Tonsillectomy for Obstructive Sleep-Disordered Breathing or Recurrent Throat Infection in Children

Project Summary Title and Description

Title
Tonsillectomy for Obstructive Sleep-Disordered Breathing or Recurrent Throat Infection in Children
Description
We anticipate this report will be of primary value to organizations that develop guidelines for tonsillectomy, to clinicians who provide care for children with indications for tonsillectomy, and for families making treatment decisions. Children who are candidates for tonsillectomy may be treated by clinicians including pediatricians, otolaryngologists, sleep medicine physicians, allergists, family physicians, anesthesiologists, infectious disease physicians, nurse practitioners, physician assistants, and nurses. This report supplies practitioners and researchers up-to-date information about the current state of evidence and assesses the quality of studies that aim to determine the outcomes and safety of tonsillectomy.
Attribution
N/A
Authors of Report
N/A
Methodology description
Working from the nomination, we drafted the initial key questions (KQ) and analytic frameworks and refined them with input from key informants representing the fields of pediatrics, otolaryngology, anesthesiology, and sleep medicine. We also spoke with a caregiver representative. We also developed population, interventions, outcomes, timing, and settings (PICOTS) criteria for intervention KQ. We identified technical experts on the topic to provide assistance during the project. The Technical Expert Panel (TEP), representing the fields of pediatrics, otolaryngology, anesthesiology, infectious disease, and sleep medicine, contributed to the AHRQ’s broader goals of (1) creating and maintaining science partnerships as well as public-private partnerships and (2) meeting the needs of an array of potential users of its products. Thus, the TEP was both an additional resource and a sounding board during the project. The TEP included eight members serving as technical or clinical experts. To ensure comprehensive retrieval of relevant studies of therapies for children undergoing tonsillectomy, we used three key databases: the MEDLINE® medical literature database via the PubMed® interface; EMBASE (Excerpta Medica Database), an international biomedical and pharmacological literature database via the Ovid® interface; and the Cochrane Library. Search strategies for KQs applied a combination of controlled vocabulary (Medical Subject Headings [MeSH] and Emtree headings) to focus specifically on tonsillectomy and harms of interventions. Team data extractors shared the task of initially entering information into the evidence tables. A second team member also reviewed the articles and edited all initial entries for accuracy, completeness, and consistency. A senior reviewer reconciled disagreements concerning the information reported.
PROSPERO
N/A
DOI
10.26300/tgw5-p593
Notes
Data entered retrospectively into SRDR. Outcome data and demographics data files have been uploaded.
Funding Source
N/A

Key Questions

1. In children with obstructive sleep-disordered breathing (OSDB), what is the comparative effectiveness of tonsillectomy compared with continuous positive airway pressure (CPAP), or watchful waiting with supportive care (including pharmacologic treatment) to improve sleep outcomes, cognitive or behavioral outcomes, and health outcomes? KQ1a. In children with OSDB and neuromuscular or craniofacial abnormalities, what is the comparative effectiveness of tonsillectomy compared with CPAP, or watchful waiting with supportive care (including pharmacologic treatment) to improve sleep outcomes, cognitive or behavioral outcomes, and health outcomes? KQ1b. In children with OSDB under age 3 years, what is the comparative effectiveness of tonsillectomy compared with watchful waiting with supportive care (including pharmacologic treatment) to improve sleep outcomes, cognitive or behavioral outcomes, and health outcomes? KQ1c. In children with OSDB and Down syndrome, what is the comparative effectiveness of tonsillectomy compared with CPAP, or watchful waiting with supportive care (including pharmacologic treatment) to improve sleep outcomes, cognitive or behavioral outcomes, and health outcomes? KQ1d. In children with OSDB who are overweight or obese, what is the comparative effectiveness of tonsillectomy compared with CPAP, weight loss, or watchful waiting with supportive care (including pharmacologic treatment) to improve sleep outcomes, cognitive or behavioral outcomes, and health outcomes? KQ2. Among children with recurrent throat infections, what is the comparative effectiveness, including harms, of tonsillectomy compared with watchful waiting with supportive care (including pharmacologic--antibiotic or non-antibiotic--treatments) on the number and severity of throat infections, quality of life, and health care utilization? KQ3. Do benefits and harms differ between partial tonsillectomy and total tonsillectomy? KQ4. Do benefits and harms differ by surgical technique (e.g., cautery, coblation)? KQ5. What are the benefits and harms of adjunctive perioperative (i.e., preoperative, intraoperative, or in post-anesthesia care) pharmacologic agents intended to improve outcomes? KQ6. What are the benefits and harms of postoperative (i.e., after discharge from post-anesthesia care and up to 10 days post-surgery) pharmacologic agents intended to reduce pain-related outcomes?

