediatr Otorhinolaryngol 67(Suppl 1):S69–S76PubMedCrossRef
24.
Zurück zum Zitat Kaygusuz I, Alpay HC, Godekmerdan A et al (2009) Evaluation of long-term impacts of tonsillectomy on immune functions of children: a follow-up study. Int J Pediatr Otorhinolaryngol 73(3):445–449PubMedCrossRef Kaygusuz I, Alpay HC, Godekmerdan A et al (2009) Evaluation of long-term impacts of tonsillectomy on immune functions of children: a follow-up study. Int J Pediatr Otorhinolaryngol 73(3):445–449PubMedCrossRef
25.
Zurück zum Zitat Johansson E, Hultcrantz E (2003) Tonsillectomy–clinical consequences twenty years after surgery? Int J Pediatr Otorhinolaryngol 67(9):981–988PubMedCrossRef Johansson E, Hultcrantz E (2003) Tonsillectomy–clinical consequences twenty years after surgery? Int J Pediatr Otorhinolaryngol 67(9):981–988PubMedCrossRef
26.
Zurück zum Zitat Moyer CA, Sonnad SS, Garetz SL, Helman JI, Chervin RD (2001) Quality of life in obstructive sleep apnea: a systematic review of the literature. Sleep Med 2(6):477–491PubMedCrossRef Moyer CA, Sonnad SS, Garetz SL, Helman JI, Chervin RD (2001) Quality of life in obstructive sleep apnea: a systematic review of the literature. Sleep Med 2(6):477–491PubMedCrossRef
27.
Zurück zum Zitat Koskenkorva T, Koivunen P, Penna T, Teppo H, Alho OP (2009) Factors affecting quality-of-life impact of adult tonsillectomy. J Laryngol Otol 123(9):1010–1014PubMedCrossRef Koskenkorva T, Koivunen P, Penna T, Teppo H, Alho OP (2009) Factors affecting quality-of-life impact of adult tonsillectomy. J Laryngol Otol 123(9):1010–1014PubMedCrossRef
28.
Zurück zum Zitat Akgun D, Seymour FK, Qayyum A, Crystal R, Frosh A (2009) Assessment of clinical improvement and quality of life before and after tonsillectomy. J Laryngol Otol 123(2):199–202PubMedCrossRef Akgun D, Seymour FK, Qayyum A, Crystal R, Frosh A (2009) Assessment of clinical improvement and quality of life before and after tonsillectomy. J Laryngol Otol 123(2):199–202PubMedCrossRef
29.
Zurück zum Zitat Baldassari CM, Mitchell RB, Schubert C, Rudnick EF (2008) Pediatric obstructive sleep apnea and quality of life: a meta-analysis. Otolaryngol Head Neck Surg 138(3):265–273PubMedCrossRef Baldassari CM, Mitchell RB, Schubert C, Rudnick EF (2008) Pediatric obstructive sleep apnea and quality of life: a meta-analysis. Otolaryngol Head Neck Surg 138(3):265–273PubMedCrossRef
30.
Zurück zum Zitat Kozak AT, Daviglus ML, Chan C, Kiefe CI, Jacobs DR, Jr., Liu K (2010) Relationship of body mass index in young adulthood and health-related quality of life two decades later: the coronary artery risk development in young adults study. Int J Obes (Lond) Jun 15 Kozak AT, Daviglus ML, Chan C, Kiefe CI, Jacobs DR, Jr., Liu K (2010) Relationship of body mass index in young adulthood and health-related quality of life two decades later: the coronary artery risk development in young adults study. Int J Obes (Lond) Jun 15
31.
Zurück zum Zitat Mills PJ, Kim JH, Bardwell W, Hong S, Dimsdale JE (2008) Predictors of fatigue in obstructive sleep apnea. Sleep Breath 12(4):397–399PubMedCrossRef Mills PJ, Kim JH, Bardwell W, Hong S, Dimsdale JE (2008) Predictors of fatigue in obstructive sleep apnea. Sleep Breath 12(4):397–399PubMedCrossRef
32.
Zurück zum Zitat Axelsson L, Andersson IH, Eden L, Ejlertsson G (2007) Inequalities of quality of life in unemployed young adults: a population-based questionnaire study. Int J Equity Health 6:1PubMedCrossRef Axelsson L, Andersson IH, Eden L, Ejlertsson G (2007) Inequalities of quality of life in unemployed young adults: a population-based questionnaire study. Int J Equity Health 6:1PubMedCrossRef
Metadaten
Titel
Health-related quality of life after tonsillotomy versus tonsillectomy in young adults: 6 years postsurgery follow-up
verfasst von
Sara Wireklint
Elisabeth Ericsson
Publikationsdatum
01.08.2012
Verlag
Springer-Verlag
Erschienen in
European Archives of Oto-Rhino-Laryngology / Ausgabe 8/2012
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-012-1990-y

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