Associated Extraction Forms

Associated Studies (each link opens a new tab)

TitleAuthorsYear
Post-tonsillectomy hemorrhage: An analysis of incidence and risk factors in Kuwait2015
Microdebrider tonsillotomy in children with obstructive tonsillar hypertrophy 2013
To compare the efficacy of ketorolac and pethidine for postoperative pain relief in first 24 hours after tonsillectomy2012
Post-tonsillectomy pain and bleeding in children: A comparison of traditional tonsillectomy with electrodissection tonsillectomy2012
Preincisional peritonsillar vs. intravenous lornoxicam for posttonsillectomy analgesia: A clinical and platelet aggregometry comparative study2012
The use of Bipolar electrocautery tonsillectomy in patients with pediatric respiratory tract obstruction2012
Coblation versus traditional tonsillectomy: A double blind randomized controlled trial2012
Intrapersonal randomized controlled trial comparing bipolar scissors and conventional cold tonsillectomy2011
Reducing post operative bleeding after tonsillectomies in children by modifying the monopolar diathermy technique: A study of 1500 patients2010
The effect of dexamethasone on morbidity related to vomiting, pain and oral intake in children after tonsillectomy2009
Single dose IV dexamethasone with preemptive transdermal diclofenac patch reduces opioid requirement and postoperative morbidity following tonsillectomy2009
Steroids for reducing post-tonsillectomy morbidity2008
A comparison of rectal diclofenac with intravenous pethidine for pain relief following tonsillectomy and adenoidectomy in children2005
The effect of preoperative intravenous dexamethasone in pediatric adenotonsillectomy2000
The preemptive analgesic effect of ketorolac and propacetamol for adenotonsillectomy in pediatric patients2009
Microdebrider partial tonsillectomy vs. electrosurgical tonsillectomy: a randomized, double-blind, paired-control study of postoperative pain
Harmonic scalpel tonsillectomy versus coblation tonsillectomy2012
Coblation Tonsillectomy Versus Blunt Dissectomy Tonsillectomy in Children2013
Diode laser versus blunt dissection tonsillectomy2012
Role of prophylactic antibiotic in reducing post-tonsillectomy morbidity2002
Morphine or Ibuprofen for post-tonsillectomy analgesia: a randomized trial
Comparison of analgesic effect between gabapentin and diclofenac on post-operative pain in patients undergoing tonsillectomy2012
Analgesia; for children undergoing tonsillectomy (a clinical trial of three analgesic regimens in a peripheral hospital)2006
Microdebrider intracapsular tonsillotomy versus conventional extracapsular tonsillectomy2014
Acetaminophen versus diclofenac sodium after pediatric tonsillectomy2005
Ultrasonic Curved Shears in Tonsillectomy: Comparative Clinical Trial Between this New Surgical Technique and the Technique with the Cold Blade Surgical Knife
Bupivacaine infiltration versus diclofenac suppository for post-tonsillectomy pain relief in paediatric patients2012
A single blind controlled study comparing bipolar elecrocautery tonsillectomy to cold dissection method in pediatric age groups2014
Comparison of Efficacy of Dexamethasone and Orogastric Suction in Reducing Post Tonsillectomy Vomiting in Children2013
Hospital and Surgeon Adherence to Pediatric Tonsillectomy Guidelines Regarding Perioperative Dexamethasone and Antibiotic Administration.2015
Celecoxib pharmacogenetics and pediatric adenotonsillectomy: a double-blinded randomized controlled study.2015
Tonsillectomy among children with low baseline acute throat infection consultation rates in UK general practices: a cohort study.2015
Comparison of local and intravenous dexamethasone for postoperative pain and recovery after tonsillectomy.2015
Does primary indication for tonsillectomy influence post-tonsillectomy haemorrhage rates in children?
A population-based study of acute care revisits following tonsillectomy.2015
The association between pediatric general emergency department visits and post operative adenotonsillectomy hospital return.
Safety and efficacy of pre-incisional peritonsillar lornoxicam in paediatric post-tonsillectomy pain: a prospective double-blind, placebo-controlled, split-body clinical study.2015
Effects of oral prednisolone on recovery after tonsillectomy.2015
Impact of systemic steroids on posttonsillectomy bleeding: analysis of 61 430 patients using a national inpatient database in Japan.2014
Evaluation of gabapentin and dexamethasone alone or in combination for pain control after adenotonsillectomy in children.2014
Molecular resonance tonsillectomy in children: comparative study over standard techniques in an 11-year study.2014
Comparison of treatment modalities in syndromic children with obstructive sleep apnea--a randomized cohort study.
Pre-emptive peritonsillar dexamethasone vs. levobupivacaine infiltration for relief of post-adenotonsillectomy pain in children: a controlled clinical study.2014
A Randomized Controlled Trial on Analgesic Effects of Intravenous Acetaminophen versus Dexamethasone after Pediatric Tonsillectomy.2013
A multicenter, randomized, double-blind placebo-controlled, single dose trial of the safety and efficacy of intravenous ibuprofen for treatment of pain in pediatric patients undergoing tonsillectomy.2014
Post-tonsillectomy morbidities: randomised, prospective controlled clinical trial of cold dissection versus thermal welding tonsillectomy.2014
Long-term changes in neurocognition and behavior following treatment of sleep disordered breathing in school-aged children.2014
Adenotonsillectomy vs observation for management of mild obstructive sleep apnea in children.2014
Randomized comparison between the combination of acetaminophen and ibuprofen and each constituent alone for analgesia following tonsillectomy in children.2013
Ropivacaine plus dexamethasone infiltration reduces postoperative pain after tonsillectomy and adenoidectomy.2013
Preoperative peritonsillar infiltration of dexamethasone and levobupivacaine reduces pediatric post-tonsillectomy pain: a double-blind prospective randomized clinical trial.2013
Pre-emptive triple analgesia protocol for tonsillectomy pain control in children: double-blind, randomised, controlled, clinical trial.2013
Radiofrequency tonsillotomy versus bipolar scissors tonsillectomy for the treatment of OSAS in children: a prospective study.2013
Adenotonsillectomy for sleep-disordered breathing in a predominantly obese pediatric population.2013
Tonsilloplasty versus tonsillectomy in children with sleep-disordered breathing: short- and long-term outcomes.2013
Perioperative dexamethasone administration and risk of bleeding following tonsillectomy in children: a randomized controlled trial.2012
Antibiotics do not reduce post-tonsillectomy morbidity in children.2013
Guillotine versus dissection tonsillectomy: randomised, controlled trial.2012
Effect of dexamethasone on nausea, vomiting, and pain in paediatric tonsillectomy.2012
Intraindividual comparison of 1,470 nm diode laser versus carbon dioxide laser for tonsillotomy: a prospective, randomized, double blind, controlled feasibility trial.2012
Coblation tonsillectomy in children: incidence of bleeding.
A comparison between dexamethasone and methylprednisolone for vomiting prophylaxis after tonsillectomy in inpatient children: a randomized trial.2012
Risk of post-tonsillectomy hemorrhage by clinical diagnosis.2012
The effect of paracetamol, metamizole sodium and ibuprofen on postoperative hemorrhage following pediatric tonsillectomy.2012
The effect of a postoperative course of oral prednisone on postoperative morbidity following childhood tonsillectomy.2012
Thermal welding versus cold knife tonsillectomy: a prospective randomized study.2012
Assessing intravenous ketamine and intravenous dexamethasone separately and in combination for early oral intake, vomiting and postoperative pain relief in children following tonsillectomy.2012
Peri-operative complications after adenotonsillectomy in a UK pediatric tertiary referral centre.
Randomised comparative study of adenotonsillectomy by conventional and coblation method for children with obstructive sleep apnoea.2012
Comparison of post-tonsillectomy pain with two different types of bipolar forceps: low temperature quantum molecular resonance device versus high temperature conventional electrocautery.2012
Harmonic scalpel versus bipolar tonsillectomy: a double-blind clinical trial.
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.2011
Comparison of three techniques in pediatric tonsillectomy.2012
Post-operative pain following coblation or monopolar electrocautery tonsillectomy in children: a prospective, single-blinded, randomised comparison.2011
Comparison of radiofrequency ablation, laser and coblator techniques in reduction of tonsil size.2011
Bipolar scissors tonsillectomy: what are the advantages?2011
Comparison of postoperative pain in pediatric patients undergoing coblation tonsillectomy versus cautery tonsillectomy.2011
Outpatient cold knife tonsillectomy in toddlers with sleep disordered breathing.2010
Tonsillectomy in children: a five-factor analysis among three techniques--reporting upon clinical results, anesthesia time, surgery time, bleeding, and cost.2010
Cost and outcomes after cold and mixed adenotonsillectomy in children.2010
Adenotonsillectomy improves slow-wave activity in children with obstructive sleep apnoea.2011
A randomized controlled trial for perioperative morbidity in microdebrider versus cold instrument dissection tonsillectomy.2010
Ambulatory pediatric otolaryngologic procedures in the United States: characteristics and perioperative safety.2010
The effects of topical viscous lignocaine 2% versus per-rectal diclofenac in early post-tonsillectomy pain in children.2010
Difference of delayed post-tonsillectomy bleeding between children and adults.2010
Determination of optimum dosage of intraoperative single dose dexamethasone in pediatric tonsillectomy and adenotonsillectomy.2009
Molecular resonance vs. coblation tonsillectomy in children.2009
A randomised controlled trial to compare postoperative pain in children undergoing tonsillectomy using cold steel dissection with bipolar haemostasis versus coblation technique.2009
Surgical management of obstructive sleep apnea in infants and young toddlers.2009
Post-tonsillectomy late haemorrhage: is it a preferably night-time event?2009
Tropisetron plus subhypnotic propofol infusion is more effective than tropisetron alone for the prevention of vomiting in children after tonsillectomy.2009
Comparison of three common tonsillectomy techniques: a prospective randomized, double-blinded clinical study.2009
Dexamethasone and risk of nausea and vomiting and postoperative bleeding after tonsillectomy in children: a randomized trial.2008
Bipolar diathermy versus cold dissection in paediatric tonsillectomy.2009
Comparison between tonsillectomy with thermal welding and the conventional 'cold' tonsillectomy technique.2008
Surgical revision of hemorrhage in 8388 patients after cold-steel adenotonsillectomies.2008
Paediatric tonsillectomy: radiofrequency-based plasma dissection compared to cold dissection with sutures.2008
Study of weight and height development in children after adenotonsillectomy.-- Not Found --
A comparison of postoperative pain and complications in tonsillectomy using BiClamp forceps and electrocautery tonsillectomy.2008
Multiparametric comparison of cold knife tonsillectomy, radiofrequency excision and thermal welding tonsillectomy in children.2008
Benchmarking surgery: secondary post-tonsillectomy hemorrhage 1999-2005.2009
Blunt dissection versus electronic molecular resonance bipolar dissection for tonsillectomy: operative time and intraoperative and postoperative bleeding and pain.
Partial tonsillectomy with scalpel in children with obstructive tonsillar hypertrophy.2008
Tonsillectomy versus tonsillotomy performed with scissors in children with tonsillar hypertrophy.2008
Intracapsular versus subcapsular coblation tonsillectomy.2008
Effectiveness of postoperative follow-up telephone interviews for patients who underwent adenotonsillectomy: a retrospective study.
Tonsilloplasty in children with obstructive symptoms.2007
Monopolar electrodissection versus cold dissection tonsillectomy among children.2007
Microdebrider-assisted partial tonsillectomy: short- and long-term outcomes.2008
Randomized, double-blind study comparing the efficacy of moderate-dose metoclopramide and ondansetron for the prophylactic control of postoperative vomiting in children after tonsillectomy.2007
A pilot randomized controlled trial of coblation tonsillectomy versus dissection tonsillectomy with bipolar diathermy haemostasis.2007
Subtotal bipolar tonsillectomy does not decrease postoperative pain compared to total monopolar tonsillectomy.2007
Pilot comparison between potassium titanyl phosphate laser and bipolar radiofrequency in paediatric tonsillectomy.2008
There is no dose-escalation response to dexamethasone (0.0625-1.0 mg/kg) in pediatric tonsillectomy or adenotonsillectomy patients for preventing vomiting, reducing pain, shortening time to first liquid intake, or the incidence of voice change.2007
Cold dissection versus coblation-assisted adenotonsillectomy in children.2007
Efficacy of tonsillectomy in treatment of recurrent group A beta-hemolytic streptococcal pharyngitis.2006
Complications of adenotonsillectomy revisited in a large pediatric case series.2006
Prolonged hospitalization following tonsillectomy in healthy children.2006
Ketoprofen and tramadol for analgesia during early recovery after tonsillectomy in children.2006
Temperature-controlled radiofrequency treatment of tonsillar hypertrophy for reduction of upper airway obstruction in pediatric patients.2006
A prospective randomised single blinded study comparing harmonic scalpel tonsillectomy with bipolar tonsillectomy.2006
Postoperative recovery after microdebrider intracapsular or monopolar electrocautery tonsillectomy: a prospective, randomized, single-blinded study.2006
Post-tonsillectomy morbidity and quality of life in pediatric patients with obstructive tonsils and adenoid: microdebrider vs electrocautery.
Comparison of posttonsillectomy pain using the ultrasonic scalpel, coblator, and electrocautery.2006
Bipolar radiofrequency dissection tonsillectomy: a prospective randomized trial.2005
The effectiveness of unilateral tonsillectomy in chronic adenotonsillar hypertrophy.2005
Harmonic scalpel tonsillectomy: a prospective study.2006
A prospective randomized single-blind trial comparing ultrasonic scalpel tonsillectomy with tonsillectomy by blunt dissection in a pediatric age group.2005
Instrumentation and patient characteristics that influence postoperative haemorrhage rates following tonsil and adenoid surgery.2005
Bipolar electrodissection tonsillectomy in children.2005
The effect of preoperative dexamethasone on early oral intake, vomiting and pain after tonsillectomy.2006
Pre-emptive effects of ibuprofen syrup and lidocaine infiltration on post-operative analgesia in children undergoing adenotonsillectomy.-- Not Found --
Randomized controlled trial of Coblation versus electrocautery tonsillectomy.2005
Harmonic scalpel versus conventional tonsillectomy: a double-blind clinical trial.2004
Use of dexamethasone to reduce postoperative vomiting and pain after pediatric tonsillectomy procedures.2004
Randomized, controlled, multisite study of intracapsular tonsillectomy using low-temperature plasma excision.2004
The surgical arrest of post-tonsillectomy haemorrhage: hospital episode statistics.2004
Contact diode laser tonsillectomy in children.2004
Day stay pediatric tonsillectomy--a safe procedure.2004
Safety of outpatient tonsillectomy in children: a review of 6 years in a tertiary hospital experience.2004
Perioperative steroids in tonsillectomy using electrocautery and sharp dissection techniques.2004
Minimum effective dose of dexamethasone after tonsillectomy.2004
Clinical assessment of pediatric obstructive sleep apnea.
Comparison of benzydamine hydrochloride and Salvia officinalis as an adjuvant local treatment to systemic nonsteroidal anti-inflammatory drug in controlling pain after tonsillectomy, adenoidectomy, or both: an open-label, single-blind, randomized clinical trial.2004
Pediatric total tonsillectomy using coblation compared to conventional electrosurgery: a prospective, controlled single-blind study.2004
Intraoperative ketorolac is an effective substitute for fentanyl in children undergoing outpatient adenotonsillectomy.2004
Adenotonsillectomy in children with obstructive sleep apnea syndrome reduces health care utilization.2004
Results of a prospective, randomized, double-blind, placebo-controlled, dose-ranging trial to determine the effective dose of ramosetron for the prevention of vomiting after tonsillectomy in children.2003
Dexamethasone reduces postoperative vomiting and pain after pediatric tonsillectomy.2003
Tonsillectomy: cold dissection versus bipolar electrodissection.2003
Harmonic scalpel tonsillectomy in children: a randomized prospective study.2003
Preemptive diclofenac reduces morphine use after remifentanil-based anaesthesia for tonsillectomy.2002
Ondansetron and dolasetron provide equivalent postoperative vomiting control after ambulatory tonsillectomy in dexamethasone-pretreated children.2002
Nutritional evaluation in surgical treatment of children with hypertrophic tonsils and or adenoids.2002
A prospective double-blind randomized controlled trial comparing the suitability of KTP laser tonsillectomy with conventional dissection tonsillectomy for day case surgery.2002
Tonsillectomy by means of plasma-mediated ablation: prospective, randomized, blinded comparison with monopolar electrosurgery.2002
Bipolar scissors versus cold dissection for pediatric tonsillectomy--a prospective, randomized pilot study.2002
Does dexamethasone with preemptive analgesia improve pediatric tonsillectomy pain?2002
Tonsillectomy. A comparative study of dissection/snare vs suction-cautery.2001
Comparison of pre- and postoperative administration of ketoprofen for analgesia after tonsillectomy in children.2002
Tonsillotomy in children with tonsillar hypertrophy.2001
Harmonic scalpel tonsillectomy versus electrocautery tonsillectomy: a comparative pilot study.2001
Paediatric coblation tonsillectomy.2001
Posttonsillectomy hemorrhage: what is it and what should be recorded?2001
Pharmacokinetics of oral diclofenac and acetaminophen in children after surgery.2001
Comparison of granisetron, droperidol, and metoclopramide for prevention of postoperative vomiting in children with a history of motion sickness undergoing tonsillectomy.2001
Prevention of vomiting after tonsillectomy in children: granisetron versus ramosetron.2001
Postoperative tonsillectomy pain in pediatric patients: electrocautery (hot) vs cold dissection and snare tonsillectomy--a randomized trial.2000
Tropisetron plus dexamethasone is more effective than tropisetron alone for the prevention of postoperative nausea and vomiting in children undergoing tonsillectomy.2000
Tropisetron reduces postoperative vomiting in children undergoing tonsillectomy.2000
Examination of acetaminophen for outpatient management of postoperative pain in children.1998
Coagulation profile as a predictor for post-tonsillectomy and adenoidectomy (T + A) hemorrhage.1994
Clinical audit: is day-case adenotonsillectomy safe?-- Not Found --
Tonsillectomy, adenoidectomy and adenotonsillectomy: are they safe day case procedures?1992
Complications of outpatient tonsillectomy and adenoidectomy: a review of 3,340 cases.1990
Post-tonsillectomy haemorrhage and analgesics. A comparative study of acetylsalicylic acid and paracetamol.1988
Post-tonsillectomy and adenoidectomy hemorrhage.1988
Postoperative risks of pediatric tonsilloadenoidectomy.1987
Complications of tonsillectomy and adenoidectomy in 9409 children observed overnight.1986
Childhood tonsillectomy and discharge after 24 hours.1986
Post-operative haemorrhage in tonsillectomy and adenoidectomy in children.1984
Guillotine tonsillectomy without anesthesia.1984
Post tonsillectomy haemorrhage.1982
A randomised controlled trial of coblation, diode laser and cold dissection in paediatric tonsillectomy.2015
Postoperative complications in obese children undergoing adenotonsillectomy.
Causes, costs, and risk factors for unplanned return visits after adenotonsillectomy in children.2015
The starship children's hospital tonsillectomy: A further 10 years of experience.2016
Risk factors for pediatric post-tonsillectomy hemorrhage.
Increased immediate postoperative hemorrhage in older and obese children after outpatient tonsillectomy.2016
Pediatric Posttonsillectomy Hemorrhage: Demographic and Geographic Variation in Health Care Costs in the United States.2016
Polysomnography results in pediatric patients with mild obstructive sleep apnea: Adenotonsillectomy vs. watchful waiting.2016
Significant improvements in quality of life following paediatric tonsillectomy: a prospective cohort study.2016
Risk of reoperation after tonsillotomy versus tonsillectomy: a population-based cohort study.2016
Inpatient Pediatric Tonsillectomy: Does Hospital Type Affect Cost and Outcomes of Care?2016
Bipolar Quantum Molecular Resonance versus Blunt Dissection tonsillectomy.2015
Post-tonsilelectomy morbidity - do steroids help.2006
Tonsillectomy and adenotomy as a one day procedure?1999
Randomized study comparing inflammatory response after tonsillectomy versus tonsillotomy.2016
The Use of Ibuprofen in Posttonsillectomy Analgesia and Its Effect on Posttonsillectomy Hemorrhage Rate.2016
Effectiveness of adenotonsillectomy in children with mild symptoms of throat infections or adenotonsillar hypertrophy: open, randomised controlled trial.2004
Adenotonsillectomy or watchful waiting in patients with mild to moderate symptoms of throat infections or adenotonsillar hypertrophy: a randomized comparison of costs and effects.2007
Alterations of the oropharyngeal microbial flora after adenotonsillectomy in children: a randomized controlled trial.2007
Postoperative hemorrhage following adenoidectomy.2012
Risk factors for postoperative hemorrhage following tonsillectomy.2011
1-year follow-up after radiofrequency tonsillotomy and laser tonsillotomy in children: a prospective, double-blind, clinical study.2012
Double-blind, randomised, controlled study of post-operative pain in children undergoing radiofrequency tonsillotomy versus laser tonsillotomy.2010
Is the systemic inflammatory reaction to surgery responsible for post-operative pain after tonsillectomy, and is it "technique-related"?2011
Postoperative morbidity and histopathologic characteristics of tonsillar tissue following coblation tonsillectomy in children: a prospective randomized single-blind study.2009
The Effect of Adenotonsillectomy for Childhood Sleep Apnea on Cardiometabolic Measures.2015
A randomized trial of adenotonsillectomy for childhood sleep apnea.2013
Predictors of obstructive sleep apnea severity in adenotonsillectomy candidates.
Prognosis for Spontaneous Resolution of OSA in Children.2015
Quality of life and obstructive sleep apnea symptoms after pediatric adenotonsillectomy.2015
Growth after adenotonsillectomy for obstructive sleep apnea: an RCT.
Complications of adenotonsillectomy for obstructive sleep apnea in school-aged children.2015
Utility of symptoms to predict treatment outcomes in obstructive sleep apnea syndrome.2015
End-Tidal Carbon Dioxide Measurement during Pediatric Polysomnography: Signal Quality, Association with Apnea Severity, and Prediction of Neurobehavioral Outcomes.2015
North of England and Scotland Study of Tonsillectomy and Adeno-tonsillectomy in Children(NESSTAC): a pragmatic randomised controlled trial with a parallel non-randomised preference study.2010
Tonsillectomy: a cost-effective option for childhood sore throat? Further analysis of a randomized controlled trial.2012
Childhood tonsillectomy: who is referred and what treatment choices are made? Baseline findings from the North of England and Scotland Study of Tonsillectomy and Adenotonsillectomy in Children (NESSTAC).2010
Key messages from the National Prospective Tonsillectomy Audit.2007
Diathermy power settings as a risk factor for hemorrhage after tonsillectomy.2009
Tonsillectomy technique as a risk factor for postoperative haemorrhage.
Pediatric tonsillotomy with radiofrequency technique: long-term follow-up.2006
Pre-surgical child behavior ratings and pain management after two different techniques of tonsil surgery.2006
Pediatric tonsillotomy with the radiofrequency technique: less morbidity and pain.2004
Incidence of post-tonsillectomy hemorrhage in children and adults: a study of 4,848 patients.2002
Hemorrhage following pediatric tonsillectomy before puberty.2001
Post-tonsillectomy and -adenoidectomy hemorrhage in nonselected patients.2003
Tonsillotomy versus tonsillectomy on young children: 2 year post surgery follow-up.2014
Child behavior and quality of life before and after tonsillotomy versus tonsillectomy.2009
Tonsillectomy and adenotonsillectomy for recurrent throat infection in moderately affected children.2002
Revisit rates and diagnoses following pediatric tonsillectomy in a large multistate population.2015
Associations between socioeconomic status and race with complications after tonsillectomy in children.2014
Variation in quality of tonsillectomy perioperative care and revisit rates in children's hospitals.2014
Dexamethasone and risk of bleeding in children undergoing tonsillectomy.2014
Efficacy of tonsillectomy for recurrent throat infection in severely affected children. Results of parallel randomized and nonrandomized clinical trials.1984
What lessons can be learned from the Austrian events?2013
Hemorrhage following tonsil surgery: a multicenter prospective study.2011
Paradigm shift in Sweden from tonsillectomy to tonsillotomy for children with upper airway obstructive symptoms due to tonsillar hypertrophy.2013
Radiofrequency tonsillotomy in Sweden 2009-2012.2014
Factors influencing morbidity after paediatric tonsillectomy: a study of 18,712 patients in the National Tonsil Surgery Register in Sweden.2016

